The Centers for Disease Control and Prevention (CDC) report that approximately 1.7 million people have a traumatic brain injury (TBI) every year, and 275,000 of those cases require hospitalization. A TBI patient can have an open injury, in which his skull is fractured, or a closed injury. Merck notes that the characteristics of the injury depend on its severity, which is determined by the Glasgow Coma Scale. For example, a score of 14 or 15 is mild TBI; 9 to 13 is moderate TBI; and 3 to 8 is severe TBI.
Mild Characteristics
The Mayo Clinic states that a patient with mild TBI can briefly lose consciousness, although not all patients do. She can also have amnesia immediately before or after the impact. Some cognitive problems can occur with mild TBI, such as issues with memory or concentration. The patient may also have changes in mood. Some sensory changes are possible, such as blurred vision, a bad taste in the mouth or ringing in the ears. After the injury, the patient can have headaches, confusion and dizziness. Merck adds that the patient may develop epidural hematoma, in which she has no symptoms followed by an "increasing headache, decreased level of consciousness and focal neurologic deficits."
Moderate Characteristics
With moderate TBI, the headache can become persistent, and the patient can have weakness, agitation and slurred speech, according to the Mayo Clinic. Merck notes that the patient has a longer loss of consciousness than with mild TBI and can have a transient lucid interval followed by a gradual neurologic deterioration. If the patient has a fracture in his skull, he can have a leakage of cerebrospinal fluid (CSF) from the nose or ear. The patient can also lose his sense of smell or hearing.
Severe Characteristics
With severe TBI, more serious brain injury can occur. Merck states that about 50 percent of adults have a good prognosis or only moderate disability. However, the mortality rate in severe TBI is between 25 and 33 percent. The Mayo Clinic notes that besides the characteristics seen in mild and moderate TBI patients, other signs of severe TBI include being unable to wake up, convulsions, loss of coordination and confusion. The cognitive deficits are also significant, such as persistent amnesia. Intracranial pressure is also possible and should be monitored.
