Traumatic Brain Injury

Traumatic Brain Injury
A traumatic brain injury (TBI) is caused by a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.

How many people have TBI?  TBIs contribute to a substantial number of deaths and cases of permanent disability annually.

Of the 1.4 million who sustain a TBI each year in the United States:

50,000 die;
235,000 are hospitalized; and
1.1 million are treated and released from an emergency department.1

Among children ages 0 to 14 years, TBI results in an estimated:

2,685 deaths;
37,000 hospitalizations; and
435,000 emergency department visits annually.1
The number of people with TBI who are not seen in an emergency department or who receive no care is unknown.

What causes TBI?

A traumatic brain injury (TBI) is caused by a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.

The leading causes of TBI are:

Falls (28%);
Motor vehicle-traffic crashes (20%);
Struck by/against events (19%); and
Assaults (11%).1

 Falls

Falls are the leading cause of TBI; rates are highest for children ages 0 to 4 years and adults ages 75 years and older.

Motor Vehicle-Traffic Crashes

Motor vehicle-traffic causes result in the greatest number of TBI-related hospitalizations.
The rate of motor vehicle-traffic-related TBI is highest among adolescents ages 15 to 19 years.

Struck By/Against Events

Struck by/against events, which include colliding with a moving or stationary object, are the third leading cause of TBI.
Approximately 1.6 – 3.8 million sports- and recreation-related TBIs occur in the United States each year.2 Most of these are mild TBIs that are not treated in a hospital or emergency department.
Assaults

Firearm use is the leading cause of death related to TBI.3
Nine out of 10 people with a firearm-related TBI die.3
Nearly two thirds of firearm-related TBIs are classified as suicidal in intent.3
Blasts are a leading cause of TBI for active duty military personnel in war zones.4


What are the signs and symptoms of TBI?

The signs and symptoms of a traumatic brain injury (TBI) can be subtle. Symptoms of a TBI may not appear until days or weeks following the injury or may even be missed as people may look fine even though they may act or feel differently.

The following are some common signs and symptoms of a TBI:

Headaches or neck pain that do not go away;
Difficulty remembering, concentrating, or making decisions;
Slowness in thinking, speaking, acting, or reading;
Getting lost or easily confused;
Feeling tired all of the time, having no energy or motivation;
Mood changes (feeling sad or angry for no reason);
Changes in sleep patterns (sleeping a lot more or having a hard time sleeping);
Light-headedness, dizziness, or loss of balance;
Urge to vomit (nausea);
Increased sensitivity to lights, sounds, or distractions;
Blurred vision or eyes that tire easily;
Loss of sense of smell or taste; and
Ringing in the ears.1

Children with a brain injury can have the same symptoms as adults, but it is often harder for them to let others know how they feel. Call your child’s doctor if they have had a blow to the head and you notice any of these symptoms:

Tiredness or listlessness;
Irritability or crankiness (will not stop crying or cannot be consoled);
Changes in eating (will not eat or nurse);
Changes in sleep patterns;
Changes in the way the child plays;
Changes in performance at school;
Lack of interest in favorite toys or activities;
Loss of new skills, such as toilet training;
Loss of balance or unsteady walking; or
Vomiting.
 
If you think you or someone you know has a TBI, contact your health care provider. Your health care provider can refer you to a neurologist, neuropsychologist, neurosurgeon, or specialist in rehabilitation (such as a speech pathologist). Getting help soon after the injury by trained specialists may speed recovery.


What are the long-term outcomes of TBI?

CDC estimates that at least 5.3 million Americans, approximately 2% of the U.S. population, currently have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI.

TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.

The severity of a traumatic brain injury (TBI) may range from “mild,” i.e., a brief change in mental status or consciousness, to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.

The following can be affected:

Thinking (i.e., memory and reasoning);
Sensation (i.e., touch, taste, and smell);
Language (i.e., communication, expression, and understanding); and
Emotion (i.e., depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).2

TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.

About 75% of TBIs that occur each year are concussions or other forms of mild TBI.

Repeated mild TBIs occurring over an extended period of time (i.e., months, years) can result in cumulative neurological and cognitive deficits. Repeated mild TBIs occurring within a short period of time (i.e., hours, days, or weeks) can be catastrophic or fatal.

The following general tips can aid in recovery:

Get lots of rest. Don't rush back to daily activities such as work or school.
Avoid doing anything that could cause another blow or jolt to the head.
Ask your doctor when it's safe to drive a car, ride a bike, or use heavy equipment, because your ability to react may be slower after a brain injury.
Take only the drugs your doctor has approved, and don't drink alcohol until your doctor says it's OK.
Write things down if you have a hard time remembering.
You may need help to re-learn skills that were lost. Your doctor can help arrange for these services.5



What are the costs of TBI?
Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $60 billion in the United States in 200