VIRGINIA COMMONWEALTH UNIVERSITY

NATIONAL RESOURCE CENTER
FOR TRAUMATIC BRAIN INJURY

Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Causes

QUESTION:
What is anoxic brain injury?

ANSWER
Anoxic brain injury refers to damage caused to the brain when its oxygen supply is cut off. In general, this occurs when there is an absence of oxygen intake (no breathing) or an impairment in oxygen transport by the blood stream. Anoxic brain injury can occur along with cardiac arrest, as a complication of surgery, or as a result of near-drowning.

When the flow of oxygen to the brain is interrupted even for just a few minutes, serious, irreversible damage can occur. While traumatic brain injury can result in bruising and swelling of the brain, anoxic brain injury causes brain cells to die. The sequela of anoxic brain injury (the physical and cognitive impairments) resemble those of other types of brain trauma. Rehabilitation for anoxic brain injury involves many of the same therapies as traumatic brain injury... physical therapy, cognitive therapy, occupational therapy, etc. The prognosis for someone with anoxic brain injury depends upon pre-morbid factors (e.g., pre-injury heart condition), the injury (e.g., length of time of anoxia), and treatment (e.g., intensity and quality of therapy).

Reference: 

  1. Long, David F. What is Anoxic Brain Injury? Washington, D.C.: Brain Injury Association, Inc. (formerly National Head Injury Foundation).
  2. Adiguzel E, Yasar E, Kesikburun S, Demir Y, Aras B, Safaz I, ... Tan AK (2018). Are rehabiliation outcomes after severe anoxic brain injury different from severe traumatic brain injury? A matched case-control study. Int J Rehabil Res. 41(1): 47-57


QUESTION:
What are the three leading causes of traumatic brain injuries?

ANSWER

In 2013, Centers for Disease Control and Prevention reported that falls were the leading cause of traumatic brain injury (TBI). Falls accounted for 47% of all TBI-related ED visits, hospitalizations, and deaths in the United States. Being struck by or against an object was the second leading cause of TBI, accounting for about 15% of TBI-related ED visits, hospitalizations, and deaths in the United States. Motor vehicle crashes were the third overall leading cause of TBI, accounting for about 14% of TBI-related ED visits, hospitalizations, and deaths.

References: 

  1. Centers for Disease Control, & Prevention. (2017). Traumatic Brain Injury–Related Emergency Department Visits, Hospitalizations, and Deaths — United States, 2007 and 2013. Morbidity and Mortality Weekly Report, Surveillance Summaries, 66(9), 1–16.
  2. Centers for Disease Control, & Prevention. (2003). Report to Congress on mild traumatic brain injury in the United States: Steps to prevent a serious public health problem. Retrieved from https://www.cdc.gov/traumaticbraininjury/pdf/mtbireport-a.pdf 


QUESTION:
What are the leading causes of traumatic brain injury in children?

ANSWER

Causes of pediatric TBI are varied and appear to differ by age. The Centers for Disease Control and Prevention (CDC) identified the following leading causes of TBI in children and adolescents ages 0 to 14:

Falls (50.2%)
Struck by/against events (24.8%)
Motor vehicle accidents (6.8%)
Assault (2.9%)
Unknown/other (15.3%)

Falls and assault (e.g., shaken baby syndrome or other physical abuse) are the most common mechanisms of TBI in infants, toddlers, and preschoolers. TBI secondary to velocity injury (e.g., motor vehicle or bicycle accidents, sports injuries) occurs more often in elementary school children and adolescents with sports and recreational activities contributing  to about 21 percent of all traumatic brain injuries among American children and adolescents.

References:

  1. Centers for Disease Control, & Prevention. (2003). Report to Congress on mild traumatic brain injury in the United States: Steps to prevent a serious public health problem. Retrieved from https://www.cdc.gov/traumaticbraininjury/pdf/mtbireport-a.pdf 
  2. Centers for Disease Control, & Prevention. (2015). Report to Congress on traumatic brain injury in the United States: Epidemiology and rehabilitation. Retrieved from https://www.cdc.gov/traumaticbraininjury/pdf/tbi_report_to_congress_epi_and_rehab-a.pdf 
  3. Centers for Disease Control, & Prevention (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths 2002–2006. Retrieved from https://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf
  4. Ciuffreda, K.J., Kapoor, N., Rutner, D., Suchoff, I.B., Han, M.E., & Craig, S. (2007). Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis.Optometry, 78(4), 155-61.


QUESTION:
My friend was diagnosed with a "closed head injury" after a car accident. She doesn't remember all of the accident, but reports feeling dazed for a period of time afterwards. She says she didn't completely lose consciousness, though. The hospital did a CT scan and sent her home. Now my friend is experiencing headaches and mood swings. Is it possible that the closed head injury caused these problems?

ANSWER
It is possible to have brain damage even if a CT scan doesn't show any problems. It is possible to have brain damage even if there was no loss of consciousness. Headaches and mood swings are both symptoms which can come from a closed head injury. It's possible to have such symptoms even when at first doctors don't find anything obviously wrong. Any time someone has new symptoms following an accident, it's a good idea to go back to the doctor to evaluate the cause and recommend treatment. The doctor might suggest that the patient sees a psychologist or psychiatrist as well.

JOIN OUR MAILING LIST

As a mailing list subscriber, you will receive e-mails of interest about once a month. You will also receive an electronic copy of our newsletter, TBI Today.

Name:

*

Email Address:

*