Statistics | Nevada Brain Injury

ABI and TBI l Brain Concerns l Levels of Injury l Causations l About Statistics l Brain Injury by the Numbers l Cost of Brain Injury

Statistical Information

A Brain Injury

can affect

everyone
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

Brain Concerns

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
Subdural Hematoma
Brain Aneurysm
Concussion

Tumor

Coup Contre Coup

Hematoma
Hemorrhage
Edema
Contusion

Closed Head Wound
Second Impact
Shaken Baby Syndrome
Penetrating Cranial injury

Stroke

Encephalopathy

BRAIN INJURY IS CALLED MANY THINGS:

Skull Fracture
Penetration
Intracranial Hematoma
Ischemia

Open Head Injury

Cerebral Laceration

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

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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

DEMENTIA

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

• 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.

IMPACTS

• 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.

VEHICLE
ACCIDENTS

• 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.

VIOLENT ATTACK

• 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.

SPORTS

• 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.

Incidence of
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.

NEUROTOXIC

Biological, chemical and physical agents can adversely affect the central and peripheral nervous system

External Toxic Abuses:

Mercury
Lead
Manganese

Carbon Monoxide

Arsenic

Hydrogen Sulfide
Pesticides/Herbicides
Methane Gas & Fuels

Ethanol
Solvents
Cleaning Products
Perfume

Tolulene

Flouride

Clorpyrifos

DDT, PCB, PERC

INFECTIONS

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.

Infection types:

• Meningitis
• Encephalitis

Vaccines, cancer or other disorders can trigger an autoimmune response and inflame affected tissues or blood transport.

TOXIC EXPOSURE

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

Substance Abuse

Alcohol Abuse
Nicotine Abuse

Inhaled Volatile Agents
Amphetamine Addiction

Stimulant Abuse
HalucInogen Abuse
Opioid Addiction

METABOLIC DISORDERS

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

Electrolyte imbalance

Poor Nutrition
Brain Abscess
Inflammation

drug overdose

Genetic predisposition
to disease
Diabetes

TRAUMA

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

SEIZURES

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.

Epileptic Seizures
Recurring seizures

• Types of Seizures:
Absence (Petit Mal)
Tonic-Clonic (Grand mal)

Atonic (drop attacks)
Clonic
Tonic
Myoclonic

STROKE

• 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

Ischemic Stroke:
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

BLOOD CLOTS

•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:

Epidural

Subdural
Subarachnoid
Intercerebral

TUMORS

• 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:

Gliomas

Meningiomas

Pituitary Tumor

Spinal Cord Tumor
Vestibular Schwannoma

Acoustic Neuroma

Medulloblastoma

HYPOXIA

• 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
deprived.
Anemic is when blood cannot carry oxygen

Toxic is poisoning

Anoxic suffocation results

• Causes stem from:

Cardiac Arrest

CPR
Drowning

Suffocation
Strangulation
Choking
Smoke Inhalation

Intoxication
Prolonged Seizure or
Status Epilepticus

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)

INCIDENCE

Over 5 Million people are reported disabled as a result of a Traumatic Brain Injury in the U.S.

Incidence Reports
ER Visits 79%
Treatment & Release. 62%

Hospitalization. 17%

Rehabilitation 13%

Death. 4%

In Nevada

11,533 ER Traumas were reported In the state of Nevada 2018

2269 classified as TBI
9437 unclassified as:
Falls 61%

Motor Vehicle 25%

Impact 6%

Violence 4%
Sports 4%

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.

Males (age)
ER Visits >75% (0-4)
Hospitalization -5% (>75)

Death 50% (>75)

Females (age)
ER Visits >25% (0-4)
Hospitalization +5% (>75)

Death 50% (>75)

African American 17%
Asian 8%

Caucasian 20%
Hispanic 11%
Native American. 26%

Overall Incidence of ethnic brain injury

INCIDENCE

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

AGE

85% of patients

do not receive treatment or counseling to

help with long term effects of

Brain Injury

Study by NIH

Nevada

Facts
Based on
Division of Public and Behavioral Health. 2018 Annual Trauma Report. Carson City, Nevada. e 1.0, July 2019.

Major

Causation
Falls 69%
Auto Accident 20%
Impact 11%

Brain Injury Severity
Minor 25%
Moderate 36%
Severe 39%

Mortality 10%

Major

Factors

Helmet Use:
Bicycles 31%
Motorcycles 23%
Off-Road 24%

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.

Individual
Initial Hospitalization
Rehabilitation

Neurological Visits

Physical Therapy
Psychological Assistance
Cognitive Therapy

Life Re-Education
Support Equipment
Technology Assistance

Nursing Assistance
Home Health
Household Redesign
Medicine
Nutritional Requirements

Recreation

Further Surgical Procedures

Special Assistance

Transportation

Insurance
Legal Aid

Financial Reorganization

Families
Initial Hospital Time Off
Rehabilitation Education

Neurological Comprehension

Therapeutic Learning
Psychological Assistance
Cognitive Therapy

Life Re-Education
Financing Support Equipment
Financing Technology

Coordinate Nursing Care
Home Health Care Schedule
Household Redesign
Medicine Organization
Nutritional Preparations

FutureSurgical or Procedures

Special Assistance Research

Transportation Concerns

Insurance Research
Legal Aid Research

Financial Reorganization

Family Behavioral Dynamics

Caregiving
Advocacy in the hospital
Advocacy in Rehabilitation

Neurological Education

Therapeutic Necessities
Psychological Comprehension
Cognitive Training

Scheduling Medicines
Scheduling Caregiving

Scheduling Medical Visits
Transporting and Assisting
Operating Support Equipment
Learning New Technology

Home Nursing Care
Boosting Morale
Medicine Organization
Nutritional Preparations

Coordinating Activities

Special Assistance Research

Respite Scheduling

Self Care

Family Behavioral Dynamics

Community
Support Groups for Injury
Support Groups for Family

Support Groups for Caregiver

Community Therapies
Recreational Support
Rehabilitation Programs

Ongoing Education
Financial Aid

Insurance
Transportation
Employment Opportunities
Support Services

Education and Classes
Assistance Programs
Outreach Programs
Supplemental Income

Legal aid Assistance

Vocational Support

Family Services

Housing Assistance

Respite Support

Cost Factors
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.