Surgical Treatment of Traumatic Brain Injury

A brain injury is any type of injury to the scalp, skull, or brain. It ranges from a mild bump or bruise to a severe traumatic head injury. Common head injuries include fractures in the skull, wounds on the scalp, concussions, and contusions.

There are different terms and interpretations when it comes to head injuries. The two most popular term commonly used are the open and closed brain injury.

Open and Closed Brain Injuries

An open head injury is a breakage in the skull that goes through the brain. On the other hand, a closed brain injury is when there is no breakage on the skull. An intact skull is the determining factor that determine for a closed or open head injury.

It is difficult to assess a brain injury just with your naked eye. There are instances that a minor injury can have a lot of bleeding. However, there are some major injuries that manifests no visual bleeding at all. It is vital to treat every head injury a serious emergency case and must be assessed by a health expert.

When considering surgical management for a traumatic brain injury (TBI), it is crucial to categorize the type of injury.

When Is Surgical Treatment Needed?

There are injuries that involves a damage to the scalp, skull and the brain. This requires a certain management. The other type can cause an increased intracranial pressure  caused by swelling or hemorrhage. This, too requires a different kind of treatment.

Surgical treatment is a common way used to treat traumatic brain injury patients but not for all cases. Conditions like closed head injury needs a bolt or intracranial pressure monitoring. It is placed on the skull of the patient.

Either one of them can be severe. In an open head injury, it leaves the skull open thus making the brain prone to infection. On the other hand, closed head injury can aggravate the patient’s condition in cases of swelling of bleeding.

In cases of bleeding for a closed head injury, then a surgical method is needed. This is done to address the bleeding and to drain the blood. The bleeding blood vessels or tissue must be repaired immediately to prevent further complications.

In severe cases of traumatic brain injury, there is presence of extensive swelling in the tissue or damages in the brain tissue. A surgical procedure must be done to remove the swelling and make space for the brain and reduce the pressure.

Signs and Symptoms

It is vital to interpret the signs and symptoms correctly before doing a surgical intervention. A surgical judgement requires a deep understanding on the underlying pathology and the effects to the patient after the surgery.

It is also important frequently observe the patient and to run adequate diagnosis to ensure his optimal health.

About 12% of patients experiencing an acute head injury requires surgical intervention. Five to eight percent may need an operation for the management and diagnosis of post traumatic complications.

Head Xray

Requesting for an x-ray is essential for the physician to evaluate the type of head injury and what treatment should be done at the earliest possible time. It is vital in studying the depressed fractures and if there are any penetrating wounds. It will also reveal the presence of any foreign material whether it be small or big, made of wood or metal. It can also show bony fragments in the deep cerebral tissues of the brain.


Another test called angiography is usually done. This is also vital in the diagnosis process and it also aids in the management of the intracranial mass lesions. Angiography is said to be more effective than the diagnostic trephination used to identify any intracranial clot.

The main goal of a surgical treatment is to prevent further damages to the brain and to maintain the flow of blood and oxygen to the brain.

The surgical treatment caused by a traumatic brain injury can be complex and challenging. The brain tissues is very delicate.

Even though surgical treatment is needed for most cases of traumatic brain injury, surgeries may be performed within hours or days after the injury. This depends on the condition of the patient. Anything that causes an increase in the intracranial pressure (ICP) must be removed such as clots, subdural hematomas and intracerebral hemorrhages.

ICP can compress the brain tissues thus preventing the blood to flow continuously to the brain. If this happens, it can damage the brain cells. Most edema subsides in a couple of days or weeks. Even though that’s the case, it may have already caused severe damages to the brain in that span of time. This will probably result to a permanent brain damage.

Although surgery is one way to treat a traumatic brain injury, it cannot ensure a complete or full recovery of the patient. Usually a surgical procedure is done to simply address the effects of a bleeding or to decrease intracranial pressure.


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