Tramatic brain injuries (TBI) are most well known to affect athletes, but they can impact anyone. A TBI occurs when physical, external forces impact the brain either from a penetrating object or a bump, blow, or jolt to the head. Not all blows or jolts to the head result in a TBI. For the ones that do, TBIs can range from mild (a brief change in mental status or consciousness) to severe (an extended period of unconsciousness or amnesia after the injury).
According to the Centers for Disease Control and Prevention (CDC), falls are the most common cause of TBIs and occur most frequently among the youngest and oldest age groups. From 2006 to 2010 alone, falls caused more than half (55 percent) of TBIs among children aged 14 and younger. Among Americans age 65 and older, falls accounted for more than two-thirds (81 percent) of all reported TBIs.
Unintentional blunt trauma includes sports-related injuries, which are also a major cause of TBI. Overall, bicycling, football, playground activities, basketball, and soccer result in the most TBI-related emergency room visits. The cause of these injuries does vary slightly by gender. According to the CDC, among children age 10 to 19, boys are most often injured while playing football or bicycling. Among girls, TBI occur most often while playing soccer or basketball or while bicycling. Anywhere from 1.6 million to 3.8 million sports- and recreation-related TBIs are estimated to occur in the United States annually.
Adults age 65 and older are at greatest risk for being hospitalized and dying from a TBI, most likely from a fall. TBI-related deaths in children aged 4 years and younger are most likely the result of assault. In young adults aged 15 to 24 years, motor vehicle accidents are the most likely cause. In every age group, serious TBI rates are higher for men than for women. Men are more likely to be hospitalized and are nearly three times more likely to die from a TBI than women.
The effects of TBI can range from severe and permanent disability to more subtle functional and cognitive difficulties that often go undetected during initial evaluation. These problems may emerge days later. Headache, dizziness, confusion, and fatigue tend to start immediately after an injury, but resolve over time. Emotional symptoms such as frustration and irritability tend to develop later on during the recovery period. Many of the signs and symptoms can be easily missed as people may appear healthy even though they act or feel different. Many of the symptoms overlap with other conditions, such as depression or sleep disorders. If any of the following symptoms appear suddenly or worsen over time following a TBI, especially within the first 24 hours after the injury, people should see a medical professional on an emergency basis.
People should seek immediate medical attention if they experience any of the following symptoms:
Other common symptoms that should be monitored include:
Studies suggest that age and the number of head injuries a person has suffered over his or her lifetime are two critical factors that impact recovery. For example, TBI-related brain swelling in children can be very different from the same condition in adults, even when the primary injuries are similar. Brain swelling in newborns, young infants, and teenagers often occurs much more quickly than it does in older individuals. Evidence suggests that younger people (ages 20 to 40) tend to have behavioral and mood change, while those who are older (ages 50+) have more cognitive difficulties.
Compared with younger adults with the same TBI severity, older adults are likely to have less complete recovery. Older people also have more medical issues and are often taking multiple medications that may complicate treatment (e.g., blood-thinning agents when there is a risk of bleeding into the head). Further research is needed to determine if and how treatment strategies may need to be adjusted based on a person’s age.
The best treatment for TBI is prevention. According to the CDC, doing the following can help prevent TBIs:
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