Brain & Spine Trauma in Adults
A traumatic injury to the brain or spine can happen in an instant — and its effects can last a lifetime. Whether the result of a motor vehicle accident, a workplace injury, a fall, or a sports collision, brain and spine trauma in adults requires immediate, expert evaluation to minimize damage, prevent complications, and preserve neurological function.
At Advanced Neurosurgery Associates, our neurosurgeons provide specialized care for adult patients with brain and spine trauma across four New Jersey locations. We bring advanced surgical expertise to even the most complex cases, working alongside emergency teams, neurologists, and rehabilitation specialists to deliver comprehensive care at every stage of recovery.
How Adult Brain & Spine Trauma Differs from Pediatric
While many of the injury types overlap between children and adults, the clinical picture in adult patients is shaped by different factors. Adults are more likely to sustain trauma from high-energy mechanisms such as motor vehicle accidents, motorcycle crashes, and falls from significant height — as well as occupational injuries and assault.
Age-related changes also matter. As the brain naturally shrinks with age, bridging veins become more stretched and vulnerable, making older adultsparticularly susceptible to subdural hematomas even from relatively minor falls. Degenerative changes in the spine — such as arthritis, disc disease, and spinal stenosis — can dramatically worsen the outcome of spinal trauma, turning what might be a minor injury in a younger person into a surgically significant event in an older one.
These factors make adult-specific neurosurgical expertise essential in evaluating and managing neurotrauma across
all age groups.
Types of Brain Trauma We Treat
Traumatic Brain Injury (TBI)
The overarching term for any brain injury resulting from an external force. In adults, the most common causes include motor vehicle and motorcycle accidents, falls — particularly in adults over 65 — workplace injuries, sports collisions, and assault. TBI severity ranges from mild concussion to severe, life threatening injury involving bleeding, swelling, and structural brain damage. Early neurosurgical assessment is critical across the full spectrum.
Concussion
A mild TBI caused by a blow or jolt to the head that temporarily disrupts normal brain function. In adults, concussion is particularly common among contact sport athletes, military personnel, and victims of motor vehicle accidents. While most adults recover with appropriate rest and management, recurrent concussions — especially those that are inadequately managed — can lead to prolonged post-concussion syndrome and long-term neurological consequences. ANA evaluates adults with concussion to exclude more serious pathology and guide evidence-based recovery.
Skull Fractures
Skull fractures in adults result from high-energy impacts and range from simple linear fractures to complex depressed or basilar fractures involving the skull base. Unlike in children, adult skulls are less pliable and more likely to fracture in patterns that involve underlying vascular structures. Basilar skull fractures carry particular risk of cerebrospinal fluid leakage, meningitis, and cranial nerve injury. Surgical repair is required in select cases depending on fracture type and associated injuries.
Epidural Hematoma
Occurs when arterial bleeding — most commonly from a torn middle meningeal artery — accumulates between the skull and the dura mater following a skull fracture. In adults, epidural hematomas classically present with a lucid interval: a brief period of apparent recovery following the initial injury before rapid neurological deterioration. This is a neurosurgical emergency requiring prompt CT imaging and, in most cases, urgent surgical evacuation.
Subdural Hematoma
The most common traumatic intracranial hemorrhage in adults, with incidence increasing significantly with age. Acute subdural hematomas from high-energy trauma are among the most surgically urgent brain injuries. Chronic subdural hematomas, which accumulate slowly over weeks and are common in older adults following even minor head impacts, may present with subtle symptoms including headache, confusion, and gradual cognitive decline. Both forms frequently require surgical drainage.
Diffuse Axonal Injury (DAI)
Results from high-speed rotational or deceleration forces — typically in severe motor vehicle crashes — that cause widespread disruption of nerve fibers deep within the brain. DAI is a major cause of prolonged unconsciousness and persistent neurological deficits following trauma. Often underdiagnosed on CT alone, it requires MRI for full characterization. Management is primarily supportive and intensive, with neurosurgical involvement in monitoring and managing intracranial pressure.
Types of Spine Trauma We Treat
Cervical Spine Injuries
Among the most consequential injuries in adult trauma, carrying significant risk of spinal cord damage and paralysis. Common causes include motor vehicle accidents, diving injuries, and falls. In older adults, pre-existing degenerative changes such as cervical stenosis can amplify the severity of even low-energy injuries, causing central cord syndrome — a pattern of weakness and sensory loss disproportionately affecting the arms — from relatively minor hyperextension forces.
Thoracic & Lumbar Spine Fractures
Fractures of the mid and lower spine are common in adult trauma, particularly from high-energy mechanisms like motor vehicle accidents and falls from height. Compression fractures, burst fractures, and fracture-dislocations each carry different implications for spinal stability and cord or nerve root involvement. Surgical stabilization is indicated when fractures are unstable, involve neurological compromise, or fail to respond to conservative management.
Spinal Cord Injury (SCI)
Traumatic spinal cord injury in adults can result in partial or complete loss of motor function, sensation, and autonomic function below the level of injury. The urgency of surgical decompression and stabilization is a critical determinant of neurological outcome — time from injury to surgery matters significantly. Our team works urgently to evaluate and intervene when SCI is present or at risk, and coordinates with rehabilitation medicine to support long-term recovery.
Degenerative Spine & Trauma
A distinguishing feature of adult spine trauma is the frequent presence of underlying degenerative spine disease. Conditions such as cervical or lumbar stenosis, herniated discs, and facet arthropathy can convert a low-energy injury into a complex surgical case. Our surgeons are experienced in navigating the intersection of acute trauma and chronic spine disease to develop treatment plans that address both simultaneously .
Diagnosis
Adult neurotrauma evaluation begins with rapid clinical assessment and neuroimaging. CT scanning remains the frontline tool for identifying fractures, hemorrhage, and mass effect. MRI provides essential detail for soft tissue injuries, spinal cord assessment, and diffuse axonal injury. In select cases, CT angiography is obtained to evaluate for traumatic injury to the carotid or vertebral arteries. Our team interprets imaging findings within the full clinical context to guide timely decision-making.
Medication
At least half of those newly diagnosed with epilepsy will become seizure-free with their first medication—if they take it regularly and as prescribed. The efficacy of these medications of course depends on the type and severity of the epilepsy. In some cases, medication may diminish but not completely control all seizure activity.
Many various types of anticonvulsant (also called antiepileptic) drugs are available. Some patients respond to one drug and some may need more than one. It may take several months before the best drug and dosage are determined. Patients are monitored throughout the medication process via blood tests.
Diet
A ketogenic diet, one which supplies the majority of calories from fat as opposed to glucose, mimics the body’s response to starvation by burning fat for energy. Scientists are not precisely sure why this diet prevents seizures, although it is being studied. Estimates vary from 10-30% of children who try it become seizure free, or almost seizure free. And over half who try it gain a 50% reduction in seizures. The remainder do not respond or are unable to tolerate the diet because of side effects.
Treatment
Treatment ranges from non surgical monitoring and medical management for stable injuries to urgent surgical intervention for those requiring hematoma evacuation, spinal decompression, or stabilization. Where surgery is indicated, our neurosurgeons employ advanced techniques including minimally invasive approaches where appropriate, intraoperative imaging, and neurophysiological monitoring to maximize safety and precision.
Every treatment plan is individualized, clearly explained, and developed in direct collaboration with the patient and their family.
Expert Neurosurgical Care Across New Jersey
Advanced Neurosurgery Associates serves adult trauma patients from four conveniently located offices across New Jersey — in Rutherford, Jersey City, New Brunswick, and Morristown. Whether you require urgent neurosurgical consultation, post-acute evaluation following a traumatic injury, or a second opinion on a recommended surgical approach, our team is here to help.
brain or spine injury Care Across New Jersey
If you or a loved one has sustained a brain or spine injury and requires expert neurosurgical evaluation, contact us today.