Acceleration-Deceleration Injury: Causes, Symptoms, and Treatment

Introduction:

Brain injury includes any injury or trauma to the head, skull, scalp, or brain cells. It can affect people as a whole or individually. It is a degeneration of the brain caused by external physical forces. The external forces produce an altered state of consciousness, leading to cognitive impairment and abnormal physical, mental, behavioral, and emotional functioning. The external force is an outside force that shakes the brain. It can also be a direct blow to the skull. These forces cause rapid acceleration and deceleration of the head.

What Is Traumatic Brain Injury?

Traumatic injury is explained below:

• Traumatic brain injury involves a blow to the head or skull. The brain is a freely floating organ in the cerebrospinal fluid. It moves at different cerebrospinal fluid levels in response to shock or clash.

• Traumatic brain injury contributes to over 60 percent of trauma-related deaths worldwide. In addition, neurological problems can occur depending on the type of collision.

• Traumatic brain injuries are classified into two types. They are primary injury and secondary injury. In direct injury, the immediate damage happens at the moment caused by a mechanical force. The secondary injury is not caused by mechanical strength.

• The pain is delayed from the moment of impact and can superimpose on a brain affected by a mechanical injury. The primary mechanism that causes direct damage is acceleration-deceleration.

What Is the Classification of Traumatic Brain Injury?

The injuries can be classified as:

• Scalp injuries.

• Skull fracture.

• Cerebral contusion and laceration.

• Epidural hematoma.

• Intracranial hemorrhage.

• Concussion.

• Cerebral edema.

• Skull fracture.

• Diffuse axonal injury.

What Are the Causes of Traumatic Brain Injury?

The major causes of traumatic brain injury are:

• Motor vehicle crashes.

• Accidental falls.

• Assaults.

• Sports-related injuries.

What Are Acceleration-Deceleration Injuries?

The acceleration-deceleration is explained as follows:

• The acceleration and deceleration injuries are caused by the differential movement between the skull and the skull contents (brain and cerebrospinal fluid).

• The acceleration and deceleration injury include diffuse axonal injury and epidural hematoma.

• The primary injury caused by acceleration and deceleration leads to unrestricted head and neck movement, resulting in shear and compressive strains.

• The forces cause intracranial hematoma (collection of blood within the skull) and damage to the brain nerves.

What Is the Diffuse Axonal Injury?

Diffuse axonal injuries are:

• Diffuse axonal injury is a kind of traumatic brain injury.

• The brain rapidly shifts inside the skull during the trauma. The axons are long connecting fibers in the brain.

• The axons are sheared as the brain accelerates and decelerates inside the skull's hard bone. It can occur in any part of the brain. It is one of the most common features of traumatic brain injury.

• It does not cause internal bleeding but causes the brain to move inside the skull, leading to the shearing of the axons.

• It includes microscopic brain cell damage, which is not visible in imaging studies.

• The mechanical force that causes diffuse axonal injury is the rotational acceleration of the brain, which results in unrestricted head movement.

• Diffuse axonal injury occurs in all motor vehicle accidents where the patient has lost consciousness. It is not visible in imaging studies.

• The brain tissue is damaged because it pushes itself against the skull. The trauma causes more pressure on the blood vessels, leading to an impaired blood supply to the brain. Internal bleeding is rare.

What Are the Signs and Symptoms of Diffuse Axonal Injuries?

The symptom of diffuse axonal injury is loss of consciousness. It can take more than 6 hours to gain consciousness. The symptoms are highly dependent upon the area of the brain that has been damaged. The signs and symptoms include:

• Headache.

• Insomnia (difficulty in sleeping).

• Nausea or vomiting.

• Fatigue.

• Dizziness and vertigo.

• Loss of balance.

• A loss of consciousness.

• Seizures.

• Coordination or balance problems.

• Disorientation to the surrounding.

• Inability to focus.

• Abnormal eye movements.

What Is an Epidural Hematoma?

Epidural hematoma is explained as follows:

• A head injury usually causes an epidural hematoma (EDH). A skull fracture occurs in 75 % of the cases. A skull fracture that tears the middle meningeal artery is the most common source of bleeding. Occasionally, an EDH can form due to bleeding from a vein.

• It is a type of acceleration-deceleration injury. Hematoma is defined as the collection of blood. The brain has three membrane layers or coverings (meninges) that occupy the space between the brain and the skull.

• The dura mater is the outermost membrane that protects the brain. There is blood collection between the dura mater and the skull.

• The skull fracture damages the blood vessel. Since it is a life-threatening condition, it requires immediate surgical intervention.

• The meninges protects the brain and the spinal cord. The blood leaks into the dura mater because of the trauma.

• The trauma damages the blood vessel that breaks out of pressure. The collection of blood forms a balloon that pressurizes the brain. It causes the brain to swell. It further changes. If internal bleeding occurs in the spinal cord, it is called a spinal hematoma.

• Extradural hematoma, epidural hemorrhage, and intracranial hematoma are the types of hematoma. It can lead to death if it is untreated.

What Are the Signs and Symptoms of Epidural Hematoma?

The signs and symptoms depend on the severity of the injury. It can arise at any time after the injury. The symptoms include:

• Confusion.

• Dizziness.

• Drowsiness.

• Severe headache.

• Nausea.

• Vomiting.

• Seizures

• Vision problems in one eye.

• Weakness on the side of the body.

• Difficulty in breathing.

• Enlarged pupil in one of the eyes.

Who Are at Risk of Epidural Hematoma?

The risk of epidural hematoma is explained as follows:

• It is widespread in people with skull fractures. More seen explicitly in young individuals who have a history of skull fractures.

• Injuries to the head include playing sports and activities such as snowboarding and skateboarding. Biking and car accidents can cause an epidural hematoma.

• It is five times more likely to happen in males than females. The occurrence is quite rare in children below the age of two and adults above the age of 60.

What Is the Treatment Plan For Epidural Hematoma?

The treatment plan depends upon the severity of the injury. The treatment includes:

1. Surgery - In most cases, surgery is recommended. It usually involves a craniotomy. In this procedure, the surgeon will open up part of the skull to remove the hematoma and reduce the pressure on the brain. In other cases, the doctor may recommend aspiration. This may only be effective for a very small hematoma that is not putting pressure on the brain.

2. Medications - The medications include mannitol, glycerol, and hypertonic saline that help reduce the swelling of the brain.

Conclusion:

Without prompt medical treatment, an acceleration-deceleration injury can cause a high risk of death. Immediate treatment increases the chances of survival and fastens the recovery. Following doctors’ recommendations and treatment plans can help one recover soon while lowering the risk of complications and permanent disability.