Head Trauma: Crushing Brain Injury

Head trauma from a crushing brain injury is typically the most damaging and life-threatening variety of traumatic brain injury. These injuries demand immediate medical treatment, and even with that treatment, functioning may be permanently impaired. It's possible to survive, and even thrive, in the face of a crushing brain injury, but the prognosis is heavily dependent upon the severity of the initial injury.

Fortunately, crushing brain injuries are the least common variety of head trauma. But because of their uncommon nature, research into best treatment practices is far less advanced than for other forms of head injuries. Additionally, crushing brain injury survivors may struggle to access skilled medical care, and may need to transfer to specialized trauma and rehabilitative facilities.

What is a Crushing Brain Injury?

Head trauma from a crushing brain injury, as the name implies, occurs when the brain and skull are crushed—usually between two hard objects. The more forceful the crushing is, the more severe damage will be, but damage also depends on factors such as the location of the injury and overall brain health. For example, people who have vascular issues may suffer blood clots or strokes after a crushing brain injury.

Side Effects of a Crushing Brain Injury Head Trauma

A crushing brain injury causes damage to the brain, blood vessels, and skull, each of which can be life-threatening:

• A skull fracture exposes the brain to further damage by robbing the brain of its protective case. Further, fragments of the skull may puncture the brain or blood vessels, causing more damage. 
• Most crushing skull injuries cause severe bleeds, as blood vessels are crushed under the weight of the skull or the objects that led to the injury. If severe enough, you can bleed to death. Even when the bleeding is relatively minor, it can cause damage to the brain or to surrounding structures, such as the spinal cord or sinuses. 

• The brain itself usually suffers extreme injuries as a result of a crushing brain injury. The severity of the damage depends upon the force behind the crushing, as well as the location of the damage. For instance, damage to the brain's language centers can produce difficulties speaking or understanding language. The damage may be short or long-term, and may change over time. It's common for brain injuries to continually produce new side effects, even as old side effects disappear.

Causes of Crushing Brain Injuries

Any injury that causes the head to be lodged between two heavy objects can produce a crushing brain injury. Some of the most common causes include:

• Entrapment, particularly due to a car accident, house fire, or natural disaster. A car fire, for example, can strand a motorist in his or her car, with the head stuck between the door and window. 
• Acts of violence. A person hit with a baseball bat, or who is punched when their head is against concrete or another firm object, may suffer a crushing brain injury. 
• Workplace injuries, such as from an accident with factory machinery.

Short-Term Effects of Crushing Brain Injuries

Head trauma from a crushing brain injury is hard to miss, since it usually involves extensive damage, may be bloody, and may even cause the head to become trapped between two objects. Any evidence that the brain has been crushed warrants immediate medical attention, even if the victim seems fine. Prompt medical intervention is the single most important determinant of long-term survival, and early treatment can significantly reduce long-term symptoms.

Some immediate effects of crushing brain injuries include:

• Distorted head shape and intense swelling. The jaw, cheeks, or nose might also be involved. 
• Bleeding from the nose, eyes, or ears. 
• Fluid leaking from the nose, eyes, or ears. 
• Bleeding from the head. 
• Intense head pain. 
• Loss of consciousness. 
• Nausea, dizziness, vomiting, fainting, and diarrhea. 
• Coma. 
• Inability to remain awake and alert. 
• Changes in mood or personality. 
• Sudden loss of consciousness; some brain injury survivors appear fine, but then become intensely sleepy or faint. 
• Changes in cognition, intelligence, or ability to understand speech. 
• Difficulty with motor skills, especially walking. 
• Strange or involuntary movements. 

Long-Term Effects of Crushing Brain Injuries

Even with the best treatment, a crushing brain injury can prove fatal, particularly if the blow to the head is forceful enough. In the immediate aftermath of the injury, doctors will focus on stopping any bleeding, removing pressure and swelling on the brain, and addressing any secondary effects of the injury, such as blood clots or stroke. Some crushing brain injury survivors require artificial respiratory assistance to continue breathing on their own. Depending upon the location and severity of the injury, they may also need the assistance of catheters, heart rate monitors, pacemakers, and a wide array of other devices.

Ultimately, the prognosis depends on overall health, the severity of the initial injury, and quality of treatment. This is why it's so important to seek treatment at a facility that has experience with crushing brain injuries. Your doctor is the best person to ask about your prognosis, but some common effects of crushing brain injuries include:

• The need for additional brain surgeries. 
• Problems with the immune system. 
• Changes in the shape of the skull, head, or face. 
• Changes in mood, personality, or mental health; these can be due to the aftereffects of the brain injury, or due to changes caused by the brain injury itself. 
• Permanent alterations in cognition, intelligence, spatial reasoning, language, or other basic functions. 
• Changes in motor skills, including potential loss of some motor skills. 
• Increased vulnerability to infections, stroke, and other health problems. 

Treatment for Crushing Brain Injuries

There are no guarantees when it comes to treating a crushing brain injury, but rigid adherence to the treatment plan suggested by your doctor offers you the best chance at a speedy and full recovery. A healthy lifestyle can also work wonders, so don't shy away from asking your doctor about the role of good nutrition, regular exercise, stress management, and other health choices. Long-term treatment options may include:

• Follow-up brain scans, and potentially additional brain surgeries.
• Ongoing medication treatment, including the use of antibiotics, anti-clot drugs, and other prescriptions as needed.
• Psychiatric care that may include therapy, medication, or both.
• Education about life with a brain injury.
• Physical, occupational, and speech therapy. Frequent participation in these activities can help your brain and body learn to work around your injuries.

For more information about brain injuries, check out our free eBook, The Simplified Guide to Understanding a Brain Injury.