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Motor vehicle accidents are the leading cause of traumatic brain injury in the United States. Serious neck injuries and head trauma are also not uncommon. These injuries are life changing for both the victim and their carers. The rate and extent of recovery varies from person to person but with proper physical and cognitive rehabilitation they can be improved.

Types of brain injury

The sudden impact of a motor vehicle collision can cause serious injury to the brain. When the head stops abruptly the brain keeps moving and is slammed against the inside of the skull damaging the tissues and nerve fibres.

If the impact fractures the skull the bone can be depressed into the brain tearing the tissues and will require surgery to remove the bone fragments. Even when there is no direct impact the force with which the brain is moved can cause nerve fibres to be stretched, twisted and damaged.

These injuries also contribute to secondary injuries which can cause widespread additional damage to the brain. Swelling of the brain, hematoma and contusions or bruises to the brain, all create a build up of intra cranial pressure. Unrelieved this pressure can cause permanent damage to the brain cells and nerves.

Treatments to relieve intra cranial pressure depend on the severity. They range from medication to reduce swelling through induced coma and hypothermia to slow blood flow. Surgery is only used in extreme cases or when non-invasive methods are not working.

Effects of brain injury

Loss of conciousness is usual with a brain injury and can be as mild as a short term concussion or as serious as a patient remaining in a permanent vegetative state.

Between these two extremes are ten stages of recovery. In the first three there is very little response to external stimuli. The patient may react to loud noises but they have no awareness of what is happening. They are incapable of doing anything for themselves.

Stages four to six involve regaining awareness of their surroundings. The patient's confusion is evident and they require substantial assistance. During stages seven and eight the patient begins to be more self sufficient. They can do normal activities with only a little help but get tired very easily.

Stages nine and ten bring a patient back to a normal functioning level. It is important to understand that a normal functioning level may not be the same as it was prior to the accident.

Other long term effects of brain injury may include severe depression, mood swings, short term memory

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