Facts on Brain Injury

Definition
Traumatic Brain Injury (TBI) is an insult to the brain, not of degenerative or congenital nature but caused by an external force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities of physical functioning.

Scope
Injury is the leading cause of mortality among Americans under 45 years of age, and TBI is responsible for the majority of these deaths. Teen drivers are responsible for about five times as many fatal car crashes per license holder as drivers between the ages of 35 and 64. Motor vehicle accidents are the number one killer of young Americans age 15 to 24.

It is estimated that TBI claims more than 50,000 American lives annually.

Each year over 1.5 million Americans sustain a TBI. Among those who survive, 80,000 people per year must learn to cope with lifelong losses of function. 5.3 million Americans- 2% of the U.S. population currently live with disabilities resulting from a brain injury.

Sports-related TBIs occur most frequently among people between the ages of 5 and 24.

After one TBI, the risk for a second injury is three times greater; after a second TBI, the risk for a third injury is eight times greater. ³

Causes of TBI

• Vehicle crashes are the leading cause of TBI, accounting for 44% of all injuries.
• Falls are the second leading cause, accounting for more than 26% of all TBI injuries.
• Alcohol is a significant factor in the occurrence of TBI. About one in two twelfth grade students report drinking monthly. More than 50% of persons with brain injury have been intoxicated at the time of injury. ^4&5
• Other causes of TBI are: assaults and firearms 17%, sports and recreation 13%.
• Every 21 seconds in the United States, one more person sustains a TBI.

Who Sustains TBIs
Males aged 15 to 24 years are at highest risk, followed by infants and the elderly.

Males are twice as likely as females to sustain a TBI due to differences in risk exposure and lifestyle.

An estimated 200,000 children are hospitalized each year with brain trauma and 30,000 sustain permanent disabilities.

Every year in the U.S., 50,000 children sustain bicycle-related brain injuries; of those, over 400 die.

When TBI Occurs
Mid-afternoons to early evenings, weekends and the summer months are critical times during which TBI is most likely to occur. ⁹

Children are especially at risk in the afternoon hours after they are dismissed from school; 42.6% of children's injuries occur on roads, 34.3% at home and 6.6% in recreation areas. ¹⁰

Consequences
Cognitive: May include short and long term memory loss; difficulties with concentration, judgment, communication, and planning, spatial disorientation.

Physical: May include seizures, muscle spasticity, vision, hearing, smell and taste loss, speech impairment, headaches and reduced endurance.

Psychosocial/Behavioral/Emotional: May include anxiety and depression, mood swings, denial, sexual difficulties, emotional lability, egocentricity, impulsivity and disinhibition, agitation, and isolation.

Cost
The cost of TBI in the United States is estimated to be $48.3 billion annually. Hospitalization accounts for $31.7 billion, whereas fatal brain injuries cost the nation $16.6 billion. ¹¹

Footnotes
¹ Kraus JF, McArthur, DL. Epidemiology of Brain Injury. Los Angeles: University of California Los Angeles; Department of Epidemiology, Southern California Injury Prevention Research Ctr. Feb. 1995.
² Kraus J. Sorenson S. Epidemiology. In Silver J. Yudofsky S. Hales R (eds), Neuropsychiatry of Traumatic Brain Injury. Washington, DC; American Psychiatric Press, Inc. 1994
³ FDA Consumer. Head injuries. Health Response Ability Systems, 1993. (File downloaded from American Online).
⁴ Ruff RM, Marshall LF, Klauber MR, Bluni BA, Grant I. Foulkes MA, et al. alcohol abuse and neurological outcome of the severely head injured. Journal of Head Trauma Rehabilitation 1990; 5:21-31.
⁵ Kreutzer JS. Doherty KR, Harris JA, Zasler ND. Alcohol use among persons with traumatic brain injury. Journal of Head Trauma Rehabilitation 1990; 5:9-20.
⁶ Annagers JF, Garbow JD, Kuriand LT, et al. The incidence, causes and secular trends of head trauma in Olmstead County, Minnesota, 1935-1974, Neurology 1980; 30:912-919.
⁷ Kraus JF. Epidemiology of head injury. In Cooper, PR (ed), Head Injury. Baltimore: Williams & Wilkins, 1993.
⁸ Research and Training Center in Rehabilitation and Childhood Trauma. National Pediatric Trauma Registry. Boston: Tufts University School of Medicine, New England Medical Center, Spring 1993.
⁹ Rimel RW, Jane JA, Characteristics of the head-injured patient. In Tosenthal M. Griffith ER, Bond MR, Miller JD (eds). Rehabilitation of the Head Injured Adult. Philadelphia: FA Davis, 1983.
¹⁰ Research and Training Center in Rehabilitation and Childhood Trauma, National Pediatric Trauma Registry. Boston: Tufts University School of Medicine, New England Medical Center. Spring 1985.
¹¹ Levin-ICF. The Cost of Disorders of the Brain. Washington DC: The National Foundation for the Brain, 1992.