Case Study on a Traumatic Brain Injury

Home » Case Study on a Traumatic Brain Injury
July 21, 2019
Edward Smith

Severe Traumatic Brain Injuries

A traumatic brain injury is always serious because it has the potential to lead to long-term complications. The neurons of the brain do not regenerate like other parts of the body, making many of the functional and cognitive deficits permanent. On the other hand, the human body is resilient, and even in cases involving a severe TBI, some functional recovery might be possible. This was demonstrated following a catastrophic traumatic brain injury that occurred in a motorcycle accident. A young man made a remarkable, meaningful recovery. The crash was published as a case report in the American Journal of Case Reports.

A Severe Motorcycle Accident

The young man was riding his motorcycle on a back road when he lost control and ran off the road. Unfortunately, he was not wearing a helmet at the time, making it far more likely that he would suffer a severe traumatic brain injury. Not long after the accident, bystanders found him lying unconscious along the side of the road with his motorcycle nearby. He had a visible head injury. They immediately called 911, and emergency paramedics transported him to the hospital.

Once in the emergency room, his heart rate was low, and his blood pressure was elevated, which was a concern for a possible brain stem injury. A detailed physical exam showed that his pupils were fixed, dilated, and not responsive to light, indicating severe damage to the cranial nerves that power the pupils. There was also a large, bloody bruise on the right side of his head. Cerebral spinal fluid (CSF) was also draining from his right ear, possibly indicating a basilar skull fracture. A CT scan showed a subdural hematoma and significant cerebral edema, concerning for an impending brain herniation.

Taken to the Operating Room for Surgery

Because of the apparent cerebral swelling, doctors had concerns it was an impending brain herniation. The young man was taken to the operating room for an emergency decompressive craniectomy procedure. In this procedure, a portion of the skull is removed so that the brain can swell without herniating. During this operation, the patient was given Mannitol and concentrated sodium chloride to try to relieve the swelling. A drain was also placed in the brain to remove fluid and further alleviate the swelling. An intracranial pressure monitor was also set. This is used to monitor the pressure inside of the skull so that adjustments could be made to prevent swelling and herniation.

Post-Operative Infection Developed

Five days after the accident, the patient started to worsen. His Glasgow Coma Scale score started to drop. His ICP monitor was showing elevated pressures, and he developed a fever. The doctors were worried that he was developing an infection. Because his oxygen level dropped after being intubated for about a week, they were worried it was in his lungs. A chest x-ray was obtained, showing that the patient was developing a severe infection in his lungs. The patient was started on potent antibiotics to try to clear the developing infection, which was eventually cleared.

Remarkable Recovery

Three weeks after the accident, the patient was making noticeable improvements. He was discharged home to a long-term care facility and eventually went home under the care of his mother. He was having trouble speaking and eating, but otherwise was doing well. He had developed a mood disorder and enrolled in speech therapy, which helped him learn how to talk again. He was able to walk without assistance but needed some help with his activities of daily living. With continued physical therapy, he might be able to make further functional improvements. This case report shows that even in the case of a devastating TBI, significant improvements are possible.

Watch YouTube Video: The Road to Recovery Following Brain Injury. This video takes a look at a person’s road to recovery after suffering a traumatic brain injury.

Fresno Brain Injury Lawyer

I’m Ed Smith, a Fresno Brain Injury Lawyer. A motorcycle accident could lead to severe brain injury. Should you or a family member suffer a severe traumatic brain injury, please call me at (559) 377-7676 or (800) 404-5400 to receive free, friendly advice.

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