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Jack Sisson's TBI Blog

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The Daily Times of Maryland is running a series of articles on Traumatic Brain Injury this month. The author, Paul Rendine, has this to say about them:
Several years ago, I wrote a series of articles about traumatic brain injuries. Surprisingly to me, I received one of the largest numbers of comments and questions -- more than 67 -- during the life of that series. I thought that this month might be the best time to both review those comments, while updating the current scientific, medical and rehabilitation programs that seem now to provide the best outlook or answers for this least understood but still highly prevalent disability.
Just click on one of the dates below to link to that day's article.

Excerpt from May 2, 2010 article:
As I write this, traumatic brain injury is a major public health problem in America, especially among male adolescents and young adults ages 15-24, as well as among elderly people of both sexes 75 years and older. Children aged 5 and younger are also at high risk for TBI, vis-à-vis shaken baby syndrome, for example.

Today, TBI costs the country more than $56 billion a year, and more than 5 million Americans alive today have had a TBI resulting in a permanent need for help in performing daily activities. Survivors of TBI are often left with significant cognitive, behavioral and communicative disabilities, and some patients develop long-term medical complications, such as epilepsy.

Excerpt from May 9, 2010 article:
Skull fractures can cause bruising of brain tissue called a contusion. A contusion is a distinct area of swollen brain tissue mixed with blood released from broken blood vessels. A contusion can also occur in response to shaking of the brain back and forth within the confines of the skull, an injury called contrecoup. This injury often occurs in car accidents after high-speed stops and in shaken baby syndrome, a severe form of head injury that occurs when a baby is shaken forcibly enough to cause the brain to bounce against the skull.

In addition, contrecoup can cause diffuse axonal injury, also called shearing, which involves damage to individual nerve cells (neurons) and loss of connections among neurons. This can lead to a breakdown of overall communication among neurons in the brain.

Excerpt from May 16, 2010 article:
Sometimes, health complications occur in the period immediately following a TBI. These complications are not types of TBI, but are distinct medical problems that arise as a result of the injury to the brain. Although complications are rare, the risk increases with the severity of the trauma.

Complications of TBI include immediate seizures, hydrocephalus or post-traumatic ventricular enlargement, CSF leaks, infections, vascular injuries, cranial nerve injuries, pain, bed sores, multiple organ system failure in unconscious patients and polytrauma (trauma to other parts of the body in addition to the brain).

Excerpt from May 23, 2010 article:
Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the patient. Some common disabilities include problems with cognition (thinking, memory and reasoning), sensory processing (sight, hearing, touch, taste and smell), communication (expression and understanding) and behavior or mental health (depression, anxiety, personality changes, aggression, acting out and social inappropriateness).

Within days to weeks of the head injury, approximately 40 percent of TBI patients develop a host of troubling symptoms collectively called post-concussion syndrome. A patient need not have suffered a concussion or loss of consciousness to develop the syndrome, and many patients with even a mild TBI can suffer from post-concussion syndrome. Symptoms include headache, dizziness, vertigo (a sensation of spinning around or of objects spinning around the patient), memory problems, trouble concentrating, sleeping problems, restlessness, irritability, apathy, depression and anxiety. These symptoms may last for a few weeks after the head injury. The syndrome is more prevalent in patients who had psychiatric symptoms, such as depression or anxiety, before the injury. Treatment for post-concussion syndrome may include medicines for pain and psychiatric conditions and psychotherapy and occupational therapy to develop coping skills.

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