Traumatic brain injuries (TBIs) are sudden and acute damage to the brain caused by a fall, motor vehicle accident, a jolt to the body, sports injury, blast (explosion) injury, or assault. Because TBIs can result in disability or death, they are a major public health concern in the United States. According to the Center for Disease Control and Prevention (CDC), from 2006-2014, the number of TBI-related emergency department visits, hospitalizations, and deaths increased by 53%. That is 2.87 million TBI-related ER visits, hospitalizations, and deaths. Over 837,000 of these injuries were children.Total TBI deaths were 56,800 people (2,529 of those deaths were children). In 2014, an average of 155 people died each day from TBI injuries.
Trauma can be classified as either impact or non-impact. Impact trauma occurs when the head makes direct contact with objects. Non-impact trauma is force from either blast waves caused by an explosion or rapid acceleration and deceleration from a vehicle. Non-impact injuries are commonly seen in the military. Injury severity, type and location, and an individual’s age and gender, all play a role in the outcomes of a TBI, because people experience TBIs differently. Patients with TBIs may have either temporary or permanent impairment of cognitive, physical, and psychosocial functions.
The classification of TBIs as mild, moderate, or severe is based on the Glasgow Coma Scale (GCS) that scores patients’ neurological function of their clinical symptoms. The GCS measures three functions: eye movement, verbal response, and motor response. The initial GCS and the severity of the TBI help predict the probability of death from the injury. The mortality (death) rate increases the more the GCS score decreases. According to the GCS, a range between 13-15 indicates a mild TBI; a range between 9-12indicatesa moderate TBI ; and a GCS of 8 and below indicates a severe TBI. Mild TBIs may cause concussions and patients may have dementia later in life as a result. Mild to moderate symptoms usually reverse within a few days to weeks after the injury. Sometimes injuries can produce long-term cognitive and behavioral deficits. Consequently , patients who have repeated mild TBIs can have Chronic Traumatic Encephalopathy (CTE). Severe TBIs may have significant risk factors that can be the source of Alzheimer’s disease, Parkinson’s disease, and possibly Amyotrophic Lateral Sclerosis (ALS).
TBIs can be limited to one or multiple areas of the brain. Some injuries are primary, meaning that injuries can occur immediately. Other injuries are secondary, which means they occur slowly over time (hours, days, or weeks). Therefore, the first 24-hours after a mild TBI are important because hematomas (bleeding on the brain) and brain swelling are possible and can cause further damage. For this reason, healthcare providers recommend watching injured persons for the following indications: unexplained sleepiness or drowsiness; loss of consciousness; fainting; changes in mood, behavior, or personality; changes in their eyes (one pupil may be dilated and the other pupil constricted, or eyes rolled back into the head); headaches; swelling at the injury site of the head or neck; difficulty concentrating; memory loss;difficulty breathing;fluid leaking from ears, eyes, or nose; difficulty speaking; a change in vision; and nausea or vomiting. If any of these symptoms occur, please call 911 and seek medical attention immediately.
Accidents are inevitable; however, traumatic brain injuries can be prevented. Here are some ways:using a seat belt in a motor vehicle; wearing a helmet while bicycling, skateboarding, or playing sports (football, baseball, softball, hockey, etc.); never driving after drinking alcohol; installing handrails on stairways; and placing nonslip mats in bathtubs.
References
Arloo, (2019). Brain Injury word cloud on a white background [ Illustration]. Retrieved from https://www.shutterstock.com/image-illustration/brain-injury-word-cloud-on-white-699589258?src=fb115e7a-4df0-4a3c-b3bc-b76ab948c2ef-1-6
CDC. (2019). Traumatic Brain Injuries and Concussions. Retrieved from https://www.cdc.gov/traumaticbraininjury/get_the_facts.html
Fehily, B., & Fitzgerald, M. (2017). Repeated Mild Traumatic Brain Injury: Potential Mechanisms of Damage. Cell transplantation, 26(7), 1131–1155. doi:10.1177/0963689717714092