Traumatic
Brain Injuries
Traumatic brain injuries are more common
than you think. More than 1.5 million people sustain traumatic
brain injuries annually compared with 176,000 cases of breast
cancer or 46,000 cases of HIV.
Of that number, over 50,000 people will
die from complications associated with their traumatic brain injuries.
Currently, over 5.3 million people are living with disabilities
associated with traumatic brain injuries.
Traumatic brain injuries are not the same as Organic Brain Syndrome,
which is a disease process commonly diagnosed in the elderly to
denote decreased mental functioning.
A traumatic brain injury can be defined as a jolt or blow to
the head or a penetration of the skull that upsets the brain's
functionality. The leading causes of traumatic brain injuries,
in descending order, is falls, motor vehicle accidents and assault.
For military personnel, blast injuries to the head in a military
zone are the leading cause of brain injuries. More serious brain
injuries can include the states of stupor, coma, vegetative state
or persistent vegetative state.
In 1995, direct costs (medical) and indirect costs (productivity)
due to brain injury topped $56 billion in the United States.
Some of the key indicators for having a brain injury include:
- Headaches
- Memory Loss
- Word-Finding Problems
- Fatigue
- Blurred vision
- Emotional Changes
- Sleep Changes
- Stimulus Overload
- Impulsiveness
- Poor Concentration
- Distraction
- Organizational Difficulties
Headache indicators include higher frequency of headaches, pain
in the temples, forehead or back of the head and / or episodes
of sharp pain. Memory loss includes short-term memory difficulties,
asking the same question over and over and / or forgetting what
one has just read. Word-finding problems include new difficulties
in coming up with the right word to say. Fatigue includes a new
condition of emotional or physical tiredness that gets worse the
more one thinks or in emotional situations. Emotional changes
include being more angered, scared or sad after the receiving
the injury.
Signs of changes in sleeping habits involve waking up throughout
the night or waking up early in the morning and not being able
to get back to sleep. Stimulus overload involves feeling overwhelmed
in busy, noisy or crowded places. Impulsiveness problems include
make quick, instinctive and potentially self-destructive decisions.
Concentration and distraction problems include an increase in
trouble staying focused and losing one's place when interrupted.
Organization difficulties include troubles getting organized and
/ or completing tasks.
Brain injury treatment includes short-term and long-term treatment.
In the short-term, medical treatment needs to be administered
as soon as possible after a head trauma occurs in order to minimize
damage, stabilize the patient and prevent further damage from
occurring. Immediate concerns include making sure there is proper
oxygen supply to the brain, adequate blood flow and maintaining
and stabilizing blood pressure.
Bruising or bleeding inside the skull is particularly important
because there is no room for the extra fluid and any extra pressure
may affect such critical areas such as breathing and heart rate
from functioning normally. In vehicular accidents, passengers
may receive bruising at the front and rear portions of the brain
due to the impact and whiplash effect. Tearing can also get in
the way of critical brain functioning and it can happen at a microscopic
level, which means it may not even show up on CT scans or MRI's.
If a brain experiences bruising or tearing it may also begin swelling.
Swelling can force the brain to push down on itself, damaging
other critical structures. In some instances, doctors will install
intra-cranial pressure monitor in order to relieve the pressure.
In the long-term, X-rays or CT scans may be recommended, depending
upon the severity of the initial trauma. Roughly, half of all
brain-injured patients will need surgery to repair or remove hematomas
(ruptured blood vessels) or contusions (bruised brain tissue).
Additional long-term treatment may include physical therapy, occupational
therapy, speech/language therapy, physiatry (physical medicine),
psychology / psychiatry, and social support. A neurologist along
with a neuropsychologist may be part of the treatment team.
Not all people of who have received traumatic brain injuries
exhibit obvious symptoms. The doctors may run CT scans, MRI's
and do blood work and all the test results will come back negative,
meaning there is no indication that a brain injury has occurred.
If the patient does exhibit some of the symptoms of having sustained
a traumatic brain injury such as memory loss, fatigue and headaches,
then neuropsychological testing is in order. Since neuropsychological
testing is somewhat expensive and outside the normal battery of
tests, a doctor may be reluctant to order such testing and insurance
companies may not be willing to pay for this without the doctor's
full backing.
In order for patients to receive neuropsychological testing,
it will be important for patients to inform their doctors of all
symptoms. This may be difficult for a patients with traumatic
brain injuries since memory may be impaired and they may experience
different symptoms at different times. If the patient can be encouraged
to write down all of the symptoms whenever they occur and present
these to his or her doctor, ordering additional testing will go
much smoother.
Neuropsychological testing is not conducted by a neurologist,
who specializes in diagnosing and treating the physiological causes
of brain injuries, but rather by a neuropsychologist who assesses
the cognition and behavior effects do to traumatic brain injuries.
Recent tests are 85 - 95 percent accurate in predicting damage
and impairment do to traumatic brain injuries.
If you suspect that a friend of loved one has received a traumatic
brain injury, remember that the quicker that action is taken in
order to diagnose and treat the injury, the more likely it is
that a positive long-term outcome will occur. Remember also that
it is important to keep as detailed records as possible of the
accident and ensuing medical care. This is so that issues with
the insurance company or possible litigation can be conducted
at a later date to help with the expenses of both the costly medical
care and any losses of future income, family involvement and pain
and suffering may be addressed in an equitable fashion.
Brain injuries are some of the most complicated injuries to diagnose
and treat. Every human being is unique, yet has similarities to
everyone else. And so, even though two treatments may have similarities
between two different individuals, each person's unique differences
have to be taken into account. The recovery process generally
takes longer than most other injuries. Much patience is needed
by both patients and caregivers. With time and treatment, though,
many who have received brain injuries can gain back a great deal
of functionality.
If you're in need of a brain injury lawyer, check out the traumatic
brain injury lawyer
page for more information on attorneys and record-keeping.
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