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Traumatic Brain Injury

Overview
Traumatic Brain Injury (TBI) and Acquired Brain Injury (ABI) occur when trauma causes damage to the brain. TBI and ABI can result when the head hits an object violently, when an object pierces the skull and enters the brain or as the result of illness or neurological disorders. The effects of TBI /ABI range from mild to severe, depending on the extent of the damage to the brain.

According to the Brain Injury Association, each year more than 700,000 Americans sustain brain damage from traumatic head injuries alone. Most are between the ages of 15 and 30 -- young, active, involved individuals who find themselves suddenly and unexpectedly disabled. In most cases, impaired attention and concentration, memory disturbances, language disabilities and/or loss of reasoning skills prevent these individuals from resuming even minimal pre-accident activities. Awareness of limitations and shattered career and personal goals lead to frustration and depression, further contributing to the individual's isolation and alienation from friends, family and community.

Treatment
Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize the individual to prevent further injury. Primary concerns include insuring proper oxygen supply to the brain and the body, maintaining adequate blood flow, and controlling blood pressure. Rehabilitation efforts include physical therapy, occupational therapy, speech/language therapy, physiatrist (physical medicine), psychology/psychiatry, and social support.

Prognosis
Disabilities resulting from a TBI vary widely and 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).
More serious head injuries may result in stupor, an unresponsive state, but one in which an individual can be aroused briefly by a strong stimulus, such as sharp pain; coma, a state in which an individual is totally unconscious, unresponsive, unaware, and unarousable; vegetative state, in which an individual is unconscious and unaware of his or her surroundings, but continues to have a sleep-wake cycle and periods of alertness; and a persistent vegetative state (PVS), in which an individual stays in a vegetative state for more than a month.

Research
Current research involves studies in laboratory and clinical settings to better understand TBI and the biological mechanisms underlying damage to the brain. This research will allow scientists to develop strategies and interventions to limit the primary and secondary brain damage that occurs within days of a head trauma, and to devise therapies to treat brain injury and improve long-term recovery of function.


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