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Brain injury includes a complex group of medical and surgical problems that are caused by trauma to the head. Some of these problems result from a direct impact to a particular portion of the skull or brain: a skull fracture occurs when the bone of the skull cracks or breaks, and in a depressed skull fracture pieces of broken skull press into the brain. This can cause bruising of the brain tissue, called contusion. Others problems result from indirect mechanisms -- the stretching and tearing of blood vessels or white matter fibres, the "bouncing" of the brain against the inside of the skull, or the secondary swelling of the brain due to injury-related chemical changes. Shaken baby syndrome is a severe form of head injury that occurs when a baby is shaken forcibly enough to cause extreme contusions. Damage to a major blood vessel within the head can cause a haematoma, or bleeding into or around the brain.
Severity can range from mild concussion to extreme coma or even death. A coma is a deep state of unconsciousness. Symptoms of brain injury may include loss of consciousness, dizziness, drowsiness, vomiting, headache, nausea, confusion or other cognitive problems. In the longer term difficulty with concentration and short-term memory, altered sleep patterns, a change in personality, depression, irritability, and other emotional and behavioural problems may become evident. Some people may have seizures as a result of brain injuries.
Immediate treatment for brain injury may involve surgery to control bleeding in or around the brain, monitoring and controlling of pressure inside the head (intracranial pressure), other methods of ensuring blood flow to the brain, and treating the body for other injuries or infections. Seizures may need long-term anticonvulsant treatment.
The outcome of acquired brain injury depends on the cause of the injury and on the location, severity, and extent of neurological damage, and can range from full recovery to death. Long term consequences may include concentration problems, memory loss, personality and behaviour disorders, and speech and language impairment; these may result in loss of employment, lack of social opportunities, isolation and withdrawal and impaired family relations.
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