Traumatic brain injury (TBI) has been at the forefront of the news the past couple of weeks, specifically as it has related to the shooting of Congresswoman Gabrielle Giffords. Highly visible TBIs such as Congresswoman Giffords capture headlines, but millions more occur behind the scenes.
Consider that in the U.S. each year there are 5 million head injuries, 2 million with permanent damage, resulting in 235,000 hospitalizations and 50,000 deaths. Well over 300,000 of our U.S. troops in Iraq and Afghanistan have incurred TBIs during their service. TBI is the second most costly type of workers’ compensation injury.
It is important to remember that brain trauma is a process and not an event. These head injuries have both primary lesions related to the structural disruption and secondary lesions related to the sequence of molecular events that follow the injury. It is critical to recognize the changes as the result of traumatic events early so that the complicating sequelae can be prevented or reduced.
After someone sustains a head injury without visible external damage, yet begins to manifest cognitive changes such as headache, difficulty thinking, memory problems, attention deficits, mood swings or frustration, there should be a higher level of suspicion that TBI is present. This is the time to enlist further evaluation and testing. Some newer radiologic modalities, such as MR spectroscopy, FDG-PET scanning and HMPAO-SPECT are able to recognize injury earlier and with greater sensitivity.
Given that the external physical damage from TBI is not always reflective of the underlying processes that have and are occurring in the patients, we must recognize that mild to moderate cognitive impairment can still be incredibly debilitating and require intensive rehabilitation. The therapy with TBI patients requires practicing skills to function at home and work. This recovery process takes months to years and involves the transition to various care settings.
TBI rehabilitation centers such as TIRR (where the Congresswoman went), as well as Shepherd Center, Craig Hospital and others, recognize that intense specialized rehabilitation is the key to successful outcomes for people with TBI. TBI rehabilitation centers focus on extensive testing and intensive therapy that begins immediately. Studies have shown that intensive therapy is associated with earlier functional gains. In addition, TBI specialists recognize the complications that can result from these injuries and set up plans to avoid them.
What you should know:
- TBI is more prevalent than many people realize.
- Early intervention to prevent secondary injury, followed by immediate and aggressive rehabilitation are the keys to successful recovery from TBI.
- There are new modalities to screen for early evidence of traumatic brain injury.
- Even mild cognitive impairments can be debilitating.
- Recovery and rehabilitation is a long process.
I recommend these resources to learn more about TBI:
Next week: The key to finding a good rehab center