Traumatic Brain Injury (TBI)

Henry Ford’s Cerebrovascular Center treats patients who have traumatic brain injury (TBI), in collaboration with physicians in the trauma/emergency and neurocritical care departments.

Henry Ford’s neurocritical care providers manage more than 1,300 patients each year, placing our units among the largest in the U.S.

What is traumatic brain injury?

Traumatic brain injury (TBI) occurs when the brain is damaged by sudden trauma. TBI can result from a fall, from the head suddenly and violently hitting an object, or from damage to brain tissue (such as by a gunshot that pierces the skull). Anyone can experience a traumatic brain injury, but TBI is most common among children and young adults, and among older adults over age 65.

Mild traumatic brain injury can cause temporary problems with brain function. More serious TBI may result in long-term complications, or even death, due to physical damage to the brain, such as bleeding, torn tissues, swelling and bruising.

Signs and symptoms of traumatic brain injury

A traumatic brain injury can range from mild to severe, depending on the cause and the extent of damage to the brain.

Mild TBI can have symptoms such as headache, confusion, dizziness, brief loss of consciousness, mood changes and trouble concentrating.

More severe TBI might include these symptoms along with others, such as:

• A headache that gets worse or does not go away
• Repeated vomiting or nausea
• Seizures or convulsions
• Inability to wake up
• Unclear thinking or memory problems
• Slurred speech
• Weak or numb limbs
• Loss of coordination
• Confusion, restlessness, or agitation

People who experience these symptoms, either immediately after a head injury or much later, should see a doctor.

Henry Ford Neurosciences Institute: complete brain injury care

A person who has had a brain injury may experience complications that affect various functional areas, including communication, sensory and behavioral changes, intellectual problems and infections.

These and other potential complications of TBI are treated by the physicians of the Henry Ford Neurosciences Institute, including:

• Seizures: TBI can cause two types of seizures, those that occur in the first week and those that recur over time, called post-traumatic epilepsy. The Henry Ford Epilepsy Center may work with these patients after the TBI is stabilized.
• Fluid accumulation: In some patients with TBI, spinal fluid builds up in the spaces in the brain. This swelling can cause increased pressure and might require surgical treatment by Henry Ford’s neurosurgeons.
• Blood vessel damage: TBI can damage large or small blood vessels in the brain, which in turn could lead to a blood clots, aneurysm or stroke.
• Degenerative brain diseases: A TBI may make it more likely that patients experience diseases that result in degeneration of brain cells, such as Alzheimer’s disease, Parkinson’s disease or dementia pugilistica (most often seen among boxers). Henry Ford’s Neurogenerative Diseases Center cares for these patients.

What causes traumatic brain injury?

Traumatic brain injury can result from incidents such as:

• Falls
• Vehicle-related collisions
• Violence (gunshot wounds, domestic violence or child abuse, including shaken baby syndrome)
• Sports injuries
• Explosive blasts or collisions with objects after a blast (such as in some combat injuries)
• Penetrating wounds
• Shrapnel or debris striking the head

Traumatic brain injury diagnosis and treatment at Henry Ford

Anyone with suspected traumatic brain injury should receive medical care right away. Physicians at Henry Ford work immediately to stabilize an individual who has a TBI to try to prevent further injury or damage.

Once a patient is stabilized, physicians may conduct imaging tests such as X-rays or imaging (CT scan or MRI) to determine the extent and prognosis of injuries. During this process, Henry Ford’s trauma physicians, neurocritical care providers and neurologists will work together to provide appropriate care.

Physicians at Henry Ford’s Neurosciences Institute and Cerebrovascular Center will evaluate a patient’s condition for appropriate care, which may include:

• Intracranial pressure monitor: Doctors may insert a probe through the skull to monitor the pressure that may result from swollen tissues in the brain due to TBI.
• Surgery: Approximately half of patients with a TBI require surgical removal or repair of bruised brain tissue (contusion) or ruptured blood vessels (hematoma). Neurologists monitor patients for possible hemorrhage, clots, aneurysm or stroke following moderate or severe TBI.
• Repairing skull fractures: Surgeons may need to repair severe skull fractures from the injury that caused the TBI.

Physicians might prescribe additional treatment for patients with TBI, including medications to minimize additional damage to the brain after an injury, and rehabilitation to regain brain function.

Leading neurological care for traumatic brain injury at Henry Ford

Traumatic brain injury treatment is a complex and evolving field. Henry Ford’s physicians are deeply involved in laboratory research and clinical trials to help evolve treatment for TBI. Recent highlights of that research include:

• Henry Ford’s neurotrauma program is the first and only in Michigan to translate laboratory investigations into clinical trial therapies for patients with traumatic brain injury (TBI). These pilot trials involved pharmaceutical agents such as statins to promote neural recovery.
• In the laboratory, Henry Ford investigators are examining the efficacy of transplanting marrow stromal cells (MSCs) in a model of head trauma. Our physicians are combining bioengineering techniques with cell therapy to repair neural injury. These results have been selected as a landmark review in Nature Medicine.
• In 2003, Michael Chopp , MD, and his team received the first National Institutes of Health (NIH) Project Grant Award in the U.S. for this work in the area of brain injury as seen in stroke and head trauma.