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TRAUMATIC BRAIN INJURY (TBI)
Prepared by R.M. Tappin for Helmets To Hardhats © 2009.
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WHAT IS TBI?WHAT IS TBI?
A term that describes sudden and physical damage and trauma to the brain
Traumatic Brain Injury:
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THE BRAIN & Its FunctionsTHE BRAIN & Its Functions
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CONCUSSION: a type of TBICONCUSSION: a type of TBI
4(http://health.allrefer.com/health/head-injury-concussion.html)
CAUSES OF TBICAUSES OF TBI
• A blow or jolt to the head• An injury that penetrates the head and
enters brain tissue• Not all blows/jolts to head cause TBI
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CAUSES OF TBICAUSES OF TBI
• Falls (28%)
• Motor vehicle-traffic crashes (20%)
• Struck by, or against, something (19%)
• Assaults (11%)
(http://www.biausa.org/)
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STATISTICS ON TBISTATISTICS ON TBI
• 50,000 die
• 235,000 are hospitalized
• 1.1 million are treated and released from an emergency department [3]
• About 5.5 million Americans estimated to have long-term care needs as a result of TBI.
• Not known how many are injured, not seen by emergency or other medical facilities, and receive no care.
(Langlois JA, Rutland-Brown W, Thomas KE)
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STATISTICS ON SERVICE STATISTICS ON SERVICE RELATED TBIRELATED TBI
• TBI is the signature wound of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF))
• Most service related TBI caused by blast injuries
• 66% of service personnel in Iraq exposed to or injured by a Blast injury
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STATISTICS ON SERVICE STATISTICS ON SERVICE RELATED TBIRELATED TBI
• 40% of service personnel returning from OIF & OEF show signs & symptoms of TBI due to a blast injury
• The large majority (80%) of combat head injuries sustained in Operation Iraqi Freedom and Operation Enduring Freedom are mild concussions as opposed to severe, debilitating TBI.
National Institute of Neurological Disorders and Stroke.
(http://www.americasheroesatwork.gov)
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SIGNS OF TBISIGNS OF TBI
• Headaches or neck pain that do not go away
• Difficulty remembering, concentrating, or making decisions
• Slowness in thinking, speaking, acting, or reading
• Getting lost or easily confused
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SIGNS OF TBI, cont’dSIGNS OF TBI, cont’d
• Feeling tired all of the time, having no energy or motivation
• Mood changes (feeling sad or angry for no reason)
• Changes in sleep patterns (sleeping a lot more or having a hard time sleeping)
• Light-headedness, dizziness, or loss of balance
• Urge to vomit (nausea)
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SIGNS OF TBI, cont’dSIGNS OF TBI, cont’d
• Increased sensitivity to lights, sounds, or distractions
• Blurred vision or eyes that tire easily
• Loss of sense of smell or taste
• Ringing in the ears
(http://www.cdc.gov/ncipc/factsheets/tbi.htm)
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ESTIMATED FORCE TO ESTIMATED FORCE TO PRODUCE TBIPRODUCE TBI
• Exact figure not known. However:• Plopping down on easy chair = 10g’s• The force of a professional boxer’s hit = 52 g’s • Between 10 and 50 g’s = estimated force
needed to cause permanent brain injury
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TYPES OF TBITYPES OF TBI
Two major types:
1. Penetrating brain injuries
2. Closed head injuries
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TYPE OF TBI: PenetratingTYPE OF TBI: Penetrating
• Foreign object enters brain (e.g. bullet)
• Damage occurs along path of injury
• Symptoms vary according to part of brain that is damaged
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Type of TBI: Closed headType of TBI: Closed head
• Results from blow to the head (e.g. car accident)
• Causes two type of brain injuries:
1. Primary
2. Secondary
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CAUSES OF TBICAUSES OF TBI
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(http://health.allrefer.com/health/head-injury-concussion.html)
Primary Closed Head Injuries:Primary Closed Head Injuries:
• Skull fracture: breaking of the bony skull
• Contusions/bruises: often occur right under the location of impact or at points where the force of the blow has driven the brain against the bony ridges inside the skull
• Hematomas/blood clots: occur between the skull and the brain or inside the brain itself
(asha.org)
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Primary Closed Head Injuries, Primary Closed Head Injuries, cont’d:cont’d:
Lacerations:
• Tearing of the frontal (front) and temporal (on the side) lobes or blood vessels of the brain
• (the force of the blow causes the brain to rotate across the hard ridges of the skull, causing the tears)
• (www.asha.org)
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Primary Closed Head Injuries, Primary Closed Head Injuries, cont’d:cont’d:
Nerve damage (diffuse axonal injury):
• Arises from a cutting, or shearing, force from the blow that damages nerve cells in the brain's connecting nerve fibers
• (www.asha.org)
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SECONDARY CLOSED HEAD SECONDARY CLOSED HEAD INJURIES:INJURIES:
Evolves over time (after trauma has occurred)
• brain swelling (edema)
• increased pressure inside of the skull (intracranial pressure)
• epilepsy
• intracranial infection
• fever• hematoma (for more info visit: www.asha.org)
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HEMATOMAHEMATOMA
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(http://health.allrefer.com/health/head-injury-prevention.html)
SUBDURAL HEMATOMAS HEMATOMAS
• ACUTE Subdural Hematomas : can occur after serious head injuries
• MILD Subdural Hematomas: can occur after mild head injuries
• SPONTANEOUS Subdural Hematomas: can occur spontaneously
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CLOSED HEAD INJURY ILLUSTRATION
( http://health.allrefer.com/health/head-injury-prevention.html)
COMMUNICATION PROBLEMS COMMUNICATION PROBLEMS CAUSED BY TBICAUSED BY TBI
• Trouble finding words
• Difficulty understanding written & verbal communications
• Difficulty spelling, reading, writing
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COMMUNICATION PROBLEMS, COMMUNICATION PROBLEMS, cont’dcont’d
• Inappropriately interrupting conversations
• Inability to follow conversation
• Using inappropriate tone of voice
• Unable to process subtleties/nuances in language (e.g. difference between tongue-in-cheek and seriousness)
(www.asha.org)
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COGNITIVE PROBLEMS COGNITIVE PROBLEMS CAUSED BY TBICAUSED BY TBI
• Slower processing of information
• Loss of short-term memory
• Poor planning, organizing skills
• Setting goals
• Completing tasks
• May act impulsively
• Difficulty solving problems
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TREATMENT OF TBITREATMENT OF TBI
• Research still being conducted• Treatment dependent on severity of the TBI• In mild TBI cognitive behavioral therapy most
common treatment form• Support treatment:
(a) nutrition (b) education (c) counseling & family support (d) medication for symptomatic relief
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LENGTH OF RECOVERY FROM LENGTH OF RECOVERY FROM TBI TBI
• Recovery varies from person to person
• Can be spontaneous
• 80 – 85% mild TBI recover within 6 months
• 15 – 20% mild TBI will recover in 1 – 2 years
• Most will make full recovery
• Some partial recovery
• Extreme cases may never recover (http://www.af.mil/news/story.asp?id=123124683)
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PLEASE PLEASE SUPPORT OUR SUPPORT OUR
TROOPS…TROOPS…
EMPLOY A VETEMPLOY A VET
We owe our We owe our freedom to them!freedom to them!
sources http://health.allrefer.com/health/head-injury-indications-of-head-injury.html
http://www.nlm.nih.gov/medlineplus/ency/article/000713.htm
http://www.asha.org/public/speech/disorders/TBI.htm
http://www.blackmanlaw.com/images/Image/tbi__big.jpg
http://www.af.mil/news/story.asp?id=123124683
National Institute of Neurological Disorders and Stroke. Traumatic brain injury: hope through research. Bethesda (MD): National Institutes of Health; 2002 Feb. NIH Publication No.: 02-158.
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