Craniocerebral trauma is an injury to the skull involving the brain. It is caused by external violence to the skull. The degree of brain injury ranges from a concussion to a brain contusion to a brain bruise. Treatment also depends on the severity of the traumatic brain injury.
Below you will find further information and selected specialists for traumatic brain injury.
Craniocerebral trauma is usually the result of an accident or a fall.
In car accidents, for example, the head often hits the steering wheel or windshield with full force. Riding a bicycle without a helmet is also a major risk. According to statistics, 95 percent of all cyclists involved in fatal accidents were not wearing a helmet. Half of them died as a result of craniocerebral trauma.
Various sports, such as ice hockey and American football, also carry a risk of head and brain injury.
Scientific studies have even found a link between the hard head impacts that occur more frequently in these sports and trauma-related diseases such as
20 percent of all traumatic brain injuries are caused by falls during leisure time, at home or at work.
Violent crimes can also trigger a traumatic brain injury, for example through punches or kicks to the head.
Other causes include epileptic seizures and fainting due to cardiac arrhythmia or alcohol and drug abuse.
A basic distinction can be made between direct and indirect injury. In the case of direct damage, the brain suffers direct damage as a result of external force. If the meninges are also injured, an open craniocerebral trauma occurs. Indirect damage, on the other hand, includes water accumulation in the brain or bleeding that occurs as a result of the violent impact.
The symptoms depend on the severity of the trauma. According to the Glasgow Coma Scale (CGS), traumatic brain injury is divided into a mild, moderate and severe form.
The classification into the three degrees of severity
is commonly used.
Grade I craniocerebral trauma corresponds to a concussion(commotio cerebri). The brain injury is mild, covered and of temporary duration. Patients lose consciousness for a few seconds to a maximum of ten minutes immediately after the accident or fall. Other typical symptoms are
Following a grade I traumatic brain injury, a so-called post-commotion syndrome can develop. This can include symptoms such as
may persist over a period of several weeks.
Contusio cerebri, also known as brain contusion, corresponds to grade II traumatic brain injury. The symptoms are similar to those of the first degree, but the unconsciousness usually lasts longer than ten minutes. The memory lapses are also more extensive and often last for more than a day.
Patients may also suffer from neurological symptoms such as paralysis or problems with speech.
Grade III, compressio cerebri or brain contusion, is the most severe form of traumatic brain injury. Patients are unconscious for more than an hour and the brain is severely injured.
Cerebral edema or bleeding in the brain can lead to a life-threatening increase in pressure in the skull. In the case of open traumatic brain injury, there is also direct contact with the outside world and therefore an increased risk of infection.
Craniocerebral trauma often causes bleeding, which can increase the intracranial pressure © SOPONE | AdobeStock
If the patient is responsive, the doctor will ask them about
If the patient is unconscious, witnesses and/or relatives may be able to help.
The doctor then uses clinical neurological examinations to check
The trauma is then assessed according to the Glasgow Coma Scale.
Depending on the severity, a computer tomography (CT) scan may be required for further diagnosis. This procedure can be used to
in the brain. A computer tomography is associated with a certain amount of radiation. For this reason, a magnetic resonance imaging(MRI ) scan may be performed on children instead.
A mild traumatic brain injury can also be ruled out by a simple blood analysis. For example, an increase in the S-100 protein, a marker for brain damage, occurs within a short time after a TBI.
The therapy differs depending on the severity of the trauma.
A mild traumatic brain injury does not always require hospitalization. The doctor may prescribe painkillers for possible headaches. Physiotherapy as well as cold and heat applications can also alleviate the symptoms.
In the case of moderate or severe trauma, however, emergency medical treatment begins at the scene of the accident. The patient's blood pressure and breathing must be kept stable under all circumstances.
Severe cases require artificial respiration, as a lack of oxygen is one of the most common causes of permanent brain damage. If the trauma has caused space-occupying bleeding, surgical measures may also be considered for treatment. Such bleeding can otherwise cause a massive increase in intracranial pressure.
Complications such as bleeding or comatose states can occur as a result of craniocerebral trauma. Therefore, those affected must be monitored in hospital for a longer period of time.
Mild traumatic brain injuries usually heal without consequences. In the case of severe trauma, however, up to 40 percent of patients die. Between two and 14 percent also remain in a coma, while 10 to 30 percent retain disabilities or limitations.
The earlier the trauma is treated, the better the prognosis.
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