Approximately 1.5 million people suffer a traumatic brain injury (TBI) in the U.S. each year. About 50,000 die and 85,000 suffer long-term disabilities from TBI each year. The top three causes of TBI are motor vehicle accidents, firearms, and falls.
TBI is unlike other traumatic injuries in many respects. Recovery is functional in nature and depends on mechanisms that are uncertain. Each brain injury is unique, symptoms may appear days or weeks after the injury, and often the victim is not even aware that a brain injury has taken place.
There are two categories of TBI. If the duration of the loss of consciousness or disorientation was less than 30 minutes, it is generally considered “mild”. In such cases, a CAT scan or MRI may appear normal, but the victim often exhibits cognitive difficulties such as memory problems, attention deficits, difficulty thinking, headaches, mood swings, and overall frustration.
If a foreign object is lodged in the brain for over 24 hours, or if there was loss of consciousness for longer than 30 minutes, the victim has likely suffered severe brain injury. The resulting difficulties range from diminishment of higher-level cognitive functions to comas. The victim may lose the ability to think, speak, the ability to move arms and legs, or have emotional problems. Long-term rehabilitation will usually be necessary, and as with both mild and severe cases, there will often be a dramatic impact on the victim’s family, job, and community.
The leading types of TBI are:
Closed head injury – caused by direct or indirect, rotational or deceleration force to the head. The skull remains intact and is not penetrated
Open head injury – direct injury to the head with penetration of the skull
Diffuse axonal injury – axons make up the white matter in the brain. They project from the brain’s nerve cells and attach to other nerve cells. In motor vehicle accidents and shaking incidents, the rotational forces or rapid deceleration can shear the axons and disrupt them.
Contusion – a bruise to part of the brain
Penetrating trauma – skull fragments or other objects that enter the brain
Secondary injury – swelling of the brain in which the cerebrospinal fluid does not drain out of the skull, causing further intracranial pressure and brain damage. If not controlled, the brain can actually herniate, or push through, the base of the skull.
Acquired brain injury - injuries other than congenital, hereditary, birth trauma, or degenerative. Causes include drugs and poisoning. Non-traumatic instances (not considered TBIs) include hypoxia and anoxia, which are insufficient and lack of oxygen to the brain, often caused by breathing problems, cardiac arrest, or bleeding.
The best approach to dealing with TBI is prevention, as there is no cure.
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