1. Traumatic Brain Injury
Definitions, Prevalence and Consequences
Rebecca Quinn, MSW

2. Traumatic brain injury is the most misunderstood, misdiagnosed,
underfunded public health problem our nation faces.”
Susan Connors, President
Brain Injury Association of America

3. TBI Grants in North Dakota
Federal TBI Planning Grant
Conducted a TBI needs and resource assessment
Developed a state TBI action plan
Federal TBI Implementation Partnership Grant
$118,000 a year, Local funds will provide $59,000 in match
Awarded to ND Department of Human Services
Contracted to The UND Center for Rural Health
Partners
Dakota Medical Foundation
Anne Carlsen Center for Children
North Dakota Head Injury Association

4. Myths of Brain Injury “They doesn’t look brain injured”
“The brain-injury should be healed by now!”
“We use only 10% of our brain”
“Time heals”
“It was just a bump on the head.”

5. So what is a Brain Injury?
Acquired Brain Injury (ABI)
Any injury to the brain that occurs after birth.
Does not include
Hereditary or congenital conditions
Birth traumas
Degenerative disorders
Traumatic Brain Injury (TBI)
Is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain.

6. Acquired Brain Injury (ABI)
Any injury to the brain
occurring after birth.
Oxygen
Deprivation
Infectious
Disease
Traumatic Brain
Injury (TBI)
Injuries occurring
From external force
Chemical or
Substance
Exposure
Stroke or
Tumor

7. Scope of the TBI An estimated 1.5 million people
will sustain a TBI each year in the United States.
Of these:
50,000 die;
235,000 are hospitalized
1.1 million are treated and released from an emergency department.

8. That means every 21 seconds…
…someone in the US sustains a traumatic brain injury!
According to the Brain Injury Association, every 21 seconds someone in the US sustains a TBI. That’s roughly 85 people every 30 minutes, and 170 people each hour.
That’s roughly 85 people every 30 minutes,
and 170 people each hour.

9. Many More Unknown Numbers do not include:
Those treated at clinics or Drs offices.
Individuals not receiving treatment
Due to lack of insurance
Thinking the injury is not a problem

10. Only 50% of those with a TBI survived.
Changes Over the Years
30 years ago –
Only 50% of those with a TBI survived.
Today –
78% survive a TBI.

11. Causes of TBI

12. TBI is the leading cause of death and disability for children, adolescents, and young adults in the United States.

13. Who experiences TBI? Anyone can get a TBI!
Yet some are more at risk than others.
Highest risk 0-4 years, 15-24, and 75 years and older.
Males are 1.5 times more likely than females to experience TBI.
Individuals who have already sustained one or more concussions.

15. “Silent Epidemic” or “Invisible Disability”
Brain injuries are often unnoticed or misdiagnosed
Often are no outward signs
May have no conclusive measures
Person looks the same
Individuals often told they would be fine.

16. Resulting Disabilities
Estimates say 15-20% of TBIs will have long term disabilities.
An estimated 5.3 million Americans have a long-term or life long need for help with activities of daily living as a result of TBI.
Estimate of TBI-Disabled Persons in ND: 12,844*

17. National statistics for TBI and other disability groups
Comparison of Disability Prevalence Rates
400,000 with Spinal Cord Injuries
National statistics for TBI and other disability groups
5 million with persistent mental illness
2 million Americans with Epilepsy
7.3 million with Developmental Disabilities
5.3 MILLION WITH TBI DISABILITIES
4 million with Alzheimer’s Disease
3 million with Stroke disabilities
500,000 with Cerebral Palsy
KEY POINTS
Most people are unaware of the true numbers of Americans living with disability as a result of a brain injury. This chart shows the significant prevalence of TBI and how it compares with other disability groups.
This population tends to be less vocal than some of the other groups, perhaps due to the overwhelming and diverse nature of their disabilities that have made it difficult for many people with TBI to advocate for their needs.

18. Focal Impact Injury
Coup-contra coup-brain slams forward and back inside skull.

19. Diffuse Axonal Injuries
Rotational forces on the brain cause the stretching, snapping and shearing of axons

20. Blast Injury Leading cause of TBI in war zones.
Primary injury results from the
complex pressure wave
generated by an explosion.
Can cause wide spread
Diffuse Axonal Injury.

21. Neuro-chemical Changes
Changes in brain chemistry and neurotransmitters
Effects neurological functioning
Body must work extra hard to restore chemical balance

22. Severity Continuum
Severe 5-10%
Moderate 10-30%
Mild 75-90%

23. Severe Brain Injury Coma for more than 24 hours.
80% have multiple long-term impairments.

24. Moderate Brain Injury
Unconscious for more than minutes but less than 24 hours.
Usually shows signs on EEG or CT scan or MRI.
33-50% have long-term difficulties in one or more areas.

25. Mild Brain Injury (mTBI)
Brief (<15 min) or NO loss of consciousness,
May also have:
dazed look, confused, headache, nausea, dizziness, groggy or tired.
CT scans, MRI, EEG or routine neurological evaluations may be normal.
“concussion” “bell rung” “ding” “blow” “bump on the noggin”

26. Mild can be a Misnomer 90% of mild TBIs will recover within 6-8 weeks.
Degree of physical injury does not always determine the degree of difficulty related to long-term functioning.
Post-Concussion Syndrome is the term for individuals who have concussion symptoms more than six months after a concussion.

27. Recovery After Brain Injury
Measured in weeks, months and years.
Usually most rapid in the first six months.
Recovery from brain injury is slow and
often incomplete.

28. Treatments Prevention is the only cure Medications
Presently no medications approved for TBI
Changes in brain chemistry
Cognitive Rehabilitation
Takes time
Qualified providers?
Lack of insurance approval

29. No Two Brain Injuries Are Alike.
As diverse as each human being is, this is how different brain injury can be for each person.
Factors influencing outcomes:
Personal
Medical
Social

30. Possible Changes after a Brain Injury
Lack of Awareness
Cognitive Fatigue
and
Cognitive Changes
Emotional
Behavioral
Changes
Physical Changes

31. Executive Functioning
Coach
Executive Function
Math
Reading
Spelling
Skills Team
Language
Attention
Memory

32. "Unidentified traumatic brain injury is an unrecognized major source of social and vocational failure,"
Wayne A. Gordon, director of the Brain Injury Research Center at Mount Sinai School of Medicine in New York

33. National Resources Brain Injury Association of America,
National Association of State Head Injury Administrators,
TBI Technical Assistance Center,
Center for Disease and Prevention,

34. North Dakota Brain Injury Association
Acknowledgments
This training and its associated training materials are supported in part by the TBI State Grant Program, Grant Number 1 H21MC , from the Department of Health and Human Services (DHHS) Health Resources and Services Administration, Maternal and Child Health Bureau. The contents are the sole responsibility of the authors and do not necessarily represent the official views of DHHS.
Additional support provided by:
North Dakota Brain Injury Association

35. For more information contact: Center for Rural Health University of North Dakota School of Medicine and Health Sciences Grand Forks, ND Tel: (701) Fax: (701)