Traumatic Brain Injury: A Silent Epidemic

Approximately every 15 seconds, someone in America suffers a traumatic brain injury (TBI). There are about 1,500,000 new brain injuries each year. Most of these are mild concussions — which can have lasting cognitive effects — but many are much more severe. Approximately 50,000 Americans die each year as the result of brain injury; in fact it is the leading cause of death in Americans under the age of 45. There are three times as many deaths resulting from brain injuries each year than result from AIDS in the U.S. There are more TBIs each year than new cases of all types of cancer combined. Granted, cancer tends to be more lethal with roughly 500,000 deaths per year to 50,000 from TBI but TBIs are still very serious. TBIs have received relatively little attention, especially compared with the widespread campaigns raising awareness for diseases like breast cancer or HIV/AIDS. Some people have started calling TBIs a “silent epidemic.”

Traumatic brain injury affects all ages but children under the age of 4 are the most likely to sustain a TBI. There is another peak between the ages of 14 and 19 as well as at ages greater than 75. Males are more likely to sustain TBIs than females are. This is due largely to males engaging in risky behavior more often than females. Additionally, males have more successful suicide attempts than females do; many of these suicides result from gunshot wounds to the head. Most TBIs result from transportation-related injuries (automobile accidents, motorcycle accidents, and so forth). However about 25% result from falls. The very young and the very old are at most risk of falling. It is estimated that 50 percent of all TBIs involve alcohol.

There are two main types of TBI — closed head injuries (e.g., hitting the head on a windshield) and penetrating head injuries (e.g., gunshot wound). In a closed head injury there is coup damage (brain damage at the site of impact), contrecoup damage (damage on the other side of the brain, resulting from the brain gaining momentum from the impact), and diffuse axonal injury (damage to the axons — the connections — of the neurons in the brain).

The severity of traumatic brain injuries is often assessed using the Glasgow Coma Scale, with scores ranging from 3 to 15. The higher the score, the more mild the injury is. TBIs can result in a variety of physical and cognitive symptoms including: movement difficulties, talking difficulties, seizures, brief to severe memory loss, and impairment of attention, planning, information processing, language, and even personality and mood changes. Loss of sense of smell and taste is also very common in TBIs. Even mild concussions (which are traumatic brain injuries) can result in usually subtle but lasting impairments. When there is recovery, it often is slow and painful.

Traumatic brain injuries occur at alarming rates in the United States and around the world but usually receive little media or political attention. This is largely because TBIs usually result from accidents or crime (e.g., assault or abuse) unlike cancer or heart disease. However, TBIs affect millions of Americans, killing 50,000 each year. Many of those who survive go on disability — often permanently. Family and friends are affected as well. TBIs can be devastating. They truly are a “silent epidemic.”