Traumatic Brain Injury

According to CDC, it is estimated that at least 1.4 million people in the United States are affected by traumatic brain injuries (TBI) every year.

Among them:

50,000 people die

235, 000 are hospitalized

1.1 million are treated for TBI and discharged from an emergency department.

Every year 475,000 cases of TBI occur in children aged from 0-14 years and 90 of TBI that occur every year are concussions or other forms of mild TBI.

Head injuries are twice as common in men as in women.

Males also account for two thirds of childhood and adolescent TBI. The great majority of head injuries are caused by road-traffic accidents, falls, sports and assaults, but the proportion of injuries due to each cause varies according to age group.

Falls and domestic accidents are much more common in the elderly, whereas assaults, sports injury & industrial injuries are more common in younger men. TBI hospitalizations are highest among African Americans and American Indians.

According to National Head Injury Foundation, causes of minor head injury are:

a. Motor vehicle accident - 28

c. Sports - 18

e. Struck by/against events - 19 of the cases of TBI. Motor vehicle accidents account for 64 of these cases, the driver was under the influence of alcohol.

There are many different causes that could result in traumatic brain injury.

It is very important to know about the cause of TBI. This is because the same cause would have resulted in other injuries as well and it is also important in the medico legal point of view.

The major causes of head injuries are:

Road traffic accidents

Domestic accidents

Sports injury

Assault, warfare & civil violence

Recreational accidents

Industrial accidents

Alcoholism

Epilepsy

Road-traffic accidents

Road-traffic accident is the most common cause of severe head injury. It may cause multiple injuries in the same person. If the person is trapped inside the vehicle and if the medical attention is delayed, his brain injury may get worsened. This is due to respiratory impairment and excessive blood loss which reduce the oxygen supply to brain.

Motor cycle riders & pedal cyclists are more likely to suffer from severe head trauma than those who drive cars and bigger vehicles. Cycling accidents occur more frequently on main roads particularly at road junctions. Provision of cycle lanes, wearing helmet while riding can reduce the incidence of head injury.

Alcohol and head injury

Alcohol is an important factor in traumatic brain injury. It is responsible for head injuries that result due to falls, assaults and road traffic accidents. But irrespective of the cause of injury alcohol intoxication is associated with a higher incidence of head injury. Moreover assessing the severity of head injury is difficult in person who is inebriated. The conscious level cannot be ascertained properly. Moreover, the injured person may get aspirated during vomiting which occurs as a result of head injury.

Sports injury

Sports injuries account for 20-30% of head injury in children & adolescents. Horse riding is the single most dangerous sport in the context of head injury. Blunt head injuries are more common in contact sports such as football, hockey & rugby caused by clashes of heads and kicks. In golf it occurs due to swinging of the club. Head injury is the most common cause of death in climbing accidents.

Other causes

Domestic accidents and falls are more common in older patients. Industrial injuries are seen frequently amongst younger age group.

Fire arm use is also an important cause of TBI. Gun shots and blasts are also the leading cause of death due to TBI in military personnel.

Traumatic brain injuries (TBI) can have a serious impact on many aspects of the human body's ability to function normally, including a person's ability to maintain balance.

A TBI is defined as brain damage caused by a severe trauma to the head and can cause a large number of problems. Balance impairments (also sometimes called balance dysfunctions or balance disorders) are common for some following a TBI.

One unexpected aspect of this problem is that compared to other medical conditions that can cause balance impairments (such as strokes or seizures), there has been relatively little study into the effects of brain injury on balance. Fortunately however, this is changing.

Symptoms of Balance Disorders

Balance disorders occur, at least temporarily, in nearly all people who have suffered a TBI. This instability can exist even when neurological tests do not detect any problems.

Symptoms common to balance impairments can include:

* Feeling dizzy, lightheaded, woozy or a sensation of spinning (vertigo)

* Burred vision

* Falling or unsteady gait (feeling of falling)

Diagnosing Balance Disorders

Maintaining balance is a complex multifunctional process that involves interplay between three systems:

Vestibular system (the inner ear balance organs)

Visual system (eyes)

Somatosenory system (joint and muscle receptors or sensors)

Normally, the brain receives and processes information about the environment and these systems work together to control balance. The primary test that is used to assess balance impairment is the Sensory Organization Test (SOT), which is conducted by evaluating each of the the three balance systems. Balance Impairment and Severity of Traumatic Brain Injury

The severity of TBI is determined using several measures such as:

Glasgow Coma Test

Length of unconsciousness (time in a coma)

Length of post-traumatic amnesia (PTA)

For TBI patients beginning rehabilitation, there is a significant relationship between TBI severity and degree of sitting and standing balance impairment. Patients with more severe TBI ratings also have more impaired balance ratings.

Recovery from Balance Disorders Caused by Traumatic Brain Injury:

A study at Wayne State University found that the degree of balance impairment for brain-damaged patients (specifically sitting balance impairment), measured at time of admission to rehabilitation can predict the Functional Independence Measure (FIM) at discharge. FIM illustrates how well patients recovering from a TBI can live independently after they are discharged. The relationship between balance impairment, brain injury severity, the prognosis for recovery from a TBI is underscored by this study.

For cases of mild traumatic brain injury in which there was no loss of consciousness and no clinically detectable problems, balance impairments (as measured by performance on the Sensory Organization Test), usually last from 3 to 10 days. However, subtle balance impairments that are harder to detect, such as abnormally high reliance on vision for maintaining balance, can persist for months or years.

Treatment for TBI balance disorders may include balance retraining exercises, general exercise, and certain drugs. Recovery takes time and recovery times vary. Some brain-injured people require assistance for years.

Further Information Regarding Traumatic Brain Injury

Blast Induced Traumatic Brain Injury and Vestibular Pathology in US Military
Physical therapists are calling for definitive vestibular screenings and assessment measures for US military service members with blast-induced traumatic brain injuries (BITBI).

Brain Tissue Regenerated in Traumatic Brain Injuries
Biomaterial gel made up of both synthetic and natural sources has the potential to spur the growth of a patient's own neural stem cells in the body, structurally repairing the brain injury site.

Traumatic Brain Injuries and Dependencies
Following a traumatic brain injury, the survivor may become dependent upon those close to them. These dependencies may be emotional in nature or based on a substance abuse. Whatever dependency is involved, it can lead to difficulties in recovering from the injury.

Role of Glutamate in Traumatic Brain Injury
Close to 1.5 million cases of traumatic brain injury (TBI) occur in the United States every year. Approximately 5.3 million people live with a TBI-related disability and an additional 60,000 people die annually from TBI. Brain injury is the ultimate cause of death in 40 percent of all fatal trauma cases. Head trauma remains the leading cause of death and severe disability in young adults.

Blood Test for Brain Injuries
A blood test that can help predict the seriousness of a head injury and detect the status of the blood-brain barrier is a step closer to reality, according to two recently published studies involving University of Rochester Medical Center researchers.

Relationships Following a Brain Injury
Following a brain injury, dynamics change. The relationship is no longer equal - you are no longer partners in the same sense you were before the injury. Initially it becomes almost like a parent-child relationship where the survivor becomes dependent upon their healthy partner.

Traumatic Brain Injury Survivor Story
The results from these tests were given to my parents. They were told that due to the extent of my traumatic brain injury I would probably not be able to succeed beyond high school. These results were never shared with me, until after I obtained my Master's Degree in Rehabilitation Counseling. The accident happened in 1967. At that time, there was a limited understanding into neurological rehabilitation, at least in my circumstances.

Treating a Traumatic Brain Injury
TBI can range from mild to severe but some victims often don't ever recover from the serious side effects associated with TBI. Luckily, with advances in technology a breadth of emerging alternative treatments and research methods are being developed to help lessen and even cure the ill effects of a severe brain injury.

Traumatic Brain Injury in the Military
Though military service does expose personnel to the risk of a penetrative brain injury, such as caused by a bullet or shrapnel, an even greater risk exists for a TBI caused by a concussive blast wave as a result of an explosive. The high occurrence of explosions due to improvised explosive devices (IEDs) in combat theaters such as Iraq and Afghanistan means American troops in the field are at a high risk of incurring a TBI.

Preventing Traumatic Brain Injuries
Age, gender, genetic history - all statistical information that could play a part into whether an individual is more or less at risk for a traumatic brain injury (TBI), a top injury affecting millions of Americans each year. Researchers are using statistics to better understand if a link may exist between demographics and TBI.