Traumatic Brain Injury (TBI)

What's the Problem?

A Traumatic Brain Injury (TBI) usually results from a blow or jolt to the head that can disrupt the normal function of the brain. The severity of the injury may range from mild—a brief change in mental status or consciousness—to severe—extended periods of unconsciousness (30 minutes or more), prolonged amnesia after injury, or a penetrating skull injury. Severe TBIs can result in death and all levels of TBI have the potential to cause short- and long-term disabilities. The leading causes of TBI are motor vehicle crashes, falls, and firearms.

Each year an estimated 1.5 million Americans experience a TBI, which is 8 times the number of people diagnosed with breast cancer and 34 times the number of new cases of HIV/AIDS. Of these people, 80,000 – 90,000 experience the onset of long-term or lifelong disability as a result of their TBI. Approximately 50,000 TBI deaths occur each year.

Who's at Risk?

Males are about twice as likely to incur a TBI as females. The two age groups most at risk for TBI are persons between the ages of 15 to 24 and individuals over 75. African Americans have the highest death rate from TBI. In children ages 0 to 14, unintentional injury is the leading cause of death and TBI is the type of unintentional injury most often associated with death.

Many types of impairments or disabilities may occur as a result of TBI and affect one's: mental capabilities (concentration, memory, judgment, and mood), movement abilities (strength, coordination, and balance), sensation (tactile sensation and senses like vision), and emotion (instability and impulsivity).

Can It Be Prevented?

Yes. Measures can be taken to decrease the chances of experiencing a TBI by changing behavior to improve one's safety. The major causes of TBI are motor vehicle crashes, falls, firearm violence, and sports/recreation activities. An example of appropriate safety precautions is wearing your seat belt or using child passenger safety seats in motor vehicles. In the event of a crash, these measures can reduce the chance of someone experiencing a TBI. Other steps that can be taken to prevent TBI include wearing a helmet when bicycling and skateboarding, taking precautions in the work place, and wearing proper protective gear when playing sports.

It is also important to recognize the symptoms of TBI and to visit a doctor if one has experienced a blow or jolt to the head. Some common symptoms associated with TBI are forgetfulness, problems concentrating, low-grade headaches that won't go away, loss of balance, and lack of energy.

The Bottom Line

• Take the time and make the effort to protect your brain (i.e. wear helmets, buckle up, follow sporting rules, etc.).
• Pay attention to incidents in which you or someone you know may have experienced a blow or jolt to the head.
• Remember to see a doctor to discuss and monitor your symptoms because diagnosing and treating a TBI is an important step in reducing possible disabilities.

Case Example

Dr. Lewis, a successful surgeon and member of the hospital board, and her teenage daughter are rushing to a school event when they have a car crash. Dr. Lewis' head slams into the steering wheel and rebounds to hit the headrest. At the time of the crash, Dr. Lewis doesn't have any bleeding and feels alright and her daughter has only minor injuries—a fractured arm and a few bruises. They both return to their everyday life. Later in the week, Dr. Lewis starts to forget things and has problems concentrating at work. At home she is moody with family members and is unable to sleep. Her forgetfulness interferes with her ability to perform her job so she goes to see a colleague about her symptoms. Her colleague asks many questions and eventually learns about the car crash. After medical testing Dr. Lewis is diagnosed with a TBI. She takes a sabbatical from work and begins extensive rehabilitation and treatment to help improve her mental status. After therapy she returns to her position as a hospital board member but can no longer practice medicine.