Every patient with cranial or cerebral injury should be referred to the emergency medical care. Even mild head traumas may have serious consequences. The brain injury and its severity can be diagnosed with the physical examination, computerized tomography, and magnetic resonance imaging.
In brain injuries, there is generally primary damage at the time of the first impact or disease and secondary damage emerging hours or days later due to the increase of the intracranial pressure and brain edema. The emergency medical care enables the prevention or reduction of secondary damage.
During the emergency care, first the vital functions are brought under control. Afterwards, some patients need to be transferred to the intensive care unit. Keeping the head up, oxygen support, pharmacotherapy against seizures, hyperosmolar treatment to reduce the brain edema, reduction of the cerebral oxygen consumption with the help of anesthetics are methods used in the traumatic brain injuries. In addition, cooling the whole body or the brain may help to decrease the brain damage. The physical examination, tomography and monitoring of the intracranial pressure are useful in the decision for surgery. If hematoma (blood accumulation) developed, the cranium is opened with a technique called craniotomy and the blood is removed and the bleeding is brought under control. In patients with brain edema, the brain is depressurized and a space for the swelling is provided with a surgical technique called decompressive craniectomy.
The weakness in arms and legs and paralysis related to brain injury are findings easy to observe at first sight. However, brain injury may impair cognitive, emotional, and behavioral functions and sometimes these dysfunctions are not recognized by the patients or relatives. The rehabilitative approach should comprise all these problems.
Weakness in the arm or leg due to brain damage, can be seen at first glance. However, brain damage also causes mental, emotional, and behavioral effects and may be more difficult to understand by the patient and those around the patient.
The result of each brain injury is unique, but is associated with the severity of the affected brain area and damage; as well as the first event that causes brain damage. A variety of problems can develop. Rehabilitation should be inclusive of all these problems.
The patient, who hospitalized in the rehabilitation center for the treatment of the brain injury, should be thoroughly evaluated by the physiatrist. Nevertheless, all health personnel should work as a team for a comprehensive therapeutic approach. Of course, the patient and his/her relatives are at the center of this team. After the vital risks are eliminated, the rehabilitation should be initiated at the early phase. The basic principles of the rehabilitation: