Traumatic brain injury (TBI) can be defined as concussion, impact, or penetrating head injury that causes disruption of normal brain functions. TBI can be caused by a sudden and hard impact on the head or by an object penetrating the skull and entering the brain. Symptoms are defined as mild-moderate or severe, depending on the duration of brain damage. Mild cases cause brief changes in mental status and consciousness, while severe cases may result in prolonged unconsciousness, coma, and even death.
Trauma is the most common cause of death under the age of 45 all over the world, and head trauma is one of the most common causes of fatal trauma. 20% of the patients are lost at the time of trauma or while being taken to the health center. Some of the patients who reach the hospital in our country are lost at the time of referral to other centers due to inadequate conditions.
Head injuries are followed up with a 15-point scoring system (Glascow Coma Score). This score, which is determined by the examination of the patient by the doctor, sheds light on the patient’s condition. Patients with a score of 14-15 are classified as mild trauma patients, patients with a score of 9-13 are classified as moderate head trauma, and patients with a score below 8 points are classified as severe head trauma. Despite the treatment, mortality was reported as 38% in patients with severe trauma.
After head trauma, concussion (concussion), contusion (brain injury), epidural hematoma (bleeding on the cerebral cortex), subdural hematoma (bleeding under the cerebral cortex), depletion fractures (cranial bone fracture due to trauma and collapse towards the brain) may occur. These conditions can occur together and with a picture accompanied by traumas in other parts of the body.
In trauma surgery, after the operation decision is taken, the patient is taken to the operating room under emergency conditions and an incision is made on the bleeding area that can include the entire bleeding area. The skull bone is opened and lifted with special drills. Bleeding is controlled with a caustic device called bipolar by drawing the blood on, under or in the brain parenchyma with aspirators. If the dice are opened, they are sewn again. The bone is replaced and the skin is sutured.
It is very important that the intensive care follow-up is carried out by the doctor in the centers where this type of surgery is performed, and that the auxiliary personnel are trained and have close neurological follow-up.
