Some Facts About Traumatic Brain Injury

Traumatic Brain Injury (TBI) is an injury to the brain where any type of sudden impact to the head is severe enough to damage brain tissue. According to the Brain Injury Association of America, about 1.4 million Americans suffer a TBI every year, and of that number:
• 1.1 million receive emergency room treatment and are released
• 50,000 die of their injury
• 235,000 are hospitalized for treatment

Those numbers are taken from hospital statistics, so the number of people who sustain TBIs but do not go to any emergency room in a hospital is not known.

Causes of TBI
Most (about 28%) are caused by falls of one sort or another. Road accidents and being struck on the head in other types of accidents account for about 20% each. About 11% are caused by violent assaults. For military personnel on active duty in a war zone, explosions are the principle TBI cause.

Those at highest risk for a TBI
• Gender – Males sustain a TBI about 1.5 times as often as a female
• Age – Two age groups have the highest risk:
• Children from babyhood to four years of age
• Adolescents from 15 to 19 years of age
• Occupation – Military personnel have the highest risk, especially paratroopers
• Race – African Americans have the highest TBI death rate

Types of TBI
Because the brain controls every aspect of human behavior, ability, and functioning, a TBI can cause uncountable constellations of impairment. Each injured person has a unique combination of disabilities, according to where exactly the brain was injured, how severely, how much bruising and bleeding resulted, and other factors that can be quite medically complex.

TBIs can be:
• Focal or diffuse – that is, confined to one brain area, or extending over several
• Open or closed – that is, caused by something penetrating through the skull or by an impact to the skull
• Mild, moderate, or severe – according to any of several classification systems, such as the Glasgow Coma Scale
• Primary or secondary

Primary and Secondary Brain Injuries
In many fatal TBIs, death does not occur immediately, but only after days or weeks. What happens in those days or weeks are the secondary injuries. They are not well-understood. Examples are brain swelling, changes in blood flow, a decrease in the acidity/alkalinity of the brain (the pH), and free radical overload (free radicals are molecules with an unpaired electron. They try to pair up that single electron by combining with other molecules, which can cause tissue damage.)

Effects of a TBI on Consciousness
In increasing order of severity, these are the abnormal states of consciousness that a TBI can cause:
• Stupor – The person is unresponsive, but can be aroused by a strong stimulus
• Coma – Total unconsciousness which may end, with the person regaining consciousness
• Persistent vegetative state – the person is unconscious but has periods of alertness and a cycle of sleeping and waking
• Minimally conscious state – apparently unconscious, but shows periodic deliberateness of movement
• Locked-in Syndrome – the person is awake and aware of their surroundings, but is completely paralyzed. Communications can be done through eye movements or blinking, in a mutually arranged code. There is a book written by means of such a code, by a French author and editor of the magazine Elle, named Jean-Dominique Bauby. He and his speech therapist developed a code where Bauby blinked his left eye, and the resulting book, translated as The Diving-Bell and the Butterfly, was published in March, 1997.

When a TBI is caused by someone else’s negligence, there may be a valid legal claim for compensation. Such negligence could be failing to keep premises safe, driving under the influence of alcohol or drugs, or failing to properly supervise an elderly person in a nursing home. When the immediate medical attention has been obtained and the injured person is somewhat stabilized, it would be worth while learning more about possible legal action. The first step would be to consult with an experienced personal injury attorney.