Traumatic brain injury (TBI) occurs because of sudden damage to the brain. The American Association of Neurological Surgery explains that TBI “is a disruption in the normal functioning of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters brain tissue.” When the brain collides with the inside of the skull it can cause the brain to bleed, bruising the brain, and/ or tearing of nerve fibers. In situations where the skull is broken, a piece of the skull could penetrate brain tissue. Surgery may be necessary to limit additional damage to the brain tissue and most effectively address certain problems (e.g., bleeding in the brain, repairing skull fractures, removing clotted blood, relieving pressure inside the skull by opening a window in the skull, etc.). There are several different types of surgical intervention that may be performed to treat a head injury, including but not limited to the following:
- Endoscopic third ventriculostomy (EVT): a surgical procedure performed to drain extra cerebrospinal fluid (CSF), which is the fluid that surrounds one’s brain and spinal cord, from the brain.
- Ventriculoperitoneal Shunt Surgery (VPS): a surgical procedure that primarily treats a condition called hydrocephalus, which occurs when excess CSF collects in the brain’s ventricles. A ventriculoperitoneal shunt which is a medical device used to relieve pressure on the brain caused by fluid accumulation is surgically placed in the brain to help drain CSF and redirect it to another location in the body where it can be reabsorbed.
- Craniotomy: an operation to open the skull to access the brain for surgical repair.
- Decompressive craniectomy: a surgical procedure in which part of the skull is removed to allow the brain to swell without being squeezed.
- Cranioplasty: the surgical repair of skull fractures or deformities.
The type of surgery selected will be informed by a variety of factors, including the type of injury, the severity of the injury, as well as the area of the brain that was injured. Surgeons must also consider the fact that for some, a TBI may only affect the exact location of the brain where the injury occurred, while for others a TBI could also affect surrounding tissues and cause damage to one’s brain in other areas apart from the initial site. Surgery after a head injury can save a life if performed early enough.
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