By Keith Hauret, EpidemiologistMarch 1, 2012
Awareness of traumatic brain injury in the United States has greatly increased over the past few years. It is an important injury that can have long-lasting effects. Active-duty service members are at increased risk for a TBI compared to their civilian peers. According to the Defense and Veterans Brain Injury Center, 29,255 service members were diagnosed with a TBI in 2009 and 30,380 were diagnosed in 2010. (These numbers were obtained from the Defense and Veterans Brain Injury Center, TBI & The Military, http://www.dvbic.org/TBI---The-Military.aspx, accessed on Feb. 23, 2012.)
TBIs also occur among family members and retirees of all ages. More than 1.7 million Americans are treated each year for a TBI, according to the Centers for Disease Control and Prevention. This includes 1.4 million persons who are treated in emergency rooms, 275,000 who are hospitalized, and 52,000 who die from the injury. The CDC estimates the yearly cost for TBIs to be $76 billion. This includes costs for medical treatment and rehabilitation, lost wages, decreased productivity at work, and impact on family members.
Many Americans sustain a TBI each year and are not treated in emergency rooms, making it difficult to know how many TBIs actually occur. Many individuals with TBIs are treated in outpatient clinics, but many never seek any medical attention. The American College of Sports Medicine estimated in a December 2011 team physician concensus statement that there are 3.8 million mild TBIs (concussions) each year just from participation in sports and recreational activities.
TBIs are caused when external forces are applied to the head and brain. These forces can result from a blow or jolt to the head, an object penetrating the head/brain, "whiplash" (as in a car crash), or pressure caused by a blast or explosion. TBIs range from "mild" (a brief change in mental status or consciousness) to "severe" (an extended period of unconsciousness or amnesia after the injury).
With the deployments in Iraq and Afghanistan, the leading causes of TBI for the U.S. civilian population are different compared to the leading causes for military service members. For the civilian population, falls (35 percent), motor vehicle crashes (17 percent), and striking the head by or against an object (17 percent) are the leading causes of TBI, according to the CDC. By comparison, a report by the U.S. Army Public Health Command says 69 percent of the TBIs that required deployed Soldiers to be hospitalized in Iraq and Afghanistan in the years 2004--2009 were from battle-related causes such as bullets, fragments and blasts. Leading non-battle causes for TBIs included motor vehicle crashes (12 percent), falls (6 percent) and sports (2 percent).
Service members and their families should be aware of TBI and its symptoms. Sometimes, symptoms will not be noticed for days, weeks or even months after the injury occurred. This is especially true with mild TBI. TBI symptoms can also be hard to distinguish from other common health problems such as post-traumatic stress disorder or depression.
Symptoms of TBI include:
• Loss of consciousness
• Excessive fatigue
• Trouble concentrating
• Forgetting things (memory problems)
• Balance problems
• Vision changes
• Sleep disturbance
Here are some tips from the CDC on how to protect oneself from brain injuries:
• Wear a helmet or other appropriate head gear.
• Wear safety belts when traveling in vehicles.
• Check for obstacles and loose debris when climbing or rappelling.
• Maintain a clean and orderly work area, free of foreign objects or debris.
• Use care when walking on wet, oily or sandy surfaces.
• Employ the buddy system when climbing ladders and working at heights.
Things Soldiers and their families can do about TBI include:
• Know the signs and symptoms of TBI.
• Seek medical care for any suspected concussion or TBI.
• Keep the Defense Veterans Brain Injury Center phone number (1-800-870-9244) nearby. DVBIC can answer questions about TBI or can direct Soldiers to medical providers.