Traumatic brain injury represents a significant health problem in Arizona. Every year, more than 5,000 cases of traumatic brain injury occur in our state. These severe head injuries hospitalize approximately one out of every 1,000 Arizonans annually.
Answering the call for expert care for traumatic brain injury, John C. Lincoln has intensified our commitment to help prevent and treat this widespread form of disability. The Level I Trauma Center at our North Mountain hospital is an essential part of how we treat the most severe, time-sensitive cases of head injury.
What Is Traumatic Brain Injury?
The result of a powerful blow to the head, a traumatic brain injury (or "TBI") can disrupt brain function and potentially lead to brain damage. While the skull can withstand considerable external force, impact may push the brain against the inside of the skull — so-called "closed-head injury." Far less common, thankfully, is brain injury resulting from an external object, such as a bullet, entering the skull.
As such, damage from TBI can be confined to one area of the brain (bruising and swelling of brain tissue, due to impact) or widespread (nerve damage, due to shaking or concussion). Symptoms may range from lack of consciousness, dizziness, nausea, dilated pupils and difficulty breathing.
Motor vehicle crashes represent half of the cases of brain injury for persons under age 75 — children up to age 4, and teens aged 15 to 19, are particularly affected. Persons ages 75 and up are vulnerable to falls and are the most hospitalized age group due to TBI.
The Role of Our Level I Trauma Center
The Level I Trauma Center at John C. Lincoln's North Mountain Hospital is a tremendous resource and partner for our neuroscience specialists. The northernmost in Arizona, our Level I Trauma Center enables us to care for — and, if necessary, operate on — the most severe traumatic brain injury cases in our region.
Caring for severe head injury requires a carefully coordinated, highly collaborative effort — from the ambulance ride to diagnostic scans, to the operating room. John C. Lincoln neurologists, neuro-intensivists and neurosurgeons at our Level I Trauma Center work around the clock. With the help of CT scan and MRI technology, neurocritical care unit, along with an adjoining laboratory, we specialize in rapidly providing neurological assessments, diagnostic scans and necessary treatment.
Likewise, our Level I Trauma Center also strives to prevent traumatic brain injury in our community through programs that emphasize motorist safety.
Traumatic Brain Injury Treatment Options
As you might imagine, how we care for a head injury depends on its type and severity. Common procedures include ventilator support, ventriculostomy, medications and continuous monitoring of vital signs. Routine neurological assessments typically include taking reflexes, measuring responses to pain and reviewing the patient's mental state.
Ventriculostomy is one of our specialties. Ventriculostomy is a tool for measuring pressure inside the head and draining cerebrospinal fluid (CSF), if necessary, to decrease pressure within the brain. Sometimes, blood that may have leaked into the CSF is also drained. While ventriculostomy is not necessarily a new technology, it does require a certain level of competency and knowledge that many hospitals do not offer.
Regardless of how a patient is injured, patient care and education sets John C. Lincoln apart. Our nursing staff is regularly educated on new technologies and neurological assessment skills so that they can identify issues quickly and ensure swift and appropriate treatment.
We are the only facility in the state of Arizona to offer services of a UCNS certified neuro-intensivist. Care by this type of a specialist after brain trauma has been shown to improve outcomes and decrease mortality. The neuro-intensivist's tools include long-term EEG monitoring, direct brain oxygen monitoring, continuous ICP monitoring, transcranial doppler and hypothermia.
After injury, the brain frequently sets off on a vicious cycle of self-destruction due to swelling and decreases in oxygenation. This can sometimes lead to seizures and high fevers. Armed with these unique tools the neuro-intensivist can interrupt this vicious cycle and set the brain on its way to recovery.