Thomas Pearson, M.D. Neurology
Traumatic Brain Injury Can Escape Diagnosis, Cause Variety of Medical Issues
From the battlefield to the football field, traumatic brain injuries are a serious and potentially long-term threat to a fully functioning life. The aftermath of brain injury has been heartbreakingly evident in the continuing recovery of Gabby Giffords, who recently resigned her seat in the U.S. House of Representatives after suffering a gunshot wound to the head a year ago at a constituent meet-and-greet near a Tucson, AZ supermarket.
The former Arizona congresswomen's case is severe, but for many people who suffer from milder brain injuries, both the assault and its effects are much less obvious.
"Traumatic brain injury causes death and permanent disability, as well as an array of less serious health challenges that can affect how people function on a daily basis," says Donna Wood, Practice Leader of Clinical Operations at Quorum Health Resources (QHR)."With approximately 1.7 million people sustaining a traumatic brain injury annually, the condition is a serious public health issue in the United States."
To increase public awareness of brain research progress, The Dana Foundation holds a global Brain Awareness Week from March 12-18. Partner agencies including hospitals, schools and senior centers will hold events to promote Brain Awareness Week. The Dana Foundation provides grant support and educates the public about brain research.
The American Academy of Neurology defines traumatic brain injury—or TBI -- as an acquired medical condition caused by sudden trauma to the brain. Brain trauma can be caused by a violent blow to the head or by an object that pierces the skull and enters the brain tissue. TBIs can be diagnosed as mild, moderate or severe, depending on the extent of brain damage.
Of the 1.7 million who sustain traumatic brain injuries each year in the United States, 52,000 will die, according to the U.S. Centers for Disease Control and Prevention (CDC). Almost a third of all injury-related deaths involve a traumatic brain injury, and nearly 275,000 of those who experience a TBI are hospitalized. The CDC put the medical costs of traumatic brain injuries in 2010 at $11.5 billion, with an additional $64.8 billion in indirect costs, such as lost productivity.
"Each year, nearly 1.4 million Americans visit an emergency room due to traumatic brain injuries," says J.C. Blair Neurologist Thomas Pearson, M.D. "Fortunately, most TBI patients are treated and released. About 75 percent of these are considered mild brain injuries, which includes concussions."
Concussions often occur from playing high-impact sports such as hockey, football and soccer. The CDC estimates that U.S. recreation-related concussions may be as high as 3.8 million annually, affecting both males and females. The long-term effects of concussion are of increasing concern for athletes of all ages. Coaches, parents and others can learn more about how to prevent, recognize and treat concussions at www.orcasinc.com, a website that addresses many public health and education concerns.
Concussions can be difficult to recognize, even by medical professionals as symptoms may not be immediately obvious or severe. Symptoms may show up in less obvious places such as; physical and emotional problems, and disrupted thinking and sleeping. In rare cases, the injury can cause a life-threatening blood clot on the brain, which requires emergency attention. An example of the risk of an untreated concussion is the actress Natasha Richardson, who died in 2009 from a clot that resulted from what seemed to be a minor head bump on a ski slope.
After a bump, blow or jolt to the head or body, the CDC recommends seeking immediate medical attention if any of these symptoms are evident:
• Headache that intensifies or does not go away
• Weakness, numbness or decreased coordination
• Repeated vomiting or nausea
• Slurred or nonsensical speech
• Drowsiness or difficulty awakening
• One pupil -- the black part in the middle of the eye -- larger than the other
• Convulsions or seizures
• Difficulty recognizing people or places
• Confusion, restlessness or agitation
• Unusual behavior
• Loss of consciousness
• Inconsolable crying in children
• Refusal to nurse or eat in children
About 35 percent of brain injuries are the result of falls, particularly among children and seniors, according to the CDC. Another 17 percent stem from motor vehicle accidents, which also account for the most deaths. Nearly 17 percent of concussions occur when the head is struck by or against another object, and 10 percent of these are from assaults.
Traumatic brain injury among military personnel serving in active war zones is a serious problem since many enemy assaults use “improvised explosive devices”, referred to as IEDs. For active duty personnel, explosions are the leading cause of TBI. The CDC statistics do not include injuries tracked by the U.S. Department of Defense or Veterans Health Administration Hospitals. The U.S. Office of the Surgeon General has created a website for patients, family members and caregivers specific to military-related TBIs at www.TraumaticBrainInjuryAtoZ.org.
While a small number of brain injuries are catastrophic for the victim, almost all can be treated, according to the website www.BrainLine.org, which is funded by the Defense and Veterans Brain Injury Center. The initial challenge can be diagnosis of this so-called "invisible injury." Medical imaging tests can detect brain bleeding or obvious physical damage. Other screening tests can assess effects on speech, movement, memory and thought. The brain injury treatment team may include emergency room doctors, neurologists, rehabilitation therapists and psychologists. And since it can require a long recovery process, social workers and case managers often step in to help family and friends deal with a variety of challenging issues.
As research aimed at treating traumatic brain injury continues, those affected will have new hope for recovering and living a full life. The example set by Gabby Giffords has illustrated this promise and stands as an example of advances already made in treating what can be a life-changing condition.
For more information about traumatic brain injury and Brain Awareness Week, go to The Dana Alliance for Brain Initiatives at www.dana.org/danaalliances.
This article is provided courtesy of J.C. Blair Health System and Quorum Health Resources.