Traumatic Brain Injury

Traumatic brain injury is a leading cause of death and lifelong disability among younger populations in the United States. The Centers for Disease Control and Prevention has estimated that 1.5 million Americans survive a traumatic brain injury each year. This article will help you understand what traumatic brain injury is, its symptoms, and some common types of traumatic brain injuries. Additionally, this article will help you to begin to understand the long-term effects of traumatic brain injury and how you can restore the health condition of the patient.

An overview of traumatic brain injury 

Traumatic brain injury is a type of injury that occurs due to a mechanical force that gives the head/skull a great amount of impact. This can be a bump, a blow, a jolt, or any other impact that disrupts normal brain function. This impact diminishes the cognitive, psychological, and physical function of the body either temporary or, in more unfortunate cases, permanently. 

TBI is a brain injury that is primarily caused by a collision of the skull with any hard surface. The brain is a very delicate organ that is responsible for our conscious behavior. 

When the brain is hit by an external force the function gets disturbed and the brain stops responding. This is where the body feels the trauma. When the brain is physically damaged, the results can be mild to serious injuries like a temporary effect in brain cells, or internal bleeding and torn tissues. 

The treatment of the injury can be minimal, or it can involve other actions like – emergency surgery, medications, and even additional surgeries years later. If the victim requires rehabilitation, he or she must go through physical therapy, occupational therapy, speech therapy, vision therapy, and possibly more. Treatment is often determined by the type of injury sustained. 

Globally, traumatic brain injury has been a major cause of death and disability. Teenagers and old age people were more victims than adults. However, in recent years the medical field has set-up advanced diagnostic technologies and treatments that have decreased the death rate. 

Traumatic Brain Injury Statistics

Traumatic brain injury is a leading cause of death and disability among children and young adults in the United States. Each year an estimated 1.5 million Americans sustain a traumatic brain injury. The results of these traumatic brain injuries are startling:

  • 230,000 people are hospitalized and survive.
  • 50,000 people die.
  • 80,000 to 90,000 people experience the onset of long-term disability.

It is estimated that 5.3 million men, women, and children are living with a permanent TBI-related disability in the United States today.

It has been reported that falls (52%) and motor vehicle crashes (20%) were the second leading causes of traumatic brain injury hospitalizations. Additionally, among deaths resulting from traumatic brain injury-related deaths, motor vehicle crashes were the leading cause for persons aged 15-24, 25-34, and 75 and older.  Motor vehicle crashes were also the number one cause of TBI hospitalizations for individuals aged 15-44.

While the risk of sustaining a traumatic brain injury exists regardless of one’s age, this risk is highest among adolescents, young adults, and persons older than 75 years. Interestingly, the risk of TBI for males is twice that of females.

The major causes of TBI are:

  • Motor vehicle crashes: Motor vehicle crashes are the leading cause of traumatic brain injuries resulting in hospitalization.
  • Violence: Suicidal behavior and assaults that involve firearms are the leading cause of traumatic brain injury-related death.
  • Falls. Falls are the leading cause of TBI among elderly populations.

Traumatic brain injuries have both short-term and long-term effects on individuals, their families, and society. The financial cost of a traumatic brain injury is enormous. According to one study, the annual economic burden in the United States was approximately $37.8 billion in 1985.

For well over 5 million Americans living with a traumatic brain injury-related disability, the financial cost is only part of the burden. The long-term impairments and disabilities associated with traumatic brain injuries are massive. As these disabilities are not readily apparent to the public (such as is the case with a broken arm showing a cast), traumatic brain injuries are often referred to as the invisible epidemic. TBI-associated disabilities, arising from cognitive, emotional, sensory, and motor impairments, can permanently alter a person’s vocational aspirations and have profound effects on social and family relationships.

Prevention of Traumatic Brain Injuries 

Listed below are certain actions that you can take to minimize the likelihood of someone you love sustaining a traumatic brain injury. Many of these are obvious, but each is good to keep in mind:

  1. Always wear your seatbelt.  Wear your seatbelt every time you drive or ride in a motor vehicle.  If you see a passenger or driver not wearing his or her seatbelt – call them out on it. It is the law. 
  2. Do not drink and drive. Operating a vehicle under the influence of alcohol or other drugs is a frequent contributing factor in TBI crashes.
  3. Always use a reliable, current, unexpired child safety or booster. You must also ensure that the safety seat is installed properly. An improperly installed car seat can injure those it was designed to protect. Texas has specific laws regarding rear-facing, forward-facing, boosters, and adult safety belts. The American Association of Pediatric Medicine’s child passenger safety guidelines are available HERE.
  4. Prevent older adult falls. Falls are the number one cause of traumatic brain injuries among the elderly. Pay special attention to any medications that may make you sleepy or dizzy. Having your eyes and ears checked at least yearly can also help minimize falls.
  5. Wear helmets while riding motorcycles, bicycles, skateboards and any other wheeled vehicle. 
  6. Lighting. Make sure to provide enough lightning on dark stairs. 
  7. Removing Obstacles. Avoid playing on a rough surface or in any environment that has obstacles in the pathway. 

A definition of traumatic brain injury 

There is no common definition of traumatic brain injury as every medical practitioner has their own elaboration for the term. The reason behind that is – the term “brain injury” is often used as a synonym of head injury that may not be associated with neurologic deficits. 

Neurologic deficits involve an inability to speak, abnormal reflexes, walking problems, etc. This is because the brain, muscles, spinal cord and nerves become weak and function abnormally.  

Whereas, TBI is just an intracranial (within the skull) injury that occurs dues to external impact on the head. 

Symptoms of a traumatic brain injury 

Some symptoms of TBI can appear instantly after the accident and some symptoms can appear after a few days or weeks. TBI can affect the physical, sensory, and mental state of the body.  

Mild symptoms – 

Physical  

  • Loss of consciousness 
  • Dazed and confused without losing the consciousness 
  • Vomiting and nausea 
  • Headache 
  • Difficulty in sleeping 
  • Loss of balance or dizziness 
  • Speech problem 
  • Fatigue 

Sensory  

  • Sensitivity to sound and light 
  • Bad taste in the mouth 
  • Blurred vision 
  • Ringing in ear 
  • Unable to recognize common smells 

Mental or cognitive 

  • Low concentration 
  • Mood swings 
  • The feeling of anxiety and depression 

Moderate to Severe TBI Symptoms – 

These symptoms may appear in the first hour or first two-three days after the accident. 

Physical  

  • Unconscious for several hours. 
  • Severe headaches 
  • Seizures 
  • Continuous vomiting and nausea 
  • Dilatation of pupils 
  • Fluid running from nose and ears 
  • Numb fingers and toes 
  • Lack of coordination 

Mental or cognitive 

  • Intense confusion 
  • Unusual behavior or agitation 
  • Mumbled speech 
  • Consciousness disorder or coma 

TBI Symptoms in Children

  • Change in eating pattern 
  • Lack of attention 
  • Poor sleep habits 
  • Depression 
  • Loss of interest in toys and fun activities 
  • Persistent crying 

Classifications and types of traumatic brain injuries 

There are 5 classifications of TBI that are based on –  

1: Primary and Secondary Injuries  

Primary Injury – It occurs at the time of the accident when the mechanical force is applied to the head. 

Secondary injury – It occurs after a certain period of time, a few hours or a few days, not at the time of the injury.  

2: Focal versus Diffuse Injuries 

Focal injury – Occurs in a specific location of the brain. 

Diffuse injury – It occurs in a widespread area of the brain. 

3: Open and Closed Injuries 

Open Injury or Penetrating Injury – This type of injury occurs when a sharp object pierces into the brain. 

Closed Injury or Non-Penetrating Injury – The skull remains unbroken in this injury, however, it is the most common injury for physical and mental disability. 

4: Degree of severity 

Traumatic brain injuries are classified as mild, moderate, and severe. As discussed below, a traumatic brain injury can be as simple as a brief loss of consciousness. It can also extent to the severe, where a person is unconscious for more than 24 hours, may slip into a coma, or may enter a persistent vegetative state.

  • Mild 
    • Brief loss of consciousness, usually for a few seconds or minutes
    • Post-traumatic amnesia for less than one hour from the time of the traumatic brain injury
    • Brain imaging results are normal
  • Moderate 
    • Loss of consciousness for 1-24 hours
    • Post-traumatic amnesia for 1-24 hours from the time of the traumatic brain injury
    • Abnormal brain imaging results
  • Severe
    • Loss of consciousness or coma for more than 24 hours
    • Post-traumatic amnesia for more than 24 hours from the time of the traumatic brain injury
    • Abnormal brain imaging results.  

Severe traumatic brain injuries may also result in the following states:

  • Coma – a state of unconsciousness from which the patient cannot be awakened;
  • Vegetative state – a state in which the patient is not in a coma but is not aware of his or her environment;
  • Persistent vegetative state – a vegetative state that has lasted for more than one month;
  • Minimally conscious or minimally responsive state – a state in which a patient with a severe traumatic brain injury is no longer in either a coma or a vegetative state. In this state, the patient may interact with his or her environment or respond inconsistently.

5: Symptoms 

Traumatic brain injury diagnosis on the basis of symptoms is mentioned above with more information.  

Long-term effects of a traumatic brain injuries 

Depending on the nature of the injury, the affects from a TBI can last for months to an entire lifetime. Here are some long-term effects of TBI. 

  • Mood swings 
  • Concentration and memory loss 
  • Speech problem 
  • Coma or unconsciousness 
  • Loss of sensitivity in toes and fingers 
  • Seizure 
  • Partial paralysis 
  • Abnormal cognitive function 

Treatment of traumatic brain injuries 

Before the treatment of TBI, the patient must go through a procedure where a CAT or CT (computed tomography) scan is required to help diagnose and prepare a report of the medical condition of the patient. Once the examination is complete the treatment can begin. 

1: Surgical Treatment – This is an operation where TBI is treated and after that patient is monitored in ICU for further recovery. 

2: Medical Treatment – After the surgery, the patient is still vulnerable to secondary injuries.  In order to prevent these, his or her medical treatment in ICU becomes a priority.  

Unfortunately, the patients must go through surgery after a TBI because there is no medical treatment for the primary injury of TBI. 

3: Glasgow coma scale – The Glasgow Coma Scale is a scale that is used in medical service to evaluate the patient’s level of consciousness. This is mostly used in ICU for patients who suffer from a head injury. 

Rehabilitation following traumatic brain injuries 

Once the patient gets discharged from the acute-care hospital he or she can improve their health condition through rehabilitation therapy. Here are some rehab therapies that you can choose from according to your deficit needs. 

  • Speech and language therapy 
  • Physical therapy 
  • Psychological care 
  • Psychiatric care 
  • Social Support 
  • Occupational therapy 
  • Physical therapy 

Traumatic Brain Injuries in relation to Car Crashes. 

In 2014, a report mentioned that the leading cause of traumatic brain injury was by falling (people with 65 years of age and above), automobile accidents (Teen above 15-24, adults from 25-34 and adults below 75 years) and other head injuries. 

The second most common reason for TBI is motor accidents. It is the responsibility of the driver to be attentive while driving which means – following the lane, maintaining the speed limit, not driving under the influence of drugs or alcohol, etc. However, even people who keep everything in mind, also get into car accidents. 

The reason for the accident can also be an automobile defect. These defects include and are not limited to defective seatbelts, defective airbags, improperly designed roofs, defective brakes and acceleration pedal, defective child seat safety and many more. 

These defects are prime contributors to the causes of accidents on the road. The biggest culprit in this scenario is the manufacturing company or the dealer. If you prove 100% that it is the manufacturing defect that brought you or your loved ones into the accident, then it is time to take necessary steps against them. 

The victim can claim compensation if the accident happened due to the negligent behavior of the manufacturing company or aggressive driver who is responsible for the injury.