Traumatic Brain Injury (TBI) is a leading cause of death and disability in the United States.

Each year, an estimated 1.5 million Americans sustain a TBI. That’s a TBI every 21 seconds!

Traumatic Brain Injury As a result of these injuries, 50,000 people die, 230,000 people are hospitalized and survive, and an estimated 80,000-90,000 people experience the onset of long-term disability. Currently, over 5.3 million people are living with disabilities resulting from a TBI.

In 2000, Maryland had 5,229 cases of non-fatal TBIs that resulted in hospitalizations. That’s more than 13 a day! And, as you will learn later, many Traumatic Brain Injuries (TBIs) are not initially diagnosed and do not result in hospitalizations, so there are actually many more Traumatic Brain Injuries (TBIs) than those included in this statistic.

How costly are TBIs to American society? It was estimated, back in 1995, that the direct and indirect costs of Traumatic Brain Injury (TBI) totaled $56.3 billion in the U.S.

Common Causes of Traumatic Brain Injury

These are the leading causes of Traumatic Brain Injury (“TBI”). . .

What Exactly Is A Traumatic Brain Injury?

Here’s a formal definition adopted by the Brain Injury Association of America Board of Directors in 1986 . . .

“Traumatic brain injury is an insult to the brain, not of a degenerative or congenital nature but caused by an external physical force, that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment.”

As the name suggests, and as this definition states, a Traumatic Brain Injury (TBI) is an injury to the brain that results from an external force, or trauma, to the head. In other words, it’s a head injury that causes damage to the brain.

The “external force” can be a direct blow to the head such as hitting the floor in a fall accident or striking the steering wheel in a car accident. Even though the skull is not penetrated or fractured, the force can cause the brain to be injured in a number of ways.

Or, the “external force” can be a rapid acceleration and deceleration (“whiplash”) of the head that shakes or rotates the brain. Examples of this are whiplash in a car accident or Shaken Baby Syndrome.

As the BIA definition states, the “external force” damages the tissues and cells of the brain causing temporary or permanent impairment in the cognitive, emotional and physical abilities of an individual.

There are two types of head injuries that damage the brain. A Penetrating Head Injury is a brain injury that occurs when an object — such as a knife or bullet — penetrates the skull or the skull is fractured. In that case, bone fragments, foreign material or dirt can get into the brain, damage brain tissue and cause infection.

However, most Traumatic Brain Injuries (TBIs) are Closed Head Injuries (CHI) that do not involve penetration of the brain.

In a Closed Head Injury (CHI), trauma to the head sets the brain in motion inside the skull. Depending upon the degree and direction of the forces applied, the brain can be damaged in many different ways. These include surface contusions of the brain from a coup-contre coup (an initial blow followed by a rebound against the opposite side of the skull) and twisting and stretching from rotational force which damage fine structures like axons.

Let me explain this second example.

Specialized brain cells called neurons do the processing work of the brain (such as thinking). Axons — long, hollow tubular structures that project from the neurons — form the “wiring” that links neuronal processing centers.

External forces can cause Axons to be damaged by twisting or stretching, preventing the neurons from functioning properly.

Diffuse Axonal Injury (DAI) occurs on the cellular level and is visible only under a microscope at autopsy. It is widely diffused and typically leaves blood vessels and major structures intact. Therefore, these Diffuse Axonal Injuries (DAI) do not appear on CTs or MRIs. As a result, this type of subtle TBI is a very under-diagnosed and under-treated malady. It is a “Silent Epidemic.”

Obviously, not all TBIs are equally serious. They range from catastrophic to subtle. However, even subtle brain injuries can have significant, permanent, life-altering consequences for the patient.

Common Symptoms Of A Traumatic Brain Injury

Traumatic Brain Injury (TBI) can be fatal. For survivors, Traumatic Brain Injury (TBI) can cause any of a number of physical, cognitive and emotional symptoms. Of course, not every patient will have all of these symptoms, and some patients will have symptoms not listed here.

However, common physical symptoms can include . . .

  • seizures of all types.

  • muscle spasticity.

  • double vision, blurred vision or low vision, even blindness.

  • loss of smell or taste.

  • speech impairments such as slow or slurred speech.

  • headaches or migraines.

  • fatigue, increased need for sleep.

  • balance problems.

Cognitive symptoms can include . . .

  • short-term memory loss, long-term memory loss.

  • slowed ability to process information.

  • trouble concentrating or paying attention for periods of time.

  • difficulty keeping up with a conversation, other communication difficulties such as word finding problems.

  • spatial disorientation.

  • organizational problems and impaired judgment.

  • unable to do more than one thing at a time.

  • a lack of initiating activities or, once started, difficulty in completing tasks without reminder.

Emotional symptoms can include . . .

  • increased anxiety.

  • depression and mood swings.

  • impulsive behavior.

  • more easily agitated.

  • egocentric behaviors, difficulty seeing how behaviors can affect others

If you have any of these symptoms after a head injury, or whiplash injury, especially if they persist for more than a few days, you should be evaluated to see if you have a Traumatic Brain Injury (TBI).

While they experience the same symptoms as a normal adult,
children and seniors present unique symptoms and diagnostic problems.

Does there have to be a loss of consciousness to sustain a brain injury?

No, loss of consciousness (LOC) is not required. Research has shown that brain injury can occur without loss of consciousness and that the neuropsychological consequences of TBI without loss of consciousness do not differ in severity from those occurring when there is a brief comatose period.

What is required is any alteration of the state of consciousness, such as being dazed or confused.

What Does A Brain Injury Lawyer Do?

A brain injury lawyer works with the treatment team to determine whether there is a TBI, and, if so, the extent of it. To do so, the brain injury lawyer must be familiar with brain physiology, diagnostic tests and treatments of Traumatic Brain Injury (TBI). Working with a litigation team of experts, the brain injury lawyer marshals the evidence of the injury and its extent and determines the best way to present the evidence convincingly to often cynical and suspicious insurance adjusters or jurors.

Brain injury law also has a human or personal side, which requires brain injury lawyers to relate to clients and the clients’ families in a positive and constructive manner with a blend of compassion, patience, understanding and tolerance.

If you have a question about traumatic brain injury that isn’t answered here, contact me.