Traumatic Brain Injury

What is a traumatic brain injury (TBI)?

Traumatic brain injury (TBI) is a condition in which there has been an external force to the head that in some way injures the brain. It can therefore vary from a minor blow to the head with transient dizziness or lightheadedness to a life-changing brain injury due to major trauma.

Because TBI covers such a wide range of injuries, its effects, symptoms, and prognoses vary. These minor injuries frequently result in the treatment and release from hospital emergency departments. Another 230,000 people are hospitalized each year with TBIs. Of these people, 99,000 will show a lasting disability.

TBIs happen to males twice as often as they do to females, with males 15 to 24 years of age having the highest risk. This risk of TBIs also increases after age 60.

What causes TBIS?

The most common cause of TBI is motor vehicle accidents, accounting for almost half of all TBIs that require hospitalization. Sports or physical activity is the second most common cause, and assaults are third. For those who are over age 65, falls are the number one cause. Although they only make up a small number of the overall cases of TBI, the number of these injuries resulting from gunshot wounds has increased in recent years. Of these, nearly two-thirds are categorized as suicide attempts.

What should I look for after a TBI?

Any type of TBI ” no matter how minor it might appear ” should be taken seriously. If there is any loss of consciousness, no matter how brief, see a doctor as soon as possible. Even if unconsciousness does not occur, the several hours that follow the injury are still very important and you should watch for the following symptoms:

• Headache
• Slurred speech
• Restlessness
• Vomiting
• Increased drowsiness
• Change in pupils
• Confusion about the time or date
• Memory loss

If any of these symptoms occur, see a doctor immediately, for they could mean that the brain is bleeding or swelling.

What are the effects of a TBI?

The effects of a TBI vary in scope from full recovery to severe disability. For those who suffer a more severe TBI, gradual improvements in function can continue for up to 10 years after the injury. The most common impairing injuries affect three main aspects of a patient's life:

• Cognition: concentration, memory, judgment, mood, comprehension, and reasoning
• Movement abilities: strength, coordination, balance
• Sensation: tactile sensation and special sense, especially vision

Some patients with TBIs will experience behavioral effects, too, such as agitation, irritability, verbal or physical aggressiveness, anxiety, depression, and impulsivity. Occasionally, a TBI will result in seizure disorder (epilepsy).

If a TBI is suspected, the doctor will run a series of tests on the brain that can detect both physical changes in the brain, as well as function.

How can TBIS be prevented and managed?

While not all TBIs can be prevented, measures can be taken to reduce the risk of the injury. People who ride motorcycles without a helmet have twice the risk of TBIs than those who do wear helmets. Along the same lines, it is estimated that between 74 percent and 85 percent of all bicycle-related head injuries could be prevented with helmets. Airbags in cars have also been shown to reduce the number of TBIs. In the elderly, paying attention to fall prevention strategies may prevent TBI.

Recovery and management of TBIs are different for each individual injury. Regardless of the degree of injury, familial support is essential. Depending on the injury's severity, the health care team can involve nurses, neurologists, physicians, physical therapists, and the help of many other health care professionals.

Like any other condition, education about one's injury and the help of local support groups can be the greatest tools for managing TBIs and preventing further complications. For more information on traumatic brain injury, please go to the Brain Injury Association of America's website at www.biausa.org.