Understanding Traumatic Brain Injury
Education and Advocacy It can be said that people take their brains for granted.
The most complex and powerful organ in the human body, the brain is what helps us to breathe, think, move, interact and make decisions during every second of our daily lives. When the brain is injured due to trauma, everything can change in a split second.
A traumatic brain injury, or TBI, is an insult to the brain resulting from a mechanical force occurring though an external blow to the head, or a significant jolt that throws the head back and/or forward. Viewed along a spectrum, concussions, or mild TBI are at one end, and severe TBI at the other. Eighty percent of TBIs are concussions/mTBI, with 10% moderate injury and 10% severe.
Traumatic brain injury occurs among the very young and the very old and everyone in between, however these two age groups are particularly at risk. Each year in Canada there are 50,000 TBIs of various degrees. This statistic is viewed as a gross underestimate because concussions/mild TBIs can be misdiagnosed, undiagnosed or initially overlooked. Because of the complexity of the brain, no two brain injuries are alike.
TBI is a major cause of death and disability worldwide. In Canada it is estimated that there are half a million people living with TBI. Common consequences are cognitive, physical and psychosocial in nature, and affect an individual, their family and daily life.
Effects differ according to the severity of the injury, the person’s life experiences, health and status before the injury and the amount of rehabilitation and support they receive. Most concussions/mTBIs resolve within a week to a few months but some can take years to get over.
“In Canada it is estimated that there are half a million people living with TBI.”
Sometimes the effects of TBI aren’t immediately visible and can be misunderstood or judged by others. Someone can be walking and talking and seem fine, but can have great difficulty with memory or organizing their thoughts or activities, or may have trouble with impulse control and social awareness and get into arguments with those around them. A severe TBI will have lifelong consequences requiring ongoing supports to maximize the person’s function and community participation.
Return to prior employment rates after TBI are only around 38%, and children can have special requirements in returning to school as well as in their development over time. Depression and anxiety are common, and substance use issues can also be a factor. Stress on families is very high.
Research in TBI over the past 20 years has led to significant advances. Improvements in pre-hospital, neurosurgical and intensive care protocols have saved the lives of people who would have died from similar injuries decades ago. Advances in imaging have enabled researchers and physicians to better understand the nature of TBI and consequences and are advancing knowledge about neuroplasticity.
Evidence is showing that certain rehabilitation interventions and treatments are more effective than others, and that community supports are effective and necessary to improve the quality of life of people with TBI. There is more to be learned and more to be done.