Question

Case Scenario: A teenage baseball player gets hit in the head with a fast- hard ball. Paramedics rush him to the hospital. Upon arrival to the ED, you find he is disoriented, he has sporadic respiratory changes, and his pupils are dilated but respond to light. He can tell you his name but not what has happened. During the exam, he vacillates between being somnolent and hyper aroused. The doctor tells parents of the boy that their child has a focal brain injury. He has no prior health conditions.

1. Question: During an observation of their son, the doctor tells the parents that the staff will be evaluating to see if there is a secondary brain injury. Give signs and symptoms of a secondary brain injury and explain why these symptoms occur. You will need to defend your answer using specific facts, data.

Answer 1

Secondary brain injury is caused due to indirect result from brain injury which leads to trauma and in most of the cases, it is followed by and appears after days of primary brain injury. This tends to increase over time and leads to death. After the head injury, the death or damage tends to occur very late in some cases, and this is due to secondary injury. Due to the secondary brain injury, it tends to destroy and damage the neurons which were not damaged during the primary brain injury. There are different types of injuries and complications which can lead to such secondary injury leading to damage to the brain cells.

Signs and symptoms of secondary brain injury are: -

• Severe and very frequent headaches
• It can lead to memory loss and become forgetful
• It can lead to seizures as well as convulsion
• Loss of sensory aspects like loss of smell or hearing
• Slurred speech and loss of communication
• Insomnia as well as hypersomnia
• Loss of vision
• Mood swings and change in personalities

These types of symptoms occur majorly due to the damage to the neurons in the brain and hence it is not able to transfer and communicate efficiently. It is not able to deliver the nerve impulse appropriately to the brain as the neurons are damaged and hence it tends to cause all the symptoms associated with the secondary brain injury. It is found that when someone suffers from secondary brain injury, the damage to the neurons and brain cells even leads to increased release in the neurotransmitters which destroys the brain cells. Also due to the damage to the blood vessels which can occur during the secondary injury, it leads to loss of cerebral autoregulation and hence the cerebral blood flow cannot be regulated nicely.