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Brain Injuries Treatment In India

Traumatic brain injury (TBI) in India usually occurs when a sudden physical assault on the head causes damage to the brain. The damage can be focal, confined to one area of the brain, or diffuse, involving more than one area of the brain.

Pathology:

Structural changes from head injury may be gross or microscopic, depending on the mechanism and forces involved. Patients with less severe injuries may have no gross structural damage. Clinical manifestations vary markedly in severity and consequences. Injuries are commonly categorized as open or closed.

Open injuries involve penetration of the scalp and skull (and usually the meninges and underlying brain tissue). They typically involve bullets or sharp objects, but a skull fracture with overlying laceration due to severe blunt force is also considered an open injury.

Closed injuries typically occur when the head is struck, strikes an object, or is shaken violently, causing rapid brain acceleration and deceleration. Acceleration or deceleration can injure tissue at the point of impact (coup), at its opposite pole (contrecoup), or diffusely; the frontal and temporal lobes are particularly vulnerable. Axons, blood vessels, or both can be sheared or torn. Disrupted blood vessels leak, producing contusions, intracerebral or subarachnoid hemorrhage, and epidural or subdural hematomas
Prognosis for Traumatic Brain Injury in Indian Patients: The outcome of TBI depends on the cause of the injury and on the location, severity, and extent of neurological damage: outcomes range from good recovery to death. Doctors often use the Glasgow Coma Scale to rate the extent of injury and chances of recovery. The scale (3-15) involves testing for three patient responses: eye opening, best verbal response, and best motor response. A high score indicates a good prognosis and a low score indicates a poor prognosis.

Treatment of Indian patients suffering from Traumatic Brain Injury :

For mild injuries discharge and observation
For moderate and severe injuries optimization of ventilation, oxygenation, and brain perfusion; treatment of complications (eg, increased intracranial pressure, seizures, hematomas); and rehabilitation
Multiple noncranial injuries, which are likely with motor vehicle crashes and falls, often require simultaneous treatment. At the injury scene,a clear airway is secured and external bleeding is controlled before the patient is moved. Particular care is taken to avoid displacement of the spine or other bones to protect the spinal cord and blood vessels. Proper immobilization should be maintained with a cervical collar and long spine board until stability of the entire spine has been established by appropriate examination and imaging. After the initial rapid neurologic assessment, pain should be relieved with a short-acting opioid (eg, fentanyl)