Traumatic Brain Injury

By KSU Counseling Services Staff

“If you put enough stress on your back, 10,000 pounds on your back, it doesn’t matter how strong your back is. It’s going to break. The brain is the same way. It can only take so much stress. A broken back may not seem like a reassuring analogy, but at least it addresses the shame that my patients so often feel. ‘The brain can’t just change the channel, like a TV remote,’ I tell them. Why do people expect their brains to be endlessly pliable, to be able to heal rapidly and perfectly after such traumas? Perhaps it’s because a mental injury is invisible. For my patients, the trauma isn’t something that happens to you. It is you.” -- “Treating Wounds you Can’t See,” Linda Blum, The Washington Post, June 29, 2008, as cited in Patricia P. Driscoll and Celia Straus in Hidden Battles on Unseen Fronts: Stories of American Soldiers with Traumatic Brain Injury and PTSD

Public awareness of traumatic brain injury (TBI) has arisen with the widespread phenomena of head injuries for those fighting wars abroad. What many don’t realize is that TBI occurs based on a number of head injuries—based on falls, motor vehicle accidents, assaults, and other common every-day factors.

Oftentimes, the symptoms of TBI are missed at the time of the injury—in part because symptoms may not appear for days or weeks after the injury. The symptoms may be subtle, with changes to the person’s personality unnoticed by his or her loved ones. Initial indicators of a head injury may involve a scalp wound, a fracture, swelling or bruising around the head, a stiff neck, nasal discharge, and a loss of consciousness. Many suggest that it would be important to get checked by a doctor any time a person has suffered a blow to the head.

Emergency care should be sought right away whenever a person who has suffered a fall or impact to the head experiences convulsions, weakness or numbness in the hands or feet, vomits repeatedly, or has slurred speech. (Children’s symptoms may involve the refusal to eat, listlessness and crankiness, altered sleep patterns, altered school performance, and a loss of interest in favorite toys or activities.)

At-Risk Groups

TBI is a major public health challenge. Those who are at special risk are male adolescents; young adults aged 15 – 24; the elderly of both sexes 75 and older, and children 5 and younger.

What is TBI?

Traumatic brain injury involves the application of some sort of concussive force to the human brain. This may occur due to direct impact, or it may even occur in the case of an explosive shockwave passing through the human brain.

Some Symptoms of TBI

Injury to the brain affects a range of potential human functions given the centrality of the brain to the human experience.

Some common symptoms of TBI involve perception challenges: blurry or double vision (or other visual disturbances) and light-headedness. Some may lose their sense of smell. Some may lose their sense of hearing. Some will lose their sense of direction. Others may find a compromise to their cognitive processes.

It involves emotional challenges: anxiety; nervousness; irritability; impulsiveness and difficulty controlling urges; behavioral changes; and depression. People with TBI may experience changes to their mental states, to their thinking or concentrating; they may have poor short-term or long-term memory. They may lack concentration and may be easily distracted. They may find it hard to persevere on a particular task. They may have a hard time with so-called “executive functions” or decision-making and self-control / self-regulation.

Physically, they may experience muscle stiffness or spasms; they may have a hard time walking or maintaining balance; they may have a hard time coordinating movements. They may experience a sense of dizziness and nausea.

They may feel weakness in one or more limbs or facial muscles or on one side of the body. They may suffer seizures. They may experience insomnia. Their speech may be slurred. They may have a hard time swallowing. They may suffer aphasia or the difficulty in finding words (naming objects) or understanding others’ speech. They may experience problems reading and writing. People with TBI may experience extreme headaches.

A Range of TBI Severity

A mild traumatic brain injury is known informally as a “concussion.” It is estimated that 15 percent of those with mild TBI will have symptoms that last a year or more. Post-injury symptoms are referred to as post-concussive syndrome. An initial concussion raises the risk of much more serious injury at the time of a second concussion.

Moderate brain injury involves the loss of consciousness for 20 minutes to 6 hours. Severe brain injury results in a loss of consciousness of greater than 6 hours and may result in permanent neurobiological damage, with lifelong challenges (to varying degrees). How serious a brain injury is depends on the severity of the initial injury, the medical interventions taken, the quality of physiological recovery, and other factors.

General Safety Tips

The Centers for Disease Control and Prevention (CDC) advise that people always wear seatbelts whenever driving or riding in a car. Children should be in a child safety seat or booster seat—depending on their age. They also suggest that people wear US Department of Transportation (DOT)-approved helmets when riding motorcycles. Whenever people are riding bicycles, playing a contact sport, in-line skating, playing baseball or software, riding a horse, or skiing or snowboarding, they should also wear the appropriate helmets.

People should avoid falls by installing handrails on stairways. They need window guards to keep children from falling out of open windows. They need to use proper step-stools with grab bars to reach items high up on shelves. They should use children’s safety gates at both the tops and bottoms of stairs. Playgrounds should be made of shock-absorbing materials.

Resources

Traumatic Brain Injury (Wikipedia)
http://en.wikipedia.org/wiki/Traumatic_brain_injury

TBI Options
http://www.tbioptions.ksu.edu/DesktopDefault.aspx