Health

September: Traumatic Brain Injury Month

 

September is national traumatic brain injury month. Concussions are known as mild traumatic brain injuries and as this video from the Centers for Disease Control explains, are caused by a blow, bump, or jolt to the head or body that causes the brain to move rapidly inside the skull, stretching and damaging brain cells and causing chemical changes in the brain.

Traumatic brain injury (TBI) is an unfortunate fact of everyday life; people fall, motor vehicle accidents happen, heads collide in various sports (more violently in some sports than in others). Military members face the additional risk of head injury caused by explosive devices. While the majority of head injuries are suffered by men and women in non-combat situations, roughly 20 percent occur during deployment.

The news continues to be filled with an alarming number of reports about the consequences of head trauma in athletes, (even young children in Pop Warner Sports training have been diagnosed with concussions from after school football programs). This increased attention on the impact of concussions  has been triggered by many reports of dementia, depression, and even suicide among former professional football players. There is no question that athletes, current and former, deserve significant attention in this regard, since the effects of recurrent concussions are quite severe.

Frankly, concussion has been a silent and ignored epidemic for too many years. However, it is important for physicians and patients to realize that concussions, with their many consequences, are not confined to athletes. Head injury is a very common problem in the general population. The two groups at highest risk for concussion are adolescents/young adults and older adults. The most common causes of concussion include car accidents, falls, and sports-related injuries. (See, “A Concussionary Tale,” for a jolting account of what a concussion feels like.)

The word concussion itself is often confusing to people. Many physicians prefer the term “minor traumatic brain injury” because it is more specific. Concussions come in different shapes and sizes, and despite what you may have heard, many concussions occur without any loss of consciousness. In its mildest form, a Grade 1 concussion is associated with no loss of consciousness and less than 15 minutes of confusion or feeling dazed. Many times, the immediate symptoms of concussion are ignored by the injured person because the symptoms are not considered that serious.

Even with mild injuries, however, the brain sustains trauma, which leads to a cascade of chemical events in the brain that can cause longer-lasting symptoms. These “post-concussion” symptoms commonly include headache, confusion, memory problems, fatigue, insomnia, dizziness, and blurry vision. Many patients report that they feel as if they are “walking in a fog”— they feel “slower,” and concepts seem harder to grasp. Some patients do not even recall a head injury, because the trauma may have induced a transient amnesia for the event.

The good news is that in 85 percent of patients, these post-concussion symptoms eventually resolve. However, in 15 percent of cases, symptoms may be persistent and disabling.

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  • Andrea September 12, 2016 at 11:50 am

    Thank you Dr Allen for this informative article. Your views on the elderly and TBI were particularly insightful. I recently got my 93 yr old father to use a rubber tip cane when out (after MUCH discussion and resistance on his part). He won’t admit it but I’ve noticed his gait appears stronger and he certainly is more confident and less fearful when getting around.

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