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Traumatic Brain Injury
Also called: Acquired brain injury, TBI 
 
 
Traumatic brain injury happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital. The worst injuries can lead to permanent brain damage or death.
Half of all traumaticbrain injuries (TBIs) are due to motor vehicle accidents. Military personnel are also at risk. Symptoms of a TBI may not appear until days or weeks following the injury. Serious traumatic brain injuries need emergency treatment.
Treatment and outcome depend on the injury. TBI can cause a wide range of changes affecting thinking, sensation, language, or emotions. TBI can be associatedwith post-traumatic stress disorder. People with severe injuries usually need rehabilitation.

Brain herniation

A brain herniation is when brain tissue, cerebrospinal fluid, and blood vessels are moved or pressed away from their usual position inside the skull.
Causes
Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most often the result of brainswelling from a head injury, stroke, or brain tumor.
Brain herniation is the most common side effect of tumors in the brain, including:
* Metastatic brain tumor
* Primary brain tumor
Herniation of the brain can also be caused by other factors that lead to increased pressure inside the skull, including:
* Abscess
* Hemorrhage
* Hydrocephalus
* Strokes that cause brainswelling
Brain herniation can occur:
* Between areas inside the skull, such as those separated by a rigid membrane like the tentorium or falx
* Through a natural opening at the base of the skull called the foramen magnum
* Through openings created during brain surgery
Symptoms
* Cardiac arrest (no pulse)
* Coma
* Lethargy
* Loss of all brainstem reflexes (blinking,gagging, pupils reacting to light)
* Loss of consciousness
* Respiratory arrest (no breathing)
Exams and Tests
Patients with a brain herniation have:
* High blood pressure
* Irregular breathing
* Irregular pulse
* Slow pulse
A brain and nervous system (neurological) exam shows changes in alertness (consciousness). Depending on the severity of the herniation and the part of thebrain that is being pressed on, there will be problems with one or more brain-related reflexes and nerve functions.
Treatment
Brain herniation is a medical emergency. The goal of treatment is to save the patient's life.
To help reverse or prevent a brain herniation, the medical team will treat increased swelling and pressure in the brain. Treatment may involve:
* Placing a drain into thebrain to help remove fluid
* Corticosteroids, such as dexamethasone, especially if there is a brain tumor, to reduce swelling
* Medications that remove fluid from the body, such as mannitol or other diuretics, which reduce pressure inside the skull
* Placing a tube in the airway (endotracheal intubation) and increasing the breathing rate to reduce the levels of carbon dioxide (CO2) inthe blood
* Removing blood or blood clots if they are raising pressure inside the skull and causing herniation
Outlook (Prognosis)
The outlook varies and depends on where in the brain the herniation occurrs. Without treatment, death is likely.
A brain herniation often causes a massive stroke. There can be damage to parts of the brain that control breathing and blood flow. This can rapidlylead to death or brain death.
Possible Complications
* Brain death
* Permanent and significant neurologic problems
When to Contact a Medical Professional
Call your local emergency number (such as 911) or take the patient to a hospital emergency room if he or she develops decreased alertness or other symptoms, especially if there has been a head injury or if the person has a brain tumor...