Traumatic Brain Injury (TBI)

Traumatic brain injury is damage to the brain from an external force: a fall, road accident, assault or sports impact. It ranges from concussion, where scans are normal, to severe injury with bleeding, swelling and coma.

Emergency care takes place wherever the injury happens. What a specialist centre can add later is assessment and rehabilitation of lasting physical, cognitive and emotional effects, plus planned operations such as skull reconstruction.

Symptome

• Headache, dizziness and nausea
• Poor concentration and memory
• Fatigue and disturbed sleep
• Irritability, low mood or personality change
• Sensitivity to light and noise
• Weakness, spasticity, speech or swallowing problems after severe injury
• Seizures
• Loss of smell

Ursachen und Risikofaktoren

Injury happens in two phases: the primary impact with bruising, shearing of nerve fibres and bleeding, then secondary damage from swelling, low oxygen and raised pressure over the following hours and days. Falls in older adults and young children, and road traffic collisions in young adults, are the main causes. Blood thinners increase the risk of bleeding.

Wie es diagnostiziert wird

• CT head: The emergency test for bleeding and fracture.
• MRI with susceptibility sequences: Shows diffuse axonal injury and small bleeds that CT misses.
• Neuropsychological assessment: Measures attention, memory and executive function to guide return to work.
• Pituitary hormone tests: Hormone deficiency is an under-recognised cause of fatigue after TBI.
• EEG: When seizures are suspected.

Behandlungsmöglichkeiten

• Emergency neurosurgery and intensive care: Removal of clots and control of pressure.
• Multidisciplinary rehabilitation: Physiotherapy, occupational and speech therapy, and neuropsychology, most effective when started early.
• Cranioplasty: Reconstruction of a skull defect after decompressive surgery, usually some months later.
• Shunt surgery: For post-traumatic hydrocephalus.
• Treatment of consequences: Spasticity, epilepsy, headache, mood and sleep problems.
• Graded return to activity: After concussion.

Wenn es dringend ist

After any head injury, get emergency care for worsening headache, repeated vomiting, drowsiness or confusion, a seizure, weakness, unequal pupils, or clear fluid from the nose or ear. This is especially important for anyone on anticoagulants.

Reisen nach Türkiye zur Behandlung

Acute head injury is treated locally and never a reason to fly. Once stable, a 4 to 8 week inpatient rehabilitation block, a cranioplasty or a full reassessment can reasonably be planned abroad. Ask about medical fitness to fly and escort needs after severe injury.

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