Traumatic Brain Injury
Traumatic brain injury (TBI) is a major source of impairment in health and disability worldwide.
The Centers for Disease Control and Prevention (CDC) estimates that in 2014 there were approximately 2.53 million emergency room visits, 288,000 hospitalizations, and 56,800 deaths related to TBI in the United States (CDC 2020).
Data from the CDC reveals that older adults suffer the most morbidity and mortality related to TBI (Daugherty 2019). It is also noted that in recent years falls have made up a larger proportion of TBI related injuries.
Traumatic brain injury can occur by several different mechanisms,
such as:
• The head being struck by an object
• The head striking an object
• Acceleration/deceleration of the brain without direct external impact
• A foreign body penetrating the brain
• The force from a blast or explosion
In regards to brain injury, there are many classification systems and many different ways to categorize patients.
A mild traumatic brain injury, also known as a concussion, is classically defined as trauma induced disruption of brain function.
In basic terms, this means that any period of loss of consciousness, any loss of memory immediately before or after the accident, or any alteration in mental state at the time of an accident can be clinically defined as a mild traumatic brain injury or concussion (Kay 1993).
Of note, brain injury with more serious symptoms are defined by further criteria.
Symptoms of concussion or traumatic brain injury
can be:
- Headache
- Blurry vision
- Dizziness or balance problem
- Nausea
- Decreased concentration or focus
- Memory impairment
- Insomnia
- Changes in mood such as anxiety or depression
- Other neurologic deficits
The brain is divided into separate regions, each of which with its own individual function.
At NeuroDoc, in addition to reviewing a patient’s symptoms, Dr Moore uses several different diagnostic tools to localize brain regions that may be injured or not working correctly.
These tools are:
- MRI of the Brain, with diffusion tenser image (DTI) sequencing
- Quantitative EEG
- Computer based cognitive tests
- Auditory and visual evoked potentials
- Videonystagmography
- Balance testing
MRI Brain with DTI: blue, green, and red lines represent individual nerve fiber tracts connecting one part of the brain to another.
By localizing the area of the brain that has been damaged or is not functioning properly, a personalized therapy program may be created specific to each person. This personalized therapy program gives patients the best chance of alleviating symptoms after a head injury and recovering mental function.
References:
Centers for Disease Control and Prevention (CDC). TBI-related emergency department visits, hospitalizations, and deaths (EDHDs). https://www.cdc.gov/traumaticbraininjury/data/tbi-edhd.html(Accessed on July 10, 2020).
Daugherty J, Waltzman D, Sarmiento K, Xu L. Traumatic Brain Injury-Related Deaths by Race/Ethnicity, Sex, Intent, and Mechanism of Injury - United States, 2000-2017. MMWR MorbMortal Wkly Rep. 2019;68(46):1050. Epub 2019 Nov 22.
Kay T, Harrington DE, Adams R, et al. Definition of mild traumatic brain injury. J Head Trauma Rehabil 1993; 8:86.