Page 4 - Microsoft Word - Final TBI Full report 9-7-2012.doc

Traumatic Brain Injury
Occurrence and Mortality in New Hampshire
NH DPHS, Injury Surveillance Program
September 2012
Traumatic Brain Injuries Are A Public Health Issue In New Hampshire. Traumatic brain
injury (TBI), often referred to as the “Silent Epidemic,” presents as an often unseen and
under-reported public health issue. “Recent data shows that on average in the United
States, 52,000 people died, 275,000 were hospitalized, and 1.4 million were treated and
released from an emergency department all due to a TBI.”
At a minimum 5.3 million
Americans live with the long-term consequences of a TBI.
This report is an effort to
comprehensively describe the frequency, causes, and demographic characteristics of new
cases (2001-2009) of traumatic brain injuries (TBI) among New Hampshire residents.
What is a traumatic brain injury and why should we be concerned? A traumatic brain
injury is caused by a blow or jolt to the head or a penetrating head injury that disrupts the
normal function of the brain. Such a blow can launch the brain on a collision course with
the inside of the skull. The skull itself can often withstand a forceful external impact
without fracturing. The result, an injured brain inside an intact skull, is known as a
closed-head injury. A traumatic brain injury may also occur when a projectile, such as a
bullet, rock, or fragment of a fractured skull, actually penetrates the brain. This is much
less common and is known as an open-head injury. Primary brain injuries, occurring
immediately as a direct result of the force applied to the brain, include the following
conditions: contusions, lacerations, hemorrhage, and diffuse axonal injury. Secondary
injuries, which evolve over time, include the following conditions: cerebral edema,
cerebral infarction, cerebral anoxia or hypoxia, cerebral infection, seizures, and changes
in brain chemistry and neurotransmitter functioning. Not all blows or jolts to the head
result in a TBI. The severity of a TBI may range from “mild” or a brief change in mental
status or consciousness to “severe” or an extended period of unconsciousness or amnesia
after the injury. The majority of TBIs that happen in a year are concussions or another
form of mild traumatic brain injury.
Why are traumatic brain injuries a public health issue? Traumatic brain injuries can cause
many different types of changes to the way a person thinks and understands the world
around him. They can affect senses such as touch, taste, and smell. A traumatic brain
injury may interfere with communication and the expression of one’s thoughts. And it
may also result in social inappropriateness, depression, anxiety, personality changes,
aggression, and acting out.
Additionally, changes in attention and concentration,
memory, and executive functioning are all hallmarks of traumatic brain injury.
Traumatic brain injuries may also increase a person’s risk for developing Alzheimer’s
disease, Parkinson’s disease, and other brain disorders that become more prevalent as one
Sustaining a traumatic brain injury can also lead to epilepsy.
Repeated mild traumatic brain injuries that occur over months and even years can result
in additive neurological and cognitive deficits. Repeated mild traumatic brain injuries that
occur over hours, days, or weeks, can be fatal.