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1. What is a traumatic brain injury?
If you experience any forceful contact to your head, and it disrupts your brain’s natural functions, then you’ve experienced a traumatic brain injury, or TBI. Your brain can be injured by other conditions, like infections or strokes, but those kinds of injuries are called “acquired brain injuries,” or ABIs. They can be just as life altering as a TBI.
Doctors classify TBIs as either mild, moderate, or severe. Since most TBIs are mild, many people who sustain a TBI find that their symptoms get better over time. In fewer but more serious cases of TBI, the effects of the damage can last a lifetime.
2. How many people have TBI?
It’s hard to imagine, but almost 1.6 million Americans sustain a TBI each year.1 Most people who are treated at an emergency room are released, but approximately 290,000 are admitted annually into the hospital. Additionally, each year, more than 50,000 die as a result of the TBI, and some 125,000 are permanently disabled as a result of the injury.2
Although we don’t know the number of people with TBI who aren’t seen in an emergency department, the Centers for Disease Control and Prevention estimates that at least 5.3 million Americans are permanently disabled as a result of a TBI — that’s nearly 2 percent of the population.3
3. What causes TBI?
The leading causes of TBI are:
- Falls (28%);
- Motor vehicle/traffic crashes (20%);
- Other events, like industrial accidents or sports-related injuries (19%)
- Assaults (11%).4
Blasts are a leading cause of TBI for active duty military personnel in war zones.5
4. Who is at highest risk for TBI?
- Males are approximately 1.5 times as likely as females to sustain a TBI.4
- The two age groups at highest risk for TBI are 0 to 4 year olds and 15 to 19 year olds.4
- Certain military duties increase the risk of sustaining a TBI.6
- African-Americans have the highest death rate from TBI.4
5. What are the costs of TBI?
TBI takes a big toll on the American economy — in 2000, it cost the US approximately $60 billion dollars overall. 7
The more severe the injury is, the more expensive it is to treat. If you were to experience a severe brain injury today, it would cost anywhere from $600,000 to $1.8 million dollars to care for you over your lifetime. If you’re a veteran, that cost could be much higher, since wartime TBIs are often accompanied by other injuries as well.
6. How does a TBI affect the brain and body?
When a TBI occurs, anything having to do with your brain is potentially affected. That means your basic body functions, like eating and sleeping, can be altered. It also means that the complex parts of your life — your emotions, your thoughts, and your ability to communicate — can also be disrupted.
In serious cases, TBI can also affect the brain’s electrical system, causing seizures. Such a condition is commonly known as epilepsy. TBI is also known to increase the risk for other conditions such as Alzheimer’s and Parkinson disease. 8,9
7. What are some common obstacles that arise after a TBI?
Treating TBI isn’t simple, and that creates many challenges for people with TBI and their families. In a 2006 report,10 the Institute of Medicine recognized the hardships that TBI creates and issued a report saying:
"…many people with TBI experience persistent, lifelong disabilities. For these individuals and their caregivers, finding needed services is, far too often, an overwhelming logistical, financial, and psychological challenge. Individuals with TBI-related disabilities, their family members, and caregivers report substantial problems in getting basic services, including housing, vocational services, neurobehavioral services, transportation, and respite for caregivers. Yet efforts to address these issues are stymied by inadequate data systems, insufficient resources, and lack of coordination. TBI services are rarely coordinated across programs except in some service sites. Furthermore, in most states, there is no single entry point into TBI systems of care."
Even long after an injury has happened, many people find that they require certain things that aren’t readily available. The most frequent unmet needs are:
- Improving memory and problem solving;
- Managing stress and emotional upsets;
- Controlling one's temper; and
- Improving one's job skills.11
8. What are some long-term effects of TBI?
Because the human brain is so complicated, it’s extremely difficult to predict the long-term effects of any TBI. Most cases of mild TBI will resolve over a course of time with minimal problems. In the case of more serious TBIs, a person can experience any number of changes over the course of months and years.
Many people with TBI have problems with basic cognitive skills. It’s hard for them to pay attention or concentrate, and they might have trouble learning new material. A TBI can also make you think more slowly, or cause you to get easily confused. Even insight — the ability to clearly perceive a situation — can be affected. People with TBI may become impulsive, or develop unusual habits. Things that were once easy — like talking and listening — may become difficult or impossible.
Because the brain regulates our emotional and psychological lives, TBI can substantially alter your sense of mental wellness. The TBI might cause a personality change, or introduce mental problems. A person with TBI may have mood swings, depression, irritability, aggression, or disinhibition.
Vision problems are a common side effect of TBI, as are changes in your other senses: smell, taste, touch, and hearing. Problems with balance, vertigo, and ringing in the ears are also common. In a small percentage of cases, seizures occur as a result of TBI and may involve a loss of consciousness and muscle contractions. In many cases, anticonvulsive drugs or surgical intervention may help to prevent or slow seizure activity.
In severe cases that affect the brain’s most basic functions, fundamental abilities can be altered or inhibited. Paralysis or spasticity (muscle tightening) can affect a person’s ability to move, swallow, or breathe. Digestive problems can arise, and hormonal changes may result. Women with TBI often experience menstrual difficulties.
With appropriate help, however, a person with TBI can find ways to cope with these difficulties.
Written exclusively for BrainLine by Michael Paul Mason. For more information about author and brain injury case manager Michael Paul Mason, go to www.michaelpaulmason.com.