What is TBI? On this episode, learn what kind of incidents/ accidents cause this type of trauma. What is a closed-head injury? Find out if your brain is affected even though your skull remains intact with no fracture. Is your brain like jelly? Find out the severity of TBI, whether from a car crash or contact sports. We use various types of indices to indicate severity of TBI at Jurmaine Health to ensure that your situation is assessed properly according to types of accidents/ TBI. What are the symptoms of TBI? How does it affect your cognition? Is recovery time the same for everyone? If you have any queries, contact us today to find out how we can help you~
because it’s an injury to its trauma to the brain, essentially trauma to the head. And then as a consequence trauma to the brain. And that could be a cause could be, for instance, any car accidents where your head is knocked common ones that you see for instance I’m falling off a ladder when you are repairing something on the roof and you hit your head on the floor. It could be a mild form of traumatic brain injury. So for instance, concussions are very common, and that’s a very mild form of traumatic brain injury. So it’s a full spectrum from severe traumatic brain injury, right up to mild traumatic brain injury.
The closed head injury is where there’s no fracture or no break in the skull. So the injury comes from just the impact of the brain moving around in the skull. So a really good example of that is in a car accident. So when the car moves, and it suddenly comes to a stop, your brain moves around in the skull and the skull is quite a solid brain structure. Solid bony structure I should say. So it prevents, it causes some impact with the brain. So that’s what a closed head injury is and that’s sort of in opposition to an open head injury, where there might be a break in the skull. So if you get hit in the head with a hammer, that’s likely to result in a break in the skull.
Yeah. And perhaps I think people don’t realize that the inside of the skull is actually really bony and rigid, so it scrapes against the soft brain tissue, and that’s where you get bruising. And I don’t think lots of people possibly think not many of us get to see the inside of a skull. We don’t realize that the inside of the skull is actually not smooth and there are a lot of bony edges.
Kimberley Meates is a Clinical Neuropsychology Registrar at Jurmaine Health who has also worked as Therapy Assistant with Victoria Community Living.
Evelyn Chen is a clinical neuropsychology registrar. She has clinical and research experience in aged care, public and private health care settings. With a Masters in Clinical Neuropsychology from The University of Melbourne (2017) and currently undertaking her PhD candidature at the same university, she specialises in traumatic brain injury assessments/management, as well as forensic and parenting capacity assessments. For her PhD, Evelyn is investigating the validity and reliability of tracking cognitive recovery in patients following a mild traumatic brain injury using smartphones.
Episode 062 : What is TBI?
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Welcome to Jurmaine Health podcast where the center for brain and body improvement and our team that believes that everyone should live their best life in their best body and with their best brain.
Hi, everyone. This is Judy, Evelyn and Kimberley and we're part of the brain team at here at Jurmaine Health. Topic for today is TBI, which also stands for traumatic brain injury. That's right. So it's one of our bread and butter assessment specialties, so to speak. Last week when we talked about what is neuro psychology, I mentioned, if I feel a bit lazy, I'll just sum it up to say that I do brain injury assessments. So TBI is a common acronym that you'll hear us use which stands for traumatic brain injury. What is traumatic brain injury, people
go for it,
because it's an injury to its trauma to the brain, essentially trauma to the head. And then as a consequence trauma to the brain. And that could be a cause could be, for instance, any car accidents where your head is knocked common ones that you see for instance I'm falling off a ladder when you are repairing something on the roof and you hit your head on the floor. It could be a mild form of traumatic brain injury. So for instance, concussions are very common, and that's a very mild form of traumatic brain injury. So it's a full spectrum from severe traumatic brain injury, right up to mild traumatic brain injury.
And Kimberley has a question for you. Sometimes people will say they've got a closed head injury. What does that mean?
The closed head injury is where there's no fracture or no break in the skull. So the injury comes from just the impact of the brain moving around in the skull. So a really good example of that is in a car accident. So when the car moves, and it suddenly comes to a stop, your brain moves around in the skull and the skull is quite a solid brain structure. Solid bony structure I should say. So it prevents, it causes some impact with the brain. So that's what a closed head injury is and that's sort of in opposition to an open head injury, where there might be a break in the skull. So if you get hit in the head with a hammer, that's likely to result in a break in the skull.
Or worse, the hammer sticking out?
open literally, your brain is open to the environment. Yeah.
One fun thing I like to tell people is because we know what's you know, the consistency of our brain is all kind of like a jelly like substance. So if you imagine that our brain is like in a water jar kind of floating in a water jar, a closed head injury or brain injury is we can really shake that jar quite vigorously. And then you'll see that jelly being smashed around. So that's literally kind of what happened.
Yeah. And perhaps I think people don't realize that the inside of the skull is actually really bony and rigid, so it scrapes against the soft brain tissue, and that's where you get bruising. And I don't think lots of people possibly think not many of us get to see the inside of a skull. We don't realize that the inside of the skull is actually not smooth and there are a lot of bony edges.
Alright, so we were talking about severity of brain injuries. Sometimes people ask, how will I know how severe the brain injury is you don't want it like, they might think, okay, I just had a car crash what's my brain injury severity? How would you answer or explain that to someone how that works the severity of an injury?
I think it's pretty broad. There's certain criteria that you can check off the criteria whether you meet a mild TBI or is it a moderate TBI or severe TBI? It depends on for instance, loss of consciousness, how long you've lost consciousness for post traumatic amnesia is another one. So your memory after the incident, for instance. So there are a lot of things that we have to check off and also to see how the person functions cognitively, I guess, after the incident, so there are checklists, I guess, and sometimes it's very hard to put a person into whether the person has got strictly a mild TBI or strictly a moderate TBI or strictly severe. There are often cases where doctors, neurosurgeons, neurologists would put on some patient's files that the person has got moderate to severe TBI or mild to moderate TBI. And the literature I think also depends on what kind of research you're reading literature you're reading. So for instance, like the term, mild TBI is really very broad. And for instance, the World Health Organization might have their own criteria in terms of what constitutes mild TBI. But also you get people with sports- related concussion, that kind of concussion can also be, I guess, classified as mild TBI. But their criteria for a sports related concussion is also quite different from the mild TBI that you get, for instance, in a car accident or you know if you fall off the roof,
so it's really tricky,
but there's certainly checklists that you get to
Okay, for both of you, sometimes people will ask us, okay, I just had a brain injury, what cognitive what thinking areas are impacted? How would you answer that?
Often depends on what has caused the brain injury. So for instance, in a car accident there's often very similar cognitive issue is seen in people who've been in that car accident, because of the way that the car moves. And because the way your brain moves, as Judy was saying before, how it moves in that water, against the glass, it can result in quite specific cognitive difficulties. So for instance, attention is often impacted. Memory is often impacted that frontal lobe where we do all our planning and organizing and inhibiting our responses that can also be often impacted with a car accident injury, but if you had an injury, say as the result of the hammer. It would then depend on where exactly the hammer has hit the skull, and any sort of bleeding. So it's quite localized difficulties. So it really would be very specific to where about that hammer had hit on the skull.
Alright. So recovery from traumatic brain injury. Sometimes people ask, how fast will I recover? Will I ever recover from a brain injury? What's your usual explanation? Or how would you explain to someone a traumatic brain injury recovery process?
It depends on the severity of the brain injury. I think it also depends on how old I guess you were when you have a brain injury depends on a number of factors. So, for instance, let's talk about mild traumatic brain injury concussion, let's say yes, typically, the bulk of people who have a concussion or have been diagnosed with a concussion should recover about the three-month mark. But there is a small percentage, so roughly 10% to, you know, 15-20% of the population who have concussion do have, do experience these symptoms or concussion symptoms, and they could experience it beyond the three- month mark. So, six months, 12 months down the track, and I'll call that
persistent concussion syndrome
Yes what they used to call the post concussion syndrome. That's not no longer in the DSM five. I think it's under the major neurocognitive or minor neurocognitive disorders. There is a different terminology to it now, but certainly we expect people to recover by the three month mark. But there are certainly people who have symptoms still in six-month 12-month mark. And people say, well, that's a minority of the population. But I guess, you know, that's a sizable number of people as well. So the next question we get typically is so when will I recover? Yeah, that's a difficult question to answer because most people will recover at really, does just take time. So you might recover at the 12-month mark, you might recover at the 18-month mark. Yeah, it's really hard to tell.
Do you tell people that most people that in general rule of thumb most people recover? That most of the recovery occurs within the first two years?
Yes, injury? Yes, that's usually what we would say to a client or a patient. But again, everybody's circumstances are different as well. And we know that with a lot of persistent symptoms as well, particularly in with concussion some of the symptoms do overlap with mood disorders. So, it depends as well whether the person has got any, you know, other conditions for instance like depression or whether you know they are undergoing a very stressful period in their lives with work, for instance, all sorts of things can impact on your cognition.
Yeah. Okay. And that's it. That's traumatic brain injury or TBI. Today, we've learned that there's various levels of severity of TBI it depends on the level of impact and how much of that brain has been injured. We talked about some of the cognitive changes that can be expected with TBI. And we talked a bit about the recovery, anything else?
So we know it's a big topic. Yes.
Introduction into you know the basics of traumatic brain injury TBI is very multifactorial.
Like it depends, like asking the question, how long does it take for me to recover? It really depends on what lots of circumstances where the injury was, how it took place, how old you were, you know, whether you have support around you, all that kind of thing comes into place. It's a tricky one to answer but like you said, it's a very broad topic.
Fortunately, that's where neuro psychology assessment comes in. We can do our job. So there you have it. That's TBI. If you have any other questions or queries or just want to touch base with us feel free to contact us at JURMAINE HEALTH, which is J U R M A I N E jurmainehealth.com.au and catch you next time.
Thanks for listening. If you enjoyed our podcast, feel free to connect with us on Instagram at jurmainehealthbody all one word we always welcome feedback and ideas too. And we're happy to answer any questions just reach out to us at our website, www.jurmainehealth.com.au. Listen in weekly for the most relevant information on how to live your best life with your best brain and body.
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