A Brain Injury
In our lifetime we can
be impacted by a brain
injury and not realize it. We can
often experience numerous injuries to our
brain and with each successive injury, the risk of more severe or permanent damage intensifies.
Brain Injury is quite
common. To help us all,
let's remove the stigma to
better understand what it is
and together discover how we can all be a part of finding solutions.
ABI and TBI
Two Types of Brain Injury
To have a better understanding of Brain Injury, it is important to know that there are two main types. The first is the one we hear more about as Traumatic Brain Injury or TBI. It is caused by an external mechanical force that impacts the brain.
The other is Acquired Brain Injury or ABI. This type of injury is more comprehensive and can result from internal disruptions that are nontraumatic in nature and may also include injuries caused by trauma or TBI. This type of injury changes the neuronal activity in the brain and can affect the physical integrity, metabolic, or functional activities of brain cells.
Neither are congenital or degeneration and both can impair physical, cognitive, and emotional/behavioral functions. The incidence in either can be partial or more fully integrated and be of a temporary or permanent nature.
Because ABI is more comprehensive and covers all brain damage not present at birth, the main purpose of separation is to identify the injuries that are classified as stemming from external damage and trauma-specific, apart from those injuries that can stem from both trauma and non-trauma.
Acquired Brain Injury was the second most prevalent disability in the U.S., estimated at 13.5 million Americans
in 2010. Now it IS the leading cause of death and disability in the world, ten years later.
World Health Organization, 2020
Source: Summary health statistics for U.S. adults: National Health Interview Survey, 2010.
Brain Injury comes in all shapes and sizes
Statistics in brain health tell us that one in six individuals in the United States is reported to be affected by a traumatic brain injury (TBI), yet in the more significant incidence of Acquired Brain Injury (ABI), reported statistical data is not as readily available. This means the total numbers of Brain Injury are considerably higher. According to the Center for Disease Control (CDC), 5.3 million individuals have been affected each year and this number compounds in the years it takes to overcome or adapt the myriad of symptoms it can produce.
Traumatic Brain Injury
Acquired Brain injury
Anoxic Brain Injury
Focal Brain Injury
Diffuse Axonal Brain Injury
Coup Contre Coup
Closed Head Wound
Shaken Baby Syndrome
Penetrating Cranial injury
BRAIN INJURY IS CALLED MANY THINGS:
Open Head Injury
Brain Injury does not discriminate anyone can be affected.
*Numbers for ABI, Acquire Brain Injury are unreported in the U.S.
5.3 MILLION people in the U.S. are reported annually to have sustained a TBI
In 2020 ONE MILLION people in the U. S. will be living with Parkinson's Disease*
Currently, ONE MILLION people in the U. S. live with Multiple Sclerosis*
Almost ONE MILLION people in the U. S. live with Aphasia*
About 800,000 people in the U.S. have a stroke each year
* each can be symptomatic of brain injury
Brain Injury may be more prevalent than we know
Brain Injury doesn't have a look, no one can tell on the outside what is going on in the inside.
There are many types and many degrees of injury, some impacts don't show up for years.
One injury can lead to another, or weaken the stress points of the first. Brain injury can compound its effect.
Mild Brain Injury
May or may not have a loss of consciousness.
Brain scans may or may not show damage.
Often a change in mental status or functioning.
No two brain injuries will be alike, they are as individual in cause and impact as we are as humans
Levels of Brain Injury
No matter how one acquires a brain injury, the level of intensity can be temporary or permanent and minor in how they impact or life-altering
Moderate Brain Injury
Occurs when loss of consciousness is a few minutes to hours.
Confusion lasts days-weeks.
Impaired physical, cognitive or behavior that lasts weeks or becomes permanent.
Severe Brain Injury
Results from a more severe impact.
Prolonged hospitalization and rehabilitation.
Can result in short or long term functional changes.
Can result in neurological and cognitive deficits
Factors that create the diagnosis for each level of brain injury come from numerous sources that include structural imaging, loss of consciousness, post-traumatic amnesia duration, The Glasgow Coma Scale Index, and the Abbreviated Injury Scale
Traumatic Brain Injury results in 30% of fatalities occurring in the United States and is the most prevalent disability in the world.
Source: Data from the National Hospital Ambulatory Medical Care Survey
Maybe it's not
Maybe the behavior is a symptom of brain injury
Maybe it's not MENTAL ILLNESS
Brain Injury Causation
We've been Encouraged to take Risks in Life
The fine line between the rewards of risk and all our attempts to achieve can include the activities that can impact our brains adversely. Whether we willingly participate or find ourselves in the unexpected role of the unforeseen victim.
Consider the following five major causes of trauma in brain injury:
• Falling is the number one cause of brain injury.
• Seniors and children are more substantially at risk.
• We all have fallen at some point with a slip, turn or thud.
When we jostle the brain inside our skull the bony ridges of the skull can scrape and impact the brain. Over time, repeated impacts can induce symptoms.
• Blows or accidental thrust impacts that move the brain in the skull.
• Overhead impact of items dropped or fallen.
From a garage door to
a hatchback that falls, or household items on
a shelf that topple or come loose, we are subject to simple impacts that occur at home or in our daily exposure.
• Crash impacts can create internal and/or external brain damage.
• Jostling the brain inside the skull with whiplash also creates brain injury.
• A variety of fractures or successive accidents may sustain damage from repeated events.
Whether driving or not, the event of a motor vehicle collision moves the brain immeasurably and can cause a multitude of injuries for the brain.
• Excessive shaking of an individual or child
• Domestic abuse impact. This is often the silent brain injury that exposes itself immediately or over time and misdiagnosed regarding emotional symptoms.
• A violent attack by an unknown assailant.
Shame and confusion often keep reported events from being included in the accounts of brain injury.
• Impacts with the head as in soccer, football, hockey, or Lacrosse.
• Falls or strikes that can occur during competitive participation.
• Blows or sudden impacts, that occur during sports.
Whether casual play or competitive interaction occurs, the nature of sports moves people to impact the body and brain in unexpected ways.
brain injury is likely
in a lifetime, the severity or number of impacts can result in different experiences for everyone.
The causations listed above are the top five major Traumatic Brain Injury (TBI) causes that can result in both TBI and ABI
Acquired Brain Injury (ABI) can result from the classification listed above and from those below too.
Biological, chemical and physical agents can adversely affect the central and peripheral nervous system
External Toxic Abuses:
Methane Gas & Fuels
DDT, PCB, PERC
Viruses, bacteria, fungi, parasites or abnormal proteins (prions) can cause inflammation of the brain and infection leaving a healthy brain damaged in one area or through abscess or empyemas and affect the whole brain.
Vaccines, cancer or other disorders can trigger an autoimmune response and inflame affected tissues or blood transport.
Disruption of necessary brain nutrients, disruption of neurotransmitters, alterations to brain chemical compositions, and deprivation of brain oxygen are a few of the ways toxic exposure to man-made substances creates brain damage.
• Intentional Exposures
Inhaled Volatile Agents
Abnormal chemical reactions in the body alter the normal metabolic processes, and adversely affect the cerebral function when damage occurs from brain disease or dysfunction.
• Causes of Metabolic Disorders
Traumatic Brain Injury incidence creates susceptibility for sustaining another brain injury.
One incidence puts an individual at risk of 2-3 times greater to incur another occurrence
A second brain injury puts an individual at a higher risk of eight times greater likelihood of another.
90% of patients who suffered a fatality from a TBI showed it as a second occurrence in an autopsy.
Analysis by the CDC National Center for Injury Prevention and Control
A sudden change in the brain's electrical system causing disruption between brain nerve cells.
Focal Seizures relate to one area of the brain
Generalized Seizures begin simultaneously
in both areas of brain.
• Types of Seizures:
Absence (Petit Mal)
Tonic-Clonic (Grand mal)
Atonic (drop attacks)
• Cerebrovascular accident or insult resulting in poor blood supply to the brain causing brain cell death.
• Impacts a loss of brain function
• Hemorrhagic Stroke:
A Brain blood vessel ruptures/bleeds
A blood clot formed in the main artery reducing blood supply
• Stroke formation:
1. Temporary shortage of blood
2. Persistant Blockage of blood flow
3. Bleeding blood vessel in the brain or surrounding tissue
•Thrombus or coagulation is a thicking of blood into a semi-solid mass that prevents excessive bleeding or blocks blood flow.
• Cerebral Sinovenus
Thrombosis - vein clot forming near the brain
• Intercerebral Hematoma - clot forming deep within the brain.
• Hemorrhage Types:
• an abnormal mass of tissue from cell proliferation.
• Primary Tumor begins in the cell tissues, meninges, or pituitary gland
• Secondary Tumor
Metastic and originating from cancer in the body that has spread.
• Types Include:
Spinal Cord Tumor
• Brain hypoxia is a form of oxygen deficiency in the brain.
• Brain Anoxia is a total loss of oxygen to brain.
Other types of Anoxia:
Hypoxic-ischemic is when oxygen is totally
Anemic is when blood cannot carry oxygen
Toxic is poisoning
Anoxic suffocation results
• Causes stem from:
Prolonged Seizure or
Statistics on Brain Injury EVERYWHERE are inconclusive
• The facts and numbers speak largely to Traumatic Brain Injury
• ABI, the larger aspect of brain injury, is not fully represented.
• Populations of Homeless, Prison, and Domestic Abuse are not fully represented.
• If the individual does not seek medical attention, they are not counted.
• Facts and figures are outdated. (Many online reports cite data from >2004)
• There are many biases' that keep individuals from reporting brain injury.
• Public awareness of brain injury is surprisingly low related to its incidence
• Data collection is just beginning, and largely for TBI, not all brain injury.
• The TBI Act was passed in 1996 for prevention, research, and improved delivery
services. In 2008 another Traumatic Brain Injury Act provided for further research and activity for prevention. Brain Injury continues to be a major health problem 24 and 12 years later, though more evidence for its impact is coming to light.
We are here to help gather the facts and figures, connect available services with need, and identify resources for education, advocacy, identification, and prevention
Because of the serious consequences of TBI and the failure of human service systems and educational programs to meet their needs properly, people with TBI want to be identified as people with brain injuries, not be labeled as having some other disability. This is extremely important if appropriate targeted and prevention efforts are to be conducted. TBI is different from other disabilities due to the severity of cognitive loss. Most rehabilitation programs are designed for people with disabilities, not cognitive disabilities which require special accommodations.
House Committee on Commerce report, 104-652, June 27, 1996
Brain Injury by the Numbers
Statistics as reported from the Center for Disease Control (CDC), National Institute of Health (NIH), Department of Health and Human Services (DHS)
Over 5 Million people are reported disabled as a result of a Traumatic Brain Injury in the U.S.
ER Visits 79%
Treatment & Release. 62%
11,533 ER Traumas were reported In the state of Nevada 2018
2269 classified as TBI
9437 unclassified as:
Motor Vehicle 25%
Every 23 Seconds a TBI is Sustained in the U.S.
AGE • GENDER • RACE
Brain Injury affects all ages throughout a lifespan. It isn't specific to gender and it ignores race. Everyone is susceptible.
ER Visits >75% (0-4)
Hospitalization -5% (>75)
Death 50% (>75)
ER Visits >25% (0-4)
Hospitalization +5% (>75)
Death 50% (>75)
African American 17%
Native American. 26%
Overall Incidence of ethnic brain injury
0-4 Most at Risk for Falls
5-14 Most at Risk for Impact
15-34 Motor Vehicle Accident Risk
> 65 Most at Risk for Falls
85% of patients
do not receive treatment or counseling to
help with long term effects of
Study by NIH
Division of Public and Behavioral Health. 2018 Annual Trauma Report. Carson City, Nevada. e 1.0, July 2019.
Auto Accident 20%
Brain Injury Severity
Seat Belt Use
age >18 39%
age 18-64 43%
age . 64 18%
The High Cost of Brain Injury
Brain Injury is rarely an individual experience. When it affects one individual, it also affects a family, loved ones and friends. It creates an adjustment in living and life is not the same. It calls for special needs, equipment, time, and care. These things add up and very few are able to navigate the extensive cost without adjustments or a struggle financially. It can also affect a community as income earners are curtailed from earning in the same way, and care falls hard on a family. Support and service is needed from the community and often in cost-effective ways.
Further Surgical Procedures
Initial Hospital Time Off
Financing Support Equipment
Coordinate Nursing Care
Home Health Care Schedule
FutureSurgical or Procedures
Special Assistance Research
Legal Aid Research
Family Behavioral Dynamics
Advocacy in the hospital
Advocacy in Rehabilitation
Scheduling Medical Visits
Transporting and Assisting
Operating Support Equipment
Learning New Technology
Home Nursing Care
Special Assistance Research
Family Behavioral Dynamics
Support Groups for Injury
Support Groups for Family
Support Groups for Caregiver
Education and Classes
Legal aid Assistance
Aside from the costs involved with the lists above, brain injury is different for everyone and can take 5-10 years for many to find a recoverable point. The average cost per year may run between $35,000 to $40,000, considerably higher if hospitalized.
The average cost for a lifetime is estimated from $85.000 to $3 million.
The annual US cost for Brain Injury is configured at 76.5 Billion annually.
Some may discover permanent disability and require a whole new structure for living. It is estimated that within two years the unemployment rate jumps from the average 5% for most individuals to 60% for those with brain injury. It is imperative for the brain-injured individual to discover a suitable occupation or contribution.
are estimated at 3.8 million
The Traumatic Brain Injury Act was established in 1996
The World Health Organization (WHO) established surveillance standards for the Central Nervous System in 1993
The Americans with Disabilities Act was established in 1990
Where do you want to Start?