Brain Injury / Trauma
Traumatic brain injury (TBI) can occur from falls, motor vehicle accidents, sports injuries, assaults, or other impacts to the head. Brain injuries range from mild concussions to severe trauma requiring urgent neurosurgical intervention. The effects can be immediate or develop over time, impacting physical, cognitive, and emotional function.
Dr Joseph Garcia Redmond provides expert evaluation and management of traumatic brain injuries, from emergency surgical treatment of severe trauma to long-term management of complications. His comprehensive neurosurgical training across Australia, New Zealand, and internationally has equipped him with the expertise to manage the full spectrum of brain injuries.
Dr Garcia Redmond works closely with emergency physicians, intensive care specialists, rehabilitation teams, and other specialists to ensure coordinated care throughout your recovery journey. His approach emphasizes not just treating the immediate injury, but supporting long-term recovery and quality of life.
What is Brain Trauma?
Traumatic brain injury (TBI) occurs when an external force causes damage to the brain. This can happen through direct impact, rapid acceleration-deceleration, or penetrating injuries.
Types of Brain Injuries:
Concussion (Mild TBI): A temporary disturbance in brain function caused by a blow to the head or body. Most concussions resolve within days to weeks, though some symptoms may persist longer.
Skull Fracture: A break in the skull bone, which may or may not be associated with underlying brain injury. Can be linear, depressed (bone pushed inward), or basilar (at the skull base).
Contusion: Bruising of brain tissue, usually caused by direct impact. Can occur at the site of impact or on the opposite side of the brain (contrecoup injury).
Intracranial Hemorrhage: Bleeding within the skull, which can be life-threatening:
Epidural hematoma: Blood between skull and outer brain covering (dura), often requiring urgent surgery
Subdural hematoma: Blood beneath the dura, can be acute (immediately after injury) or chronic (develops over weeks)
Subarachnoid hemorrhage: Bleeding around the brain surface
Intracerebral hemorrhage: Bleeding within brain tissue itself
Diffuse Axonal Injury: Widespread damage to brain nerve fibers from rapid acceleration-deceleration forces, often seen in severe motor vehicle accidents. Can cause prolonged unconsciousness.
Penetrating Injury: Objects piercing the skull and entering brain tissue, such as gunshot wounds or impalement injuries.
Secondary Brain Injury: Complications developing after the initial trauma, including brain swelling, increased pressure within the skull, inadequate oxygen delivery, or infection.
The information on this website is intended as a general guide and should not replace professional medical advice. Every patient's situation is unique. Please schedule a consultation with Dr Garcia Redmond for personalised assessment and recommendations.
What Are the Symptoms of Brain Trauma?
Symptoms vary widely depending on injury severity and location.
Mild TBI (Concussion) Symptoms: Brief loss of consciousness (not always present), confusion or feeling dazed, headache, dizziness or balance problems, nausea or vomiting, sensitivity to light or noise, memory problems or difficulty concentrating, sleep disturbances, mood changes or irritability, blurred vision.
Moderate to Severe TBI Symptoms: Loss of consciousness (minutes to hours or longer), severe or worsening headache, repeated vomiting, seizures or convulsions, weakness or numbness in limbs, slurred speech or difficulty speaking, confusion, agitation, or unusual behavior, clear fluid draining from nose or ears (may indicate skull fracture), unequal pupil sizes, loss of coordination, coma.
Delayed Symptoms: Some brain injury complications develop hours or days after the initial trauma including gradually worsening headache, progressive confusion or drowsiness, new weakness or numbness, persistent vomiting, behavioral changes.
When to Seek Immediate Medical Attention: Call emergency services immediately if someone with a head injury experiences loss of consciousness (any duration), severe or worsening headache, repeated vomiting, seizures, confusion or unusual behavior, slurred speech, weakness or numbness, unequal pupil sizes, clear fluid from nose or ears, drowsiness that progressively worsens.
Even seemingly mild head injuries should be evaluated by medical professionals, especially in young children, older adults, or people taking blood-thinning medications.
How is Brain Trauma Diagnosed?
Emergency Assessment:
Glasgow Coma Scale (GCS): Standardized assessment of consciousness level
Neurological examination: Evaluation of brain and nerve function
Pupil examination: Checking for signs of increased brain pressure
Imaging Studies:
CT scan: The primary imaging test for acute head trauma, rapidly detects bleeding, fractures, and swelling
MRI scan: Provides more detailed imaging of brain tissue, used for subacute or chronic injuries and to detect subtle damage
Skull X-rays: Occasionally used to assess fractures
Additional Tests:
Blood tests: To assess overall condition and guide treatment
Intracranial pressure monitoring: May be placed in severe TBI to monitor brain pressure
Continuous monitoring: Heart rate, blood pressure, oxygen levels in intensive care settings
Dr Garcia Redmond will review all diagnostic information and explain the extent of injury and treatment implications.
How Do You Treat Brain Trauma?
Treatment depends on injury severity, type of damage, and patient condition.
Mild Traumatic Brain Injury (Concussion)
Conservative Management: Rest (physical and cognitive), gradual return to activities as symptoms improve, pain management with appropriate medications (avoiding aspirin and ibuprofen initially), monitoring for worsening symptoms, avoiding alcohol and additional head impacts during recovery, follow-up assessment to ensure appropriate recovery, graduated return to work, school, and sports following established concussion protocols. Most concussions resolve within 1-4 weeks.
Moderate to Severe Traumatic Brain Injury
Emergency Medical Management: Airway protection and breathing support, blood pressure management, prevention and treatment of seizures, temperature control, fluid and electrolyte management, nutritional support.
Medications: Sedatives to reduce brain activity and oxygen demand, medications to reduce brain swelling, anti-seizure medications, pain management.
Surgical Treatment Options
Surgery may be necessary for various brain trauma complications:
Evacuation of Hematoma: Surgical removal of blood collections (epidural, subdural, or intracerebral hematomas) that are causing pressure on the brain. This typically involves craniotomy (opening in the skull) to access and remove the blood.
Decompressive Craniectomy: Removal of a section of skull to allow swollen brain tissue to expand, reducing dangerous intracranial pressure. The bone is typically replaced months later in a separate procedure (cranioplasty).
Skull Fracture Repair: Depressed skull fractures may require surgical elevation and fixation. Open fractures with contamination require cleaning and repair to prevent infection.
ICP Monitor Placement: A device inserted through the skull to continuously monitor pressure inside the brain, guiding treatment decisions.
Ventriculostomy: A catheter placed into the brain's fluid spaces to drain excess cerebrospinal fluid and reduce pressure.
Dr Garcia Redmond uses advanced surgical techniques and technology to provide the safest, most effective treatment for traumatic brain injuries requiring surgical intervention.
Your Recovery and Aftercare
Recovery from brain trauma varies enormously depending on injury severity, age, overall health, and complications. Dr Garcia Redmond and his team will support you throughout your recovery journey.
After Mild TBI (Concussion): Most symptoms resolve within 1-4 weeks. Some individuals experience post-concussion syndrome with symptoms lasting months. Gradual return to normal activities as tolerated.
After Moderate to Severe TBI: Hospital Stay: Ranges from days to weeks or longer depending on injury severity. May include time in intensive care and acute rehabilitation units.
Initial Recovery includes a close monitoring of neurological status, management of complications (swelling, seizures, infection), early mobilisation and rehabilitation when stable, nutritional support and medical care.
Rehabilitation: Comprehensive rehabilitation is crucial for optimal recovery and may include
Physiotherapy: For mobility, strength, balance, and coordination
Occupational therapy: For daily living skills and return to work preparation
Speech and language therapy: For communication and swallowing difficulties
Neuropsychology: For cognitive rehabilitation and psychological support
Vocational rehabilitation: For return to work or education
Follow-Up Care:
Regular follow-up appointments are essential to monitor recovery and manage complications:
Clinical examinations to assess neurological function
Imaging studies if needed to monitor healing
Assessment and management of post-traumatic complications
Coordination with rehabilitation specialists
Seizure management if required
Cranioplasty planning if bone flap was removed
Support Services:
Brain injury recovery can be challenging for patients and families. Support services may include:
Brain injury support groups and counseling services
Neuropsychological support
Social work assistance
Disability services
Carer support programs
Frequently Asked Questions About Brain Trauma
What Are the Risks Associated with Brain Trauma?
Immediate Complications:
Brain swelling and increased intracranial pressure
Seizures
Bleeding or rebleeding
Infection (especially with open fractures or surgery)
Blood clots in legs or lungs
Cerebrospinal fluid leaks
Long-Term Complications:
Post-Concussion Syndrome: Persistent symptoms following concussion including headaches, dizziness, cognitive difficulties, and mood changes lasting months or longer.
Post-Traumatic Epilepsy: Development of seizures after brain injury, occurring in 5-10% of moderate to severe TBI cases. Risk is higher with penetrating injuries or intracerebral bleeding.
Chronic Traumatic Encephalopathy (CTE): Progressive brain degeneration associated with repeated head trauma, particularly seen in contact sports athletes and military personnel. Can cause cognitive decline, mood disorders, and behavioral changes.
Cognitive Impairments: Memory problems, difficulty concentrating, slowed processing, executive function difficulties. Severity varies widely.
Emotional and Behavioral Changes: Depression, anxiety, irritability, impulsivity, personality changes, post-traumatic stress disorder.
Physical Impairments: Weakness, coordination problems, balance difficulties, sensory changes, chronic pain, fatigue.
Hydrocephalus: Accumulation of fluid in the brain requiring shunt placement.
Chronic Subdural Hematoma: Slow accumulation of blood beneath the dura, sometimes occurring weeks to months after seemingly minor head trauma, particularly in older adults.
Surgical Risks:
Infection or bleeding
Neurological deterioration
Incomplete relief of pressure
Need for additional procedures
Complications from anesthesia
Dr Garcia Redmond will discuss your individual risk factors and work to minimize complications through expert surgical care and careful monitoring.
How long does it take to recover from a concussion?
Most concussions resolve within 1-4 weeks with appropriate rest and gradual return to activities. However, recovery time varies. Some individuals, particularly those with previous concussions, may experience symptoms lasting months (post-concussion syndrome). Children and adolescents may require longer recovery periods. Complete cognitive and physical rest in the first few days, followed by gradual activity resumption guided by symptoms, promotes optimal recovery.
When can I return to sports after a concussion?
You should not return to sports or activities with risk of further head impact until completely symptom-free and cleared by a medical professional. Returning too soon increases risk of prolonged symptoms or serious complications (second impact syndrome). Follow a graduated return-to-play protocol, typically taking at least 1-2 weeks after symptom resolution. Dr Garcia Redmond can provide guidance on safe return to sports.
Do all head injuries require a CT scan?
Not all head injuries require CT scanning. Mild injuries without loss of consciousness, amnesia, or concerning symptoms may be observed without imaging. However, CT scans are recommended for moderate to severe injuries, any loss of consciousness, deteriorating mental status, focal neurological symptoms, severe headache, repeated vomiting, suspected skull fracture, or in high-risk patients (elderly, on blood thinners). Emergency physicians use established criteria to determine imaging necessity.
Can you have a brain injury without losing consciousness?
Yes. Loss of consciousness is not required for brain injury or concussion. Many significant brain injuries occur without any loss of consciousness. Symptoms like confusion, amnesia, headache, dizziness, or altered behavior after head impact indicate possible brain injury regardless of consciousness level.
What is second impact syndrome?
Second impact syndrome is a rare but catastrophic condition where a second concussion occurs before complete recovery from an initial concussion. This can cause rapid, severe brain swelling and has high mortality rates. This is why it's crucial not to return to activities with head impact risk until fully recovered and medically cleared.
Why do some people deteriorate hours or days after head injury?
Some brain injury complications develop gradually. Bleeding can slowly accumulate (particularly subdural hematomas), brain swelling can worsen over hours, or initially missed injuries may become apparent. This is why monitoring after head injury is crucial and why people should seek immediate care if symptoms worsen after initial improvement.
Can you recover from severe traumatic brain injury?
Recovery varies enormously. Some patients with severe TBI make remarkable recoveries, while others have permanent impairments. Younger age, shorter duration of unconsciousness, absence of significant brain swelling, and early rehabilitation improve outcomes. Recovery typically continues for at least 6-12 months and sometimes for years. Even with lasting impairments, ongoing rehabilitation can help maximize function and quality of life.
What are the long-term effects of multiple concussions?
Repeated concussions, particularly when occurring before complete recovery from previous concussions, increase risk of prolonged symptoms, permanent cognitive problems, and potentially chronic traumatic encephalopathy (CTE). CTE is a progressive degenerative brain disease associated with repeated head trauma. Anyone with multiple concussions should be carefully evaluated, and steps should be taken to prevent further head injuries.
Do I need to wake someone up every hour after a head injury?
This is an outdated practice. While monitoring is important, you don't need to wake someone every hour. Instead, wake them 2-3 times during the first night to check they can be easily roused, are oriented, and have no worsening symptoms. If symptoms worsen or the person cannot be roused, seek immediate medical care.
Why Choose Rivercity Brain & Spine for Brain Trauma Care?
Comprehensive Neurosurgical Expertise: Dr Garcia Redmond's training across major trauma centers in Australia, New Zealand, and internationally has provided extensive experience in managing all severities of traumatic brain injury.
Emergency Care Experience: Skilled in urgent and emergency neurosurgical interventions for life-threatening brain trauma.
Advanced Surgical Techniques: Utilizes modern neurosurgical techniques and technology for optimal outcomes in trauma surgery.
Multidisciplinary Collaboration: Works closely with emergency physicians, intensive care specialists, rehabilitation teams, and other specialists for coordinated care.
Long-Term Management: Provides ongoing care for brain injury complications including post-traumatic epilepsy, chronic subdural hematomas, and cranioplasty procedures.
Patient and Family Support: Recognizes the impact of brain injury on families and provides compassionate guidance throughout the recovery process.
Rehabilitation Coordination: Facilitates access to comprehensive rehabilitation services to optimize recovery.
SCHEDULE A CONSULTATION
Neurosurgery Brisbane
If you or a loved one has experienced a brain injury and requires specialist neurosurgical assessment or ongoing management of complications, Dr Garcia Redmond can help.
Contact Rivercity Brain & Spine today to schedule your consultation.