Traumatic Brain Injury: Frequently Asked Questions
Traumatic brain injury causes a disruption in the normal functioning of the brain. Abbreviated TBI, it isn’t just one condition. Instead, it covers a variety of injuries that lead to problems with brain function. Concussion is the most common TBI. It is a mild form that usually lasts a short time. Severe TBI can have lifelong effects and even cause death. Here are answers to some common traumatic brain injury questions.
What is traumatic brain injury?
Traumatic brain injury (TBI) is damage to the brain following trauma, such as a blow to the head. A blow causes the brain to move suddenly and forcefully within the skull. This primary injury damages the brain. It also causes secondary changes in cells, chemical signals and blood vessels in the brain. The cascade of secondary injuries leads to more damage and destruction of brain tissue.
What are the symptoms of traumatic brain injury?
Traumatic brain injury symptoms vary and can range from mild to severe, depending on the injury. They can also last for hours to days in mild injuries to months or years in severe ones. Possible TBI symptoms include:
- Headache, irritability and sensitivity to noise
- Loss of consciousness, convulsions or seizures
Sometimes, symptoms don’t occur for hours or days after the initial injury. So, you should always seek medical attention for a head injury, even if symptoms don’t show up immediately.
What causes traumatic brain injury?
Falls are the leading cause of traumatic brain injury. They account for about one-third to one-half of all TBIs. Other common causes include motor vehicle or traffic accidents, being struck by or colliding against an object (including sports injuries), and violent assault.
Any motion that causes whiplash, violent hits to the body, or violent shaking can cause TBI. This includes shaking a baby or small child. It also includes sports injuries, which account for about 21% of TBI in children and teens. The fluid that normally cushions the brain isn’t able to overcome such jarring forces. Brain tissue damage is the result. Depending on the amount of force, the damage can be mild, like a bruise, or severe with hemorrhaging and tearing of brain tissue.
What is the Glasgow scale?
The Glasgow Coma Scale (GCS) is a tool doctors use to assess the severity of a traumatic brain injury. It has three sections: eye opening response, verbal response, and motor response. The scores from each section are added to reach the GCS. A GCS of 13 to 15 is a mild head injury, 8 to 12 is a moderate head injury, and 8 or less is a severe head injury.
How common is traumatic brain injury?
According to the CDC (Centers for Disease Control and Prevention), at least 2.87 million TBIs occurred in 2014 in the United States. (This is the latest year the CDC has reported.) Of these cases, 837,000 involved children. These injuries lead to approximately 288,000 hospitalizations, of which 23,000 were children.
There are an estimated 13.5 million Americans living with some sort of disability from TBI. And each year, long-term or lifelong disability from TBI affects up to 90,000 Americans. Sadly, about 50,000 American die each year as a result of a TBI.
Who is most at risk of traumatic brain injury?
The age group at highest risk of traumatic brain injury are those 75 years of age and older. Very young children—ages 0 to 4 years—have the next highest risk, followed by young adults ages 15 to 24 years. Males account for nearly 80% of TBI occurrences.
Participating in contact sports is one of the main risk factors for TBI. About 10% of these athletes experience a concussion each year. Professional boxers have the highest risk; about 87% of them have sustained a TBI. Football also has a reputation for high rates of TBI. Among high school football players, 20% have a TBI each year. The rate falls to 10% for college players. Other high-risk groups include soccer players and active duty military personnel in war zones.
What treatments are available for traumatic brain injury?
Traumatic brain injury treatment strategies depend on the severity of the injury. Mild concussions may only require rest until symptoms resolve. This rest should be mental as well as physical by avoiding activities that require thinking and concentration. Standard recommendations include taking a break from watching TV, playing video games, reading, and using a computer, tablet or smartphone. In some cases, it’s necessary to shorten school or work days, or take time off completely.
For more serious injuries treatment may include:
- Medicines to treat headache, sleep problems, depression, and anxiety. Ask your doctor before taking over-the-counter pain relievers. Acetaminophen (Tylenol) is usually the safest choice because it doesn’t increase the risk of bleeding.
- Physical and occupational therapy
- Speech and language therapy
- Surgery to remove blood clots in the brain, relieve pressure on the brain, stop bleeding, or repair skull fractures
People with ongoing effects of TBI often deal with feelings of frustration and a lack of control over their lives. Counseling and support groups can provide a positive atmosphere to express these feelings and learn how to deal with them in a healthy way.
When TBI is severe, most people need some form of rehabilitation, or rehab. The level of rehab depends on the extent of the injury and disability. Some people will need extended stays at a rehab facility to relearn basic skills, such as walking.
What are the long-term effects of traumatic brain injury?
Traumatic brain injury can cause long-lasting effects if the injury is severe or after multiple injuries. After a single concussion, it’s rare to have persistent effects. However, people at high risk of concussion, such as athletes, are likely to sustain multiple concussions. This can lead to post-concussive syndrome, when symptoms last for months or even longer.
Long-term effects of TBI can include:
- Balance problems or vertigo
- Brain fog; slowed thinking; memory problems; or difficulty concentrating, understanding situations, or learning new things
- Chronic headaches
- Difficulty talking or with the senses, such as vision, hearing, smelling or tasting
- Personality or behavioral changes and changes in mood
What is the prognosis for traumatic brain injury?
It’s hard to predict who will sustain disability or traumatic brain injury symptoms years later and who will eventually recover. Recovery time and the future outlook depend on several factors, including the severity of the injury and your age and overall health. The full extent of the injury may not be apparent right away. It may require frequent follow-up visits and evaluations for a period of time afterwards.
People who have sustained a TBI play an important role in their recovery. Dedication to rest is vital. Returning to sports or activities too soon can lead to long-term complications. Never resume activities until your doctor clears you. If symptoms occur after you return, stop and seek medical care immediately.
Researchers are still studying the link between TBI and degenerative brain diseases, such as dementia and Parkinson’s disease. TBI seems to increase the risk of these diseases, but it isn’t currently possible to predict who will be affected.
How can you prevent traumatic brain injury?
People at high risk of traumatic brain injury can take safety precautions to help protect themselves. This includes:
- Exercising regularly to maintain and improve strength and balance
- Improving home safety for elderly people by removing rugs and other fall hazards and installing grab bars
- Making homes childproof with stair gates, bed rails, window guards, and furniture anchors
- Using a seatbelt, properly adjusting the head restraint, and correctly using car seats
- Wearing the right head protection with a proper fit for contact sports and recreational activities, such as biking and skiing