Traumatic Brain Injury, TBI, occurs in three general ways; the head being struck with force, the head striking an object, and/or the brain undergoing movement within the skull yet without visual trauma to the exterior of the head.
TBI is sometimes broken down into two categories: closed head injury (CHI) and open head injury (OHI). CHI refers to damage to the brain that does not involve exterior trauma to the head.
OHI is a visible injury where damage to the head and brain is much more evident. Regardless of the type of injury suffered, TBI is often a very serious condition that can have devastating effects for those who suffer the injury and their loved ones. In fact, brain injury is the leading cause of death and disability among children and young adults.
When the brain is damaged at the point of impact, it is referred to as a coup injury. A contra coup injury refers to damage opposite the point of impact. The individual brain fibres are damaged when the brain moves inside the skull (known as shearing) and causes the fibres to stretch and tear. The fibres can also be damaged as a result of pressure changes caused by the movement of the brain in the closed skull cavity (referred to as cavitation).
What are the causes of Traumatic Brain Injury, TBI?
The most common cause of traumatic brain injury involves automobile or motor vehicle accidents (accounting for nearly ½ of all TBI cases). The second leading cause of traumatic brain injury deaths is from firearm-related occurrences. The second leading cause of non-fatal brain injury occurs when someone falls. While falls can occur in everyday life (such as with unsafe equipment or surfaces), the most common instance is during sports-related activities. Some of the more common activities include tackle football, rugby, skiing, skateboarding, bicycle riding, horseback riding, etc.
While it is nearly impossible to predict or prevent when a traumatic injury will occur, the use of protective gear such as airbags, safety helmets, and alcohol abuse training can greatly reduce the occurrence of traumatic brain injury.
Who’s At Risk for Traumatic Brain Injury, TBI?
Practically speaking, anyone can befall an accident that results in traumatic brain injury. The leading cause of traumatic brain injury varies according to age and demographic group. TBI due to falling is most prevalent among younger children and older adults. Conversely, motor vehicle crashes more often involve individuals between the ages of 15 and 35. Within this demographic, males dominate the group. The typical TBI sufferer within this category is the adventurous, consumer of alcohol who drives fast and lives life on the edge.
Causes of brain injury in children include falls, abuse, recreation accidents, and motor vehicle accidents. Very young children are most susceptible to "Shaken Baby Syndrome" can cause a closed head injury. Other examples include falls from shopping carts, accidents involving children in "walkers," and falls from windows. Elementary/school-aged children are most often injured in recreational accidents, playground falls, SUV rollover accidents and/or bicycle accidents.
The severity of Traumatic Brain Injury, TBI
The disability that an individual sustains depends upon the portion of the brain that was injured. Because the frontal and temporal lobes of the brain are exposed to the sharp protrusions of the inner aspect of the skull they are most prone to injury. Data from certain sources indicate that somewhere between 20 - 30% of traumatic brain injuries that occur each year are severe enough to result in lifelong disability.
Symptoms of TBI
Traumatic Brain Injury can have myriad effects on different individuals. Some of the most common outwards symptoms and effects include:
Loss of memory
Loss of taste and smell
Hearing and balance disorders
Common Symptoms of Traumatic Brain Injury, TBI, Explained
Common sequels to head injury include balance or equilibrium difficulties. These are tied to problems with vision and hearing. Head injury sufferers often experience post-trauma vision syndrome that often includes a subclassification known as midline shift syndrome.
The effect of midline shift syndrome includes a constant sense of disequilibrium, difficulty with the maintenance of balance, and inappropriate posture and weight distribution on the balls of the feet, as well as an inappropriate gait and directional drift. Many patients who experience this complain that their perception of the world is a little off; they may perceive the horizon as slightly tilted, walls may be tilted or constantly compressing in upon them.
Severe brain injury can often involve emotional ramifications such as alterations in mood and erratic behaviour. Patients often need to see a neuropsychiatrist (a psychiatrist specializing in brain-related disorders) in order to address these problems and/or obtain the appropriate medication to stabilize the mood of the brain injury sufferer. It is also very possible to become dis-inhibited towards social incidents and scenarios; this can include basic biological urges. Damage in certain areas of the brain, such as within the limbic system, can serve to increase a person’s sexual arousal. Other neurologic damage, especially in the areas of the frontal lobes, can result in a person becoming dis-inhibited in their language and action towards strangers.
Brain injury sufferers often have difficulty processing information correctly -- making it difficult to attribute cause and effect to their actions or being unable to distinguish rational action due to competing stimuli in the brain. Communication skills such as the ability to handle the subtleties of language or interpret non-verbal signals may occur. Mild brain injuries can also reduce problem-solving skills of an individual.
Traumatic Brain Injury, TBI Is Not Always Cut and Dry
Traumatic brain injury survivors oftentimes suffer minimal outward physical manifestations of injury (especially in the case of closed head injury). Physicians and other health care professionals often paint rosy outcomes for their recovery of the patient. The result is that many do not receive the care and treatment that they need to address the physical, cognitive, psychological, and social impairments that they’ve undergone. Generally speaking, the medical community is not well trained in neurobehavior and doctors often fail to diagnose the short-term and potentially chronic aspects of closed head injuries during a regular office visit. Outside of the regional head injury treatment centres, neurologists do not often treat trauma victims. For their part, neurosurgeons themselves have referred to only the most severe cases of acute disorders and coma.