A sports injury, a minor car accident, or even a fall on the sidewalk can cause a traumatic brain injury, an underestimated cause of death and serious disability in the United States. Traumatic brain injury is a type of acquired brain injury that is not heredity, congenital, degenerative, or induced by birth trauma. Traumatic brain injury is caused by trauma to the brain from an external force.
March is Traumatic Brain Injury Awareness month. Worldwide, there are over 27 million new cases of TBI each year. In the US, at least 2.8 million people sustain a TBI each year, meaning someone in the US sustains a TBI every 9 seconds. Over 230,000 people require hospitalization and survive annually, 50,000 people die, and 80-90,000 people will have long term disability from their TBI. To put this in perspective, colon cancer, the second leading cause of cancer deaths in the US kills 50,000 people annually. The number of people who sustain a TBI and do not seek treatment is unknown.
The leading cause of TBI in the US are falls, accounting for 48%, followed by the head being struck by or against an object (17%), then motor vehicles collisions (13%), unknown causes (13%), and finally assaults at 8%. The risk of TBI is significant for all age groups, but is highest among adolescents, young adults, and people over 75. Males are twice as likely to sustain a TBI than females and twice as likely to be hospitalized from them. Violence and motor vehicle collisions are the leading cause of TBI in the young, while falls are the leading cause of death among the elderly. People over the age of 75 have the highest rate of hospitalizations and death from TBI.
TBI data also suggests that some groups are at greater risk of death and disability from TBI. These groups include minorities, service members and veterans, homeless, people in detention facilities, domestic violence survivors, and people living in rural areas. Factors affecting this include access to healthcare, violent circumstances, and the consequence of TBI being associated with mental health issues including depression, anxiety, and substance abuse. People in rural areas are more likely to die from TBI due to limited access to level 1 trauma centers, increased time to travel to emergency medical care, and difficulty in getting specialized TBI care.
TBI has gained general interest over the years largely due to sports. Concussions are type of mild TBI. The term mild refers to the severity of traumatic brain injury, not the consequences of the injury. Protocols have been developed to allow competitors to safely return to school, work, or competition. The old days of “how many fingers do you see” and “shake it off and get back in there”, have rightly gone away. Yes, it is frustrating to see my team suffer because their star player was hurt or targeted and had to leave the game. However, studies show that people who have sustained a concussion are at risk of further damage and long-term disability if they sustain further head trauma within 2-3 weeks of the initial injury.
Not all concussions cause loss of consciousness. It is important to recognize common symptoms and get care when present. Some common concussive symptoms include headaches, nausea or vomiting, fatigue, sleep problems, confusion, irritability, light and sound sensitivity, balance problems, slowed thinking or attention difficulties, memory problems depression, and anxiety just to name a few. Many of these are non-specific or could easily be overlooked. It is important to seek medical care if a head injury is sustained, no matter how minor and any of these or other concerns happen. Early recognition and treatment help prevent further injury and long-term disability.
For further information on Brain injury, visit the Brain Injury Association of America at biusa.org.
Dr. James Lee serves as the Coroner of Winn Parish. He is a General Surgeon and Surgical Oncologist who has been practicing in Winnfield for over ten years. Dr. Lee attended the University of Colorado for his medical degree. He completed his residency in Surgery at the University of Oklahoma before completing a fellowship in Surgical Oncology and Endoscopy at Roswell Park Cancer Institute in Buffalo, NY. Dr. Lee and his wife Scarlett live in Winnfield with their son and are active in the community.