Traumatic Brain Injury & Neurotrauma
Acute mechanical injury to the brain, skull, or intracranial blood vessels requiring expert assessment and monitoring.
What is Traumatic Brain Injury & Neurotrauma?
Traumatic Brain Injury (TBI) occurs when sudden physical force or deceleration causes damage to the cerebral parenchyma, vascular structures, or calvarium. It ranges from mild concussions to severe injuries with skull fractures, acute subdural or epidural hematomas, brain contusions, and elevated intracranial pressure.
Common Symptoms & Signs
- Loss of consciousness ranging from seconds to prolonged coma
- Persistent vomiting, worsening severe headache, or dizziness
- Clear fluid draining from the nose or ears (possible CSF leak)
- Unequal pupil sizes or sluggish pupil response
- Retrograde amnesia (loss of memory surrounding the incident) or disorientation
Causes and Risk Factors
- •Motor vehicle collisions, pedestrian injuries, and motorcycle accidents
- •Falls from heights or domestic falls in vulnerable individuals
- •Workplace and industrial trauma or physical assaults
Diagnostic Procedures & Imaging
When Urgent Medical Evaluation is Required
- •Any head injury accompanied by loss of consciousness
- •Repeated vomiting or worsening drowsiness
- •Blood or clear fluid from ears or nose
- •Seizure following head impact
Treatment Modalities
Non-Surgical & Medical
- •Intensive Neuro-Care Monitoring: Serial neurological assessments, intracranial pressure (ICP) management, and sedation
- •Osmotherapy (Mannitol or hypertonic saline) to control elevated intracranial pressure
- •Seizure prophylaxis and cervical spine immobilization
Surgical Interventions
- •Emergency Craniotomy for Hematoma Evacuation: Immediate relief of life-threatening mass effect from acute epidural or subdural hematomas
- •Decompressive Craniectomy: Removal of a large section of the skull to give a severely swollen brain room to expand without herniation
- •Elevation and Debridement of Depressed Skull Fractures
When is Surgery Considered?
Surgery is performed urgently when an intracranial hematoma exceeds critical volume thresholds, creates significant midline shift, or when intracranial pressure remains refractory to medical management.
What a Consultation Involves
In elective or post-acute cases, consultation focuses on reviewing previous trauma scans, assessing persistent post-concussive symptoms, evaluating skull defects for cranioplasty, or checking for delayed hydrocephalus.
Frequently Asked Questions
When does a head bump require emergency evaluation?
Emergency medical care must be sought immediately if there is any loss of consciousness, persistent vomiting, worsening headache, confusion, clear fluid draining from the nose, or weakness in an arm or leg.
What is a cranioplasty?
When a bone flap is removed during emergency decompressive surgery for severe swelling, a cranioplasty is the later reconstructive surgery to restore the skull contour and protect the brain using the patient's preserved bone or a custom 3D implant.
Surgical Interventions for Traumatic Brain Injury & Neurotrauma
- [1] Vitowanu JM, et al. Cohort Analysis of Acute and Subacute Intracranial Trauma. 2023.
- [2] Carney N, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017.
Discuss This Condition
Have your scans and clinical records evaluated for diagnostic clarity or surgical indication.