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Traumatic
Brain Injury (TBI)
A
Summary
by:
George Pararas-Carayannis, Ph.D.*
(Excerpts
from summary prepared under contract for the ReGenesis Medical
Center/ Dec 2000)
*
Disclaimer -
I am not a medical doctor. All material provided at this website
is for informational purposes only. Readers are encouraged to
confirm the information contained herein with other sources.
Patients and consumers should review the information carefully
with their professional health care provider. The information
is not intended to replace medical advice offered by physicians.
I will not be liable for any direct, indirect, consequential,
special, exemplary, or other damages arising therefrom.
Introduction
 Traumatic
brain injury (TBI) occurs frequently. It is estimated that every
15 seconds someone sustains a brain injury and that every five
minutes, one of those people will die and another will become
permanently disabled. Each year in this country, a total of more
than two million people sustain some form of traumatic brain
injury, with 1,000,000 being severe enough to be treated in hospital
emergency rooms.
Approximately 75,000
to 100,000 die each year as a result of a TBI, most deaths occurring
at the time of injury or within the first two hours of hospitalization.
Of those who survive their initial injury, approximately 70,000
to 90,000 become permanently disabled and have to endure lifelong
debilitating loss of function. This is higher than the combined
incidence of Alzheimer's disease, Parkinson's disease, and multiple
sclerosis. An additional 2,000 of those sustaining a head injury
will exist in a persistent vegetative state.
According to the Brain
Injury Association, TBI is a leading cause of death and disability,
particularly among children and young adults. Males are more
likely to suffer serious brain injuries than are females. The
highest rate of injury occurs among young men between the ages
of 14 and 24. Each year, more than 1,000,000 children sustain
brain injuries, ranging from mild to severe trauma. Falls are
the most common cause of playground injuries, and 75% of children's
deaths by falling from playground equipment, result from brain
injuries.
Causes of
TBI
Motor vehicle crashes
account for 50% of all fatal and non-fatal TBIs. This includes
all crashes involving cars, trucks, motorcycles, bicycles, and
pedestrians. The majority of fatal brain injuries are due to
motor vehicle crashes (43%) and firearms (34%) followed by falls
(9%). Between 32 and 73% of all brain injuries resulting in hospitalization,
are accompanied by a high blood alcohol level. Fatality crashes
involving men are much more likely to be alcohol related than
those involving women (The Insurance Institute for Highway Safety
1994).
Among the elderly, falls are second only to motor vehicle crashes
as the leading cause of TBI. Child abuse accounts for 64% of
traumatic brain injuries in infants. Also, each year in the United
States, 50,000 children sustain bicycle related brain injuries.
Over 400 of these children die as a result of their injuries.
Traumatic
Brain Injury
The term "brain
injury" refers to any injury of the brain and can be caused
by fracture or penetration of the skull (such as in the case
of a vehicle accident, fall or gunshot wound), a disease process
(neurotoxins, infections, tumors, metabolic abnormalities, etc.)
Symptoms
of Traumatic Brain Injury
Traumatic brain injury
can have serious and devastating, lifelong effects on the physical
and mental functioning of the survivor.
Physical symptoms
may include Impairment of speech, vision and hearing
loss, headaches, muscle spasticity, partial or complete paralysis
and seizure disorders.
Cognitive symptoms
may include loss of consciousness, short and long-term memory
losses, limited concentration, impaired perception and communication,
difficulties with reading, writing, planning, and judgment.
Beyond the obvious
physical effects of brain injury, survivors frequently cope with
psychological, social, behavioral and emotional impairments.
These may include fatigue, altered personality, mood swings,
denial, anxiety, depression, sexual dysfunction, lack of motivation,
loss of self esteem, and problems with interpersonal skills.
In some cases, the injury survivor may not even have awareness
of any resulting impairments.
Closed Head
Injury
The term "closed
head injury" is used when the brain has been damaged without
penetration of the skull by another object. Such injury often
occurs without leaving obvious external signs. A closed head
injury such as in the case of Shaken Baby Syndrome can result
from rapid acceleration or deceleration of the head, in which
the brain is damaged by severe and violent shaking or twisting.
Depending on the location and severity of the injury, the body
can be affected in a myriad of ways. When the injury results
from head trauma, damage to the brain may occur at the time of
impact or may develop later due to swelling (cerebral edema)
and bleeding into the brain (intracerebral hemorrhage) or bleeding
around the brain (epidural or subdural hemorrhage). When the
head is hit with sufficient force, the brain turns and twists
on its axis (the brain stem), interrupting normal nerve pathways
and causing a loss of consciousness. If this unconsciousness
persists over a long period of time, the injured person is considered
to be in a coma, a condition caused by the disruption of the
nerve fibers going from the brain stem to the cortex.
If the injury is severe,
as in the case of an acceleration deceleration injury in which
the moving head impacts against a hard, fixed surface, multiple
areas of the brain are damaged. For example, a compression fracture
occurs in the area where the head impacted the fixed surface.
Upon impact, the brain rebounds forward and backward against
the skull (this is called coup-contracoup), which tears the subdural
veins, causes damage to the temporal lobes as they move across
the rough bony structures within the skull, and results in bleeding,
swelling of the brain stem, and shearing of the blood vessels
and nerve fibers.
Mild Traumatic
Brain Injury (MTBI)
Mild traumatic brain
injury (MTBI), also known as concussion, is a frequent form of
head injury. Almost every concussion causes some damage to the
brain, and the damage from successive concussions is cumulative.
The additional risks from a series of concussions include premature
senility, Alzheimer's disease, and Parkinson's disease.
Differences
between closed and penetrating TBIs
The difference between
closed and penetrating injuries can be profound. In a bullet
wound to the head, for example, a large area of the brain may
be destroyed but the resulting neurologic deficit may be minor
if that area was not a critical one. In contrast, closed head
injuries result in more widespread damage and can result in more
extensive neurologic deficits. These deficits can include partial
to complete paralysis, cognitive, behavioral, and memory dysfunction,
persistent vegetative state, and death. These last two are the
most feared outcomes in cases of brain injury, however advances
in trauma care have led to decreased rates for both in recent
years.
Alternative
treatment therapies
Free
radicals are formed at some point in almost every mechanism of
secondary brain injury. These highly reactive molecules attack
the fatty acids in the myelin and cell-membrane. If unchecked,
lipid peroxidation spreads over the surface of the cell membrane
and eventually leads to cell death. Antioxidants are therefore
important to recovery as well as prevention in protecting the
brain after an injury. Vitamins are also helpful in repairing
injured brain cells.
Several protocols
of treatment can be given to patients that have sustained a head
injury, but particularly intravenous Glutathione, EDTA chelation,
and Meyer's cocktail. Glutathione is an important nutrient and
energy source for the brain and acts as a major antioxidant within
each cell in patients who have sustained a traumatic brain injury.
Hyperbaric Oxygen Therapy treatments are also helpful in forcing
more oxygen into the body under pressure and to dissolve in all
the body's fluids. These fluids carry the extra oxygen to the
damaged cells in the brain and help the healing process.
Miscellaneous
Summaries on Chronic Illnesses
heart disease | |
stroke | diabetes |
| high blood
pressure
| | high cholesterol | | Alzheimer's | |
Parkinson's
| |
arthritis | |
chronic
fatigue
|
| poor circulation | | brain injury | | multiple sclerosis | | cerebral palsy | | life extension | | memory
loss |
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