Brain Injury: How Bad Is It?

Knowing which area of the brain has been injured is important.

Knowing which area of the brain has been injured is important since each area of the brain controls different functions. Diagnostic exams and tests can be done to find general information about where the damage is located and how much damage has been done.

An MRI of the brain

These exams and tests can include some or all the following:

- A neurological exam is a series of questions and simple commands asked by the neurologist to see if the patient can open their eyes, move, speak, and understand what is happening around them. Examples are: “What is your name?” “Where are you?” “ What day is it?” “ Wiggle your toes.” “Hold up two fingers.”

- Regular xrays are pictures of bones which show if they are broken or fractured.

- A CT (CAT) Scan is a painless, special x-ray of the brain or other parts of the body.

- An MRI (Magnetic Resonance Imaging) Scan is a painless, but noisy, special x-ray that takes pictures of body tissues. An MRI can show a skull fracture and bleeding in or around the brain.

- An EEG (Electroencephalograph) is also a painless test where electrodes are attached to the head to measure the electrical activity of the brain.

- An angiogram is a study of the blood vessels of the brain. Dye is put into an artery that supplies blood to the brain. This test can tell if the arteries or veins are damaged.

- An ICP (Intracranial Pressure) monitor is a small tube placed through a small hole in the skull and directly into, or on top of, the brain. The ICP monitor measures pressure inside the brain. A craniotomy is done to drill a hole in the skull.

- The Glasgow Coma Scale (GCS) is an objective way of measuring the level of consciousness after a trauma by checking three types of responses—eye opening, motor responses (movements), and verbal responses (talking; knowing time, place, and who they are). The GCS is performed in the emergency room and intensive care unit to help decide the seriousness of the brain injury and the need for ICP monitoring. See more about the Glasgow Coma Scale below.

Glasgow Coma Scale

Certain scores on the Glasgow Coma Scale have significance. Patients with a Glasgow Coma Scale score of 7 or less are considered comatose. Patients with a Glasgow Coma Scale score of 8 or less are considered to have suffered a severe head injury.

*Decerebrate Posture is the position of a patient, who is usually comatose, in which the arms are rigidly straight and internally rotated and the legs are extended with the toes rigidly pointed. It is usually observed in patients afflicted by compression of the brainstem at a low level.