Traumatic Brain Injury (TBI)

Classification of Traumatic Brain Injuries

Concussion

The mildest form of TBI. In concussion, there are no visible tissue damages, but the functioning of nerve cells is disrupted. Symptoms are usually reversible with proper therapy.

Brain Contusion

A more severe injury involving brain tissue destruction, small hemorrhages, and vascular damage. The course of the condition depends on the degree of contusion.

Brain Compression

Occurs due to the formation of an intracranial hematoma compressing brain tissue. Requires urgent surgical intervention.

Penetrating Injuries

Result from skull fractures with penetration of an object into the brain. These injuries are extremely dangerous and carry a high risk of infection.

Other Types of TBI

These include axonal injuries (a type of brain injury where axons — long projections of nerve cells that transmit signals between neurons — are damaged), open and closed skull fractures, and combined injuries.

Causes of Traumatic Brain Injuries

The causes of TBI can vary. Most often, they occur in road traffic accidents, falls, and blows during sports activities. Some cases are caused by domestic or occupational accidents, as well as acts of violence. In severe situations, TBI can be associated with natural disasters or industrial accidents.

Symptoms of Traumatic Brain Injuries

General Symptoms

• Loss of consciousness of varying duration;

• Headache;

• Nausea, vomiting;

• Dizziness;

• Memory and speech disturbances.

Symptoms of Concussion

Short-term loss of consciousness, disorientation, headache, photophobia, tinnitus.

Symptoms of Brain Contusion

Speech disturbances, paresis, seizures, prolonged loss of consciousness, pronounced neurological signs.

Symptoms of Brain Compression

Progressive deterioration after a “lucid interval,” pupil dilation, vomiting, and blood pressure drop.

Symptoms of Penetrating Injury

Bleeding, cerebrospinal fluid leakage, severe consciousness impairment, convulsions, critical patient condition.

Diagnosis of Traumatic Brain Injuries

Diagnostic Stages

Initial examination and assessment of consciousness using the Glasgow Coma Scale (GCS):

Eye Opening (E):
4 — spontaneous;
3 — to verbal command;
2 — to pain;
1 — none.

Verbal Response (V):
5 — oriented, answers appropriately;
4 — disoriented but answers;
3 — inappropriate words;
2 — incomprehensible sounds;
1 — none.

Motor Response (M):
6 — obeys commands;
5 — localizes pain;
4 — withdraws from pain;
3 — abnormal flexion (decortication);
2 — abnormal extension (decerebration);
1 — no movement.

Final score: GCS = E + V + M (maximum 15, minimum 3). 15 — clear consciousness; 13–14 — mild confusion; 9–12 — moderate impairment; 8 or below — coma.

Next, a neurological status assessment is conducted.

Instrumental Diagnostic Methods

• Computed tomography (CT);

• Magnetic resonance imaging (MRI);

• Skull X-ray;

• Electroencephalography (EEG).

Treatment of Traumatic Brain Injuries

Conservative Treatment

Prescribed for mild and moderate cases: bed rest, medications to improve cerebral circulation, and intracranial pressure control.

Surgical Treatment

Used for severe injuries: hematoma removal, craniotomy, restoration of bone structures.

Complications of Traumatic Brain Injuries

Coma

Occurs in severe brain damage and requires intensive care.

Long-term Neurological Disorders

Speech, movement, memory, and emotional disturbances.

Post-traumatic Syndrome

Chronic headaches, insomnia, irritability.

Other Possible Complications

Epilepsy, hydrocephalus, recurrent hemorrhages.

Rehabilitation After Traumatic Brain Injury

Rehabilitation Stages

Early stage in the hospital, followed by recovery in specialized centers.

Rehabilitation Approaches

Physical therapy, physiotherapy, cognitive therapy, speech therapy, and psychological support.

Prognosis and Prevention of Traumatic Brain Injuries

The prognosis depends on the severity of the injury, the patient’s age, and the timeliness of medical care. Prevention includes using seat belts and helmets, and following safety rules at work and home.

Treatment of Traumatic Brain Injuries in Russia

Clinics

Scandinavia Clinic (Saint Petersburg) — provides advanced neurosurgical care for TBI and operates under the principle of continuous patient observation from diagnosis to recovery.
MEDSI — one of the largest healthcare networks in Russia, offering modern diagnostics, treatment, and comprehensive rehabilitation for patients with various brain injuries.
European Medical Center (EMC, Moscow) — combines international TBI treatment protocols with experienced neurosurgeons and multidisciplinary teams.

Cost

The cost of treatment depends on the severity of the injury, the extent of surgical intervention, and the duration of rehabilitation. On average, the cost of hospitalization and therapy in leading Russian clinics ranges from $1,800 to $7,000.

MARUS Assistance

MARUS accompanies patients with TBI at every stage: from choosing a clinic in Russia to organizing hospitalization, medical consultations, and rehabilitation programs. The team helps clarify treatment costs, prepare documents, and provides support during recovery. This allows patients and their families to focus on healing rather than organizational concerns.