Traumatic Brain Injury A to Z - Classifications of TBI

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Classifications of TBI

The DVBIC is a group of fifteen TBI Programs in the Department of Defense and the Department of Veterans Affairs hospitals and two civilian TBI rehabilitation programs. These DVBIC sites work collaboratively to provide and improve TBI care for active duty military, veterans and their eligible beneficiaries.

There are a few different ways to categorize traumatic brain injuries. They can be grouped based on whether the injury is open or closed, whether the injury is located in a small, specific area, known as a focal injury, or occurring over a large area, called a diffuse injury. A third way to classify the brain injury is based on how severe the injury is.

A closed injury can occur when the head hits or is hit by an object, but the object does not break through the skull or protective covering of the brain. An open, or penetrating injury occurs when an object does break through the skull and the brain’s protective coverings.

How severe a TBI is, is based on the following three things:

  1. Loss of consciousness
  2. Loss of memory, and
  3. The Glasgow Coma Scale score

The Glasgow Coma Scale scores a person’s eye opening abilities, verbal responses and motor responses.

A mild Traumatic Brain Injury, or concussion, may cause a loss of consciousness or a loss of memory. A brain injury is classified as mild TBI or concussion when the patient experiences:

  • A loss of consciousness, if any, lasting for less than 30 minutes
  • Memory loss after the traumatic event, called post-traumatic amnesia or PTA, that lasts for less than 24 hours
  • A Glasgow Coma Score of 13 – 15

A brain injury is classified as Moderate TBI when the patient has:

  • A loss of consciousness that lasts for more than 30 minutes but less than 24 hours
  • Post-traumatic amnesia lasting for 24 hours to 7 days, or
  • A Glasgow Coma Score of 9 – 12

Patients with moderate TBI usually make a good recovery with treatment or learn to manage any problems that result from the injury.

A brain injury is classified as Severe TBI when the patient has:

  • A loss of consciousness that lasts for more than 24 hours
  • Post-traumatic amnesia lasting for 7 days or longer, or
  • A Glasgow Coma Score of 8 or less, which indicates that the patient is in a coma

Severe TBI is often caused by crushing blows or penetrating wounds to the head. These injuries can severely damage the brain. In many cases, it’s not possible to recover completely from a severe TBI.

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