Traumatic Brain Injury Surgery: Types, Survival Rate, Recovery December 8, 2023.

Traumatic Brain Injury Surgery

Traumatic brain injuries (TBI) are a common type of catastrophic injury. They can occur in an instant and can be life-altering depending on how severe the injury is. Traumatic brain injuries are from an outside force that causes a hard jolt or hit to the head. These injuries can happen from falling, sports injuries, car accidents, or assault. Traumatic brain injury cases can range from mild injuries that will heal within a few weeks, or severe injuries that may require major surgery.

  1. 214,110 Americans were hospitalized for traumatic brain injuries (2020)
  2. 190 Americans died each day from a TBI (2021)
  3. 5.3 million Americans are living with TBI-related disabilities

Symptoms of Traumatic Brain Injuries

It is important to know the symptoms of traumatic brain injuries. If you or someone you know is experiencing these symptoms after a hard hit to the head, get medical help as soon as possible. Brain injuries are not something to push aside to see if you feel better in the coming days. When someone suffers a hard hit or jolt to the head, the best plan of action is to always be assessed by a doctor. Some symptoms don't show for days or weeks, so an injury you originally thought was minor could be a lot worse than you thought.

Mild Injury Symptoms

  1. Confusion
  2. Sensitivity to light
  3. Headache
  4. Nausea
  5. Dizziness

Moderate to Severe Injury Symptoms

  1. Unconscious for 30 minutes to 6+ hours
  2. Vision loss
  3. Seizures
  4. Speech problems
  5. Coordination problems
  6. Headache that doesn't go away
  7. Memory loss

Diagnosing a Traumatic Brain Injury

Advanced technology in the medical field makes it possible for doctors to see if there is blood or bruising in the brain after a TBI. Even though the technology is advanced, it can still be hard for doctors to diagnose mild brain injuries. To diagnose moderate to severe cases of brain injuries, tests need to be performed quickly. Imaging tests can be done to diagnose some traumatic brain injuries, but they can not detect all of them. The imaging tests that can be done are a computerized tomography scan (CT) or magnetic resonance imaging scan (MRI).

According to Mayo Clinic, a CT scan is a series of X-rays that create cross-sectional images of bone, tissue, and blood vessels. When a CT scan is done to diagnose a brain injury, it creates a detailed image of the brain. This will show any fractures, bleeding, swelling, and bruises in the brain.

An MRI is similar to a CT scan, but an MRI creates a 3D image of organs in the body. When an MRI is performed to diagnose a traumatic brain injury it measures the small changes in blood flow that happens when there is brain activity. Medical professionals can monitor if there is a change in brain function after the accident.

Surgeries for Severe Brain Injuries

In cases of severe brain injuries, two major surgeries can be done in hopes of helping the patient. These surgeries are a craniotomy and a decompressive craniectomy.

Craniotomy

A craniotomy is a procedure done by a neurosurgeon where a part of the bone is removed from the skull in order to get to the brain. Once the neurosurgeon has access to the brain they can treat it. Craniotomies are done after a patient suffers a traumatic brain injury, aneurysm, near drowning, or cardiac arrest. Craniotomies are usually not planned, but they have to be done quickly to save the patient from severe brain damage.

Survival Rate

A study was done by reviewing data from 2005 to 2015 at a level-two trauma center. It was done to research the survival rate after a TBI-related craniotomy. This study only included younger adults, ages 18-30. All of the patients had either a closed head injury (80%), depressed skull fracture (16%), or a gunshot wound to the head (4%). Out of the 50 patients who received a craniotomy, 6 deaths occurred. The survival rate was around 88%.

A different study was performed to determine the survival rate of TBI-related craniotomies in older adults ages 60 and older. There were 2,166 patients in this study. At the end of 30 days, there was a 75% survival rate. A year after the craniotomy there was a 62% survival rate.

Recovery

Recovering from a craniotomy can take anywhere from 6 to 8 weeks. Keep in mind that several factors will affect how long the recovery takes.
These factors include:

  1. Age
  2. Health before injury
  3. If there were complications
  4. How severe the injury was
  5. Type of brain injury

Many people who receive these surgeries will go on to live normal lives, but there is a lot of post-surgery rehabilitation patients have to go through. Rehabilitation may be needed to help the patient relearn speech, improve coordination, and help regain brain function. It may take months, or even years to make a full recovery from a craniotomy.

Decompressive Craniectomy

The other surgery is a decompressive craniectomy, which is an emergency surgery performed when the patient's brain is swelling or bleeding. During this procedure, the neurosurgeon removes a large piece of the bone in the brain to relieve pressure. When the brain swells pressure builds up and it can lead to very dangerous outcomes for the patient, if not treated quickly. Since a decompressive craniectomy is performed as a life-saving measure, some patients live with a permanent disability even if they undergo surgery.

Survival Rate

In 2016 a study was done to research how successful a decompressive craniectomy was in reducing brain swelling, compared to other medical treatments. Six months after surgery, there was a 73% survival rate. How successful a decompressive craniectomy is, depends on the patient's condition before the surgery. Since this is a life-saving measure, if the initial injury is severe, there's a higher risk of a bad outcome.

Recovery

Similar to a craniotomy, patients will have to undergo extensive post-surgery rehabilitation to help with brain function, coordination, and speech. The incision to your skull should heal within a couple of months, but patients may be recovering in other ways for years.

Are the Survival Rates Better the Quicker it is Taken Care Of?

Time is everything with life-threatening injuries. Patients typically have a better outcome if surgery is done sooner rather than later. This is why you should be assessed by a doctor after a hard jolt or hit to the head to make sure you did not suffer a severe brain injury. Once the brain swells after an injury, it causes brain damage because the brain is not getting the blood it needs to function. Delayed treatment for a traumatic brain injury can lead to irreversible brain damage or death.

Decompressive craniectomy surgery is a life-saving measure, so the longer surgery is delayed there is a higher risk of death or severe disability. Having a decompressive craniectomy surgery within 24 hours of the injury reduces the risk of death.

Long-term Outcomes After Surgery

Even though many people can go back to living a normal life after a craniotomy, some still struggle with daily life.
Some long-term outcomes of a craniotomy include:

  1. Memory loss
  2. Speech problems
  3. Difficulty waking
  4. Decreased coordination

For a decompressive craniectomy, there may be greater long-term outcomes, depending on how severe the initial injury was. Some people remain in a vegetative state after a decompressive craniectomy. This is due to the brain swelling from the initial accident, not necessarily the surgery. But, some people are able to recover with minor long-term effects.

Contact Our Traumatic Brain Injury Attorneys

Dealing with the effects of a traumatic brain injury is stressful enough. Finding a trusted brain injury attorney will take some weight off of your shoulders by fighting to get you or your loved one justice.
The Mellino Law Firm has fought for Cleveland-area clients for almost 40 years. We handle cases that involve catastrophic accidents, medical malpractice, and wrongful death.
If you or a loved one suffered a traumatic brain injury please contact our office at (440) 333-3800 or fill out our contact form and one of our attorneys will reach out to you.