by the Mild Traumatic Brain Injury Committee of the Head Injury
Interdisciplinary Special Interest Group of the American Congress
of Rehabilitation Medicine. (J Head Trauma Rehabil 1993:8(3):86-87)
patient with mild traumatic brain injury is a person who has had
a traumatically induced physiological disruption of brain function,
as manifested by a least one of the following:
Any period of loss of consciousness;
Any loss of memory for events immediately before or after the accident;
Any alteration in mental state at the time of the accident (e.g.,
feeling dazed, disoriented, or confused); and
Focal neurological deficit(s) that may or may not be transient;
but where the severity of the injury does not exceed the following:
amnesia (PTA) not greater than 24 hours. - after 30 minutes,
an initial Glasgow Coma Scale (GCS) of 13-15; and - loss of consciousness
of approximately 30 minutes or less;
definition includes: 1) the head being struck, 2) the head striking
an object, and 3) the brain undergoing an acceleration/deceleration
movement (ie, whiplash) without direct external trauma to the head.
It excludes stroke, anoxia, tumor, encephalitis, etc. Computed
tomography, magnetic resonance imaging, electroencephalogram, or
routine neurological evaluations may be normal. Due to the lack
of medical emergency, or the realities of certain medical systems,
some patients may not have the above factors medically documented
in the acute stage. In such cases, it is appropriate to consider
symptomology that, when linked to a traumatic head injury, can
suggest the existence of a mild traumatic brain injury.
above criteria define the event of a mild traumatic brain injury.
Symptoms of brain injury may or may not persist, for varying lengths
of time, after such a neurological event. It should be recognized
that patients with mild traumatic brain injury can exhibit persistent
emotional, cognitive, behavioral, and physical symptoms, along
or in combination, which may produce a functional disability. These
symptoms generally fall into one the following categories, and
are additional evidence that a mild traumatic brain injury has
physical symptoms of brain injury (e.g., nausea, vomiting, dizziness,
headache, blurred vision, sleep disturbance, quickness to fatigue,
lethargy, or other sensory loss) that cannot be accounted for by
peripheral injury or other causes;
cognitive deficits (e.g., involving attention, concentration, perception,
memory, speech/language, or executive functions) that cannot be
completely accounted for by emotional state or other causes; and
behavioral change(s) and/or alterations in degree of emotional
responsivity (e.g., irritability, quickness to anger, disinhibiting,
or emotional lability) that cannot be accounted for by a psychological
reaction to physical or emotional stress or other causes.
patients may not become aware of, or admit, the extent of their
symptoms until they attempt to return to normal functioning. In
such cases, the evidence for mild traumatic brain injury must be
reconstructed. Mild traumatic brain injury may also be overlooked
in the face of more dramatic physical injury (e.g., orthopedic
or spinal cord injury). The constellation of symptoms has previously
been referred to as minor head injury, post-concussive syndrome,
traumatic head syndrome, traumatic dephalgia, postbrain injury
syndrome and posttraumatic syndrome.
What is Brain Injury?
injury is an external or internal insult to the brain.
and afterbirth physiological changes, even minor incidences, can
change a person's life permanently. A blow or impact to the head,
a tumor, a stroke or a disease may disturb a brains daily functions.
Any insult to the brain is referred to as a brain injury. Any problem
that affects the brain creates difficulties for the affected individual
and their immediate family.
minor impact can disrupt brain activity. Usually the person's reaction
is to be dazed and confused. Often there is total recovery. Those
who continue to suffer with the consequences of head injury need
special care to facilitate in their rehabilitation. These injuries
may cause subtle or even major changes in personality and behavior
in an individual, such as irritability, anxiety, depression, memory
problems other psychological and possible physical difficulties.
When Does a Brain Injury Occur?
brain injury may occur at any time. There is no age, gender or
sect that escapes it. Brain injury targets those in the best of
health. Brain injury happens indiscriminately. The ramifications
of a brain injury can be devastating for the individual and their
family. This is why correct evaluations and rehabilitation programs
are the most important first steps.
MOST OFTEN ASKED
What is Acquired Brain Injury?
acquired brain injury is an injury to the brain secondary to trauma,
stroke, post-surgical complications, and/or certain disease processes
(e.g., tumors, aneurysms).
What is Traumatic Brain Injury?
insult to the brain caused by a direct blow to the skull via a
closed or open head injury.
What are causes of Traumatic Brain Injury?
of the causes stem from accidents and assaults. Accidents that
cause traumatic brain injury are motor vehicle incidents, bullet
wounds, physical assaults, physical battering, shaken baby syndrome,
domestic violence, falls, sports and recreation injuries. Consequences
may include; cognitive, speech, hearing, taste, smell, /balance/vestibular,
vision, physical mobility dysfunctions, and psycho-social, behavioral
and/or emotional impairments.
How can a family cope?
family can cope by being involved with strong support groups as
well as having patience and understanding.
What types of rehabilitation are available to the Traumatic Brain
New York City and Downstate hospitals offer acquired and traumatic
brain injury programs, which are covered by most insurance plans.
The brain injury program includes: psychological, cognitive, physical,
vestibular, vision, vocational, speech, occupational, recreational,
music therapies and support groups for the recovering brain injury
individual and their family.
Brain Injury, is a silent and growing concern in this borough,
the state and throughout the country. Traumatic brain injury crosses
bridges and travels through the tunnels to Manhattan and elsewhere.
A rapid motion of the head in many directions (sometimes called "whiplash")
may cause traumatic brain injury. It is also an acceleration and
deceleration of the head during which the brain is thrust back
and forth at crushing speeds thus bouncing the brain off the walls
of the skull. An example of this is when you shake an uncooked
egg. The sloshing sound you hear is the yoke hitting the shell.
Shake the egg hard enough, the yoke cracks and breaks. This is
what happens to your brain during rapid acceleration and deceleration.
Your brain becomes injured. This is traumatic brain injury or traumatic
brain injury is known as "The Silent Epidemic" because it is often
unseen. Physical symptoms often do not accompany a brain injury,
therefore; the brain injury is not visible.
brain injury may cause intellectual, emotional, social, behavioral,
vocational, cognitive, visual, vestibular, speech, hearing, and
physical difficulties. Additionally, smell and taste are often
affected. The intellectual, behavioral, vocational difficulties
may often affect present and care, future life styles and personality
behavior of the brain-injured recovering and recovered individual.
In most instances, the person you knew, no longer exists. A new
person reemerged, a person who is unknown to you and even to them.
This person is different and will more than likely never be the
person you knew and loved. They are a different person. They are
discoverers of a new individual with new potentials to be fulfilled.
The symptomatology of traumatic brain injury often shows itself
immediately. Denial is the first line of defense. The symptoms
vary greatly and it depends upon the extent of the location of
the brain injury. Memory problems, learning difficulties, personality
changes and physical disabilities are common and often seen by
the recovering individual family members and friends. They can
either be subtle or major in nature.
Cognitive impairments: May be very mild to exceedingly severe.
They include memory deficits (short or long term), difficulties
with concentration, slowness, thinking, attention, perception,
communication, reading, writing skills, planning, sequencing,
Physical impairments: Speech, hearing, vision, and sensory
impairments, headaches, dizziness, vertigo, lack of coordination,
spastically of muscles, paralyses to one or both sides, and seizure
disorders are often seen.
Psycho-Social/ Behavioral/ Emotional Impairments: Such impairments
include fatigue, mood swings, denial, self-centeredness, anxiety,
depression, lowered self-esteem, sexual dysfunction, restlessness,
lack of motivation, inability to self-monitor, difficulty with
emotional control, inability to cope, agitation, excessive laughing
or crying and difficulty relating to others.
is no cure for traumatic brain injury, only correct rehabilitation
and development of compensatory skills, sharpened strategies and
heightened techniques for the traumatic brain injured recovering
brain injury is not a mental disorder. It is a dysfunction of the
brain due to an injury. It is covered separately by the American
Disabilities Act, United States Federal Law and New York State
brain injury is an acquired brain injury and an acknowledged disability.
Injury As A Community Problem
Judith A. Falconer, Ph.D. [email protected]
injury is appropriately called "The Silent Epidemic"
head injuries occur annually in the United States
individuals are admitted to hospitals for head injuries each
in every 220 people in the US is suffering from the effects
of a head injury
sustain nearly 2 times as many head injuries as females
50 percent of those who sustain head injuries 35
vehicle accidents cause nearly one-half of all head injuries
injuries occur in more than two-thirds of all automobile accidents.
a split second, the lives of young, previously healthy individuals
are tragically and permanently altered. Families frequently find
that they must go through a mourning process where they bury
the person they previously knew and develop a relationship with
a new and perhaps less likable stranger. In "head" injury, the
critical damage is done to the brain rather than the head.
brain, with its protective coverings of hair, skin, and skull
as well as cushion of fluid, was sufficiently protected until
we developed weapons which propelled us and other objects at
high rates of speed. Although many people think head injuries
only occur when the person loses consciousness, a significant
injury can occur without loss of consciousness and without the
injured person's awareness.
syndrome", characterized by difficulty concentrating, irritability,
headache, and problems with memory after an apparently minor
blow to the head or other body part, has recently received considerable
attention from health care practitioners. Generally, the symptoms
disappear in several days to several months and the person functions
normally, but some individuals never completely recover.
indicated in the statistics quoted earlier, one of the most common
sources of head injuries is motor vehicle accidents; other common
causes include bicycle and skateboard accidents, sports injuries,
falls and gunshot wounds. While not all head injuries can be
prevented, there is clear and convincing evidence that seatbelts
and helmets can significantly reduce the incidence of head injuries
and lessen the severity of those that do occur.
the last decade, most individuals who sustained severe head injuries
died. Advances in trauma care and medical technology have resulted
in significantly improved survival rates, although many survivors
have severe deficits. A variety of medical/physical problems
may follow head injury, including: seizure disorders; paralysis
or weakness on the side opposite the injury; ataxia (uncoordinated
body movements); increased muscle tone and spasticity; decreased
physical endurance; balance disorders; speech/eating control
the major problems are head injury are rarely medical or physical.
Instead the survivor, friends and family members must cope with
a wide range of cognitive, behavioral, and emotional deficits.
Often, the person who has sustained the head injury will be unaware
that he or she is different and blame others for problems encountered
in daily life. Family members may find that the former easygoing
person is easily angered, strikes out, and behaves very inappropriately
in public situations. Most commonly, the individual who has sustained
a significant head injury will have: difficulty learning and
remembering new material; problems organizing, starting and completing
tasks; decreased ability to analyze visual material; and decreased
ability to problem solve in new situations. Additionally, the
injured person may become anxious, depressed and/or frustrated
when they repeatedly fail at tasks which were easy prior to their
injury. Many individuals who sustain significant head injuries,
are unable to monitor their behavior and lack insight into the
effect of that behavior on themselves and others.
they find that even long standing friendships do not survive
the behavioral, thinking and personality changes cause by the
head injury. Initially the injured individual loses friends;
far too often the rest of the family becomes increasingly isolated
because of the time commitment involved in providing necessary
care and supervision.
injuries have a devastating impact upon the injured individual,
the family and the community. If society continues to place a
premium on intellectual abilities, the situation is likely to
become worse for head injured individuals, with fewer options
for employment and satisfying interpersonal relationships, limited
housing, and families unable to cope with multiple demands. Everyone
should work toward prevention of head injuries through community
using seat belts and encouraging others to do so
legislation requiring use of seat belts and protective headgear
legislation aimed at eliminating drunk drivers from the highways
the 55 mph speed limit
to develop and require appropriate protective equipment/regulations
for sports participants
unless we are willing to remove all risks from daily life, head
injuries will continue to occur. Given extremely sophisticated
medical technology, more individuals will survive catastrophic
head injuries and remain in the community for near normal lifespans.
accommodate these individuals, we must develop appropriate resources,
alternatives to institutional care which are accessible, supervised,
employment settings which meet the unique physical, cognitive,
behavioral, emotional and social needs of individuals who have
sustained head injuries
care programs to provide supervised recreational and social
cost respite care for families who provide home care
sufficient pool of reliable, trained individuals to provide
attendant care and supervision
cost accessible public transportation
recreational programs As an individual, you can make a significant
difference in the lives of individuals who have sustained head
injuries and their families.
example, you could:
transportation to individuals who are not able to use the limited
public transportation which is available
respite for family members by taking the injured individual
to community activities
relationships with friends who have a head injured family member
and support community groups working on solutions to the problems
of head injury
About Head Injury
head injuries occur each year in the United States. Brain injury
causes between 70,000 and 100,000 deaths each year.
will require hospitalization each year as a result of brain injury.
Every year 70,000 - 90,000 people will suffer life long physical,
intellectual and psychological disabilities as a result of their
Each year more
than 30,000 New Yorkers suffer a head injury serious enough to
be admitted to a hospital. It is estimated that 8,000 of these
people will be left with serious or lifelong disabilities as
a result of their injury.
are the most frequent reasons for visits to physicians and emergency
A brain injury
occurs every 16 seconds; a death from head injury occurs every
One out of
80 children born this year are expected to die of a vehicular
related brain injury before their 25th birthday.
person with a brain injury is a young male between the ages of
16 and 24 who is injured in a vehicular accident.
injured person with a brain injury typically requires between
5-10 years of intensive rehabilitation with long-term follow
kills more Americans under the age of 34 than all other causes
combined and has claimed more lives since the turn of the century
than all United States wars combined.
injuries are not preventable, such as in stroke, evasive brain
surgeries, aneurysms, and such.
It is not realistic
for an individual to wear a helmet 24 hours a day, but what an
individual we can do is be diligent in preventing brain injury
in as many ways that are possible such as wearing helmets when
in active leisure activities, seat belts when in a motor vehicles,
being careful to not to bump our heads into cabinets or such,
receiving the Lyme disease vaccine and if symptoms arise seeking
out a physician immediately for intervention therapy, and when
falling down putting out your hands or being conscious of how
you are about to fall to as to cushion your skull.
about Traumatic Brain Injury
of the scientific and technological advances that have been made
in the field of brain injury, many myths still persist about
traumatic brain injury. Whether the myths exist through ignorance
or by intentional design, the real problem is that these myths
often prevent legitimately injured people from receiving the
medical care, treatment and therapy that they desperately need
There are also
too many lawyers who are not able to provide proper representation
for their client with brain injury, often times because they
are of the notion that psychiatric consequences of traumatic
brain injury, even though disabling, are not as "serious" as
will take a brief look at five of the most common myths associated
with brain injury particularly as they relate to the field of
law. The article will also offer some suggested questions that
may be used to dispel misleading in formation about these myths
in the courtroom setting.
Loss of consciousness is a necessary prerequisite for traumatic
brain injury. According to the book by Drs. Silver, Yudolfsky
and Hales entitled Neuropsychiatry of Traumatic Brain Injury,
35 percent of the people studied in scientific literature sustained
a traumatic brain injury without a reported loss of consciousness.
This myth has been particular easy to dispel and it has been
the author's experience that the following questions can be in
would you agree that a person need not lose consciousness or
be in a coma to sustain a traumatic brain injury?
during your career, have you made diagnosis of traumatic brain
injury for patients whose hospital record indicated there was
no loss of consciousness? And
during your career have you actually provided or recommended
care and treatment for someone with a diagnosis of brain injury
who did not lose consciousness as a result of trauma?
Myth 2: When
describing a brain injury, the words "mild" or "minor" mean "insignificant." Even
so-called minor brain injuries (i.e.. A minor concussion or a
simple skull fracture) may have long term effects on mental function
and quality of life.
In the Society
of Automotive Engineers publication entitled Automotive
Safety by Jeffrey A. Pike, there is discussion of traumatic
brain injury entitled "Minor Injuries." According to Pike, "a
number of relatively subtle, not as easily detectable neuropsychological
deficits may exist after some "minor" head trauma and may be
capable of interfering with an individual's ability to function
at a pre-injury level. These deficits may include: verbal and
communicative disorders; deficits in information processing
ability; deficits in reaction time; short and intermediate-term
memory difficulties; problems with perceptions and deficits
in concept formation and general reasoning ability."
the following questions could help dispel the myth.
would you agree that the word "mild" or "minor" to describe a
head injury, does not mean the injury is insignificant? And
would you agree that there is literature and research that suggests
that some persons may develop cognitive or emotional problems
as a consequence of what is described as a "minor" or "mild" brain
Myth 3: The
case involving traumatic brain injury is not that serious because
it is only "psychiatric problems." The third edition of the American
Psychiatric Textbook of Neuropsychiatry states that unlike many
psychiatric illnesses that have gradual onset. traumatic brain
injury often occurs suddenly and devastatingly. Although some
individuals recognize that they no longer have the same abilities
and potential they had before the injury, many others with significant
disabilities deny that there have been any changes.
disturbances associated with frontal lobe injury can include:
impaired social judgment; labile effect; uncharacteristic lewdness;
inability to appreciate the effects of one's behavior or remarks
on others; a loss of social graces and a reduced attention to
personal appearance and hygiene. After brain injury, an individual
may exhibit behaviors that tend to be more disorderly, suspicious,
argumentative, isolated, disruptive and/or anxious.
can have drastic and lasting effects on a person with brain injury
and should be addressed in court with questions such as:
would you agree that a person can develop psychiatric problems
as a consequence of traumatic brain injury? And
during your career, have you actually determined that someone
was disabled from competitive employment because of psychiatric
problems such as depression?
Myth 4: In
order to be considered a traumatic brain injury, the head must
actually strike or impact another surface. This is simply not
true. There are two basic types of brain injury, open head injury
and closed head injury. Open head injuries are caused by bullets
or other penetrating objects. Closed head injury, the more common
of the two is usually caused by a rapid movement of the head
during which the brain is whipped back and fourth bouncing off
the inside of the skull.
of the rapid movements pulls apart and stretches nerve fibers
or axons, breaking connections between different parts of the
brain. This means that even if the head does not strike or come
into contact with another surface, a traumatic brain injury can
occur simply from the brain's movement inside the skullcap. Concussions
and injury caused after a severe neck injury (ie. Whiplash) can
also result in brain injury.
the following questions can be utilized:
would you agree that a person can sustain traumatic brain injury
without actually striking their head? And
during your career, have you made diagnosis of persons with brain
injury who reported that they did not strike their head during
the traumatic event?
Myth 5: The
cognitive impairments identified on the neuropsychological testing
do not fit any known pattern of cognitive impairments following
traumatic brain injury. Behavioral repercussions of brain injury
vary with the nature, extent, location and duration of the injury;
the age; the sex, physical condition and physiological differences.
is a very individualized condition and no two individuals with
brain injury will share identical symptoms and deficits. To make
that point during testimony, the author suggests a line of questioning
such as, Doctor, would you agree that different types of cognitive
impairments and psychiatric conditions on different individuals?
of this article is for assistance to all individuals as a learning
mechanism for understanding the symptoms of traumatic brain injury.
It is with this knowledge that the individuals who has sustained
a brain and their family along with their caring friends and
associates to have the empowerment to obtain the assistance,
help, respect, dignity, care and necessary treatment they deserve
and are entitled to.
have chest pain, they think heart attack. When people feel numb
or weak on one side, they don't think brain attack. That can
be a dangerous mistake. Seeking immediate medical care is crucial
because clot- busting medications, if administered quickly, can
minimize the disabling and sometimes deadly effects of stroke
by opening arteries and restoring blood flow.
hours, all our options are open," says George C. Newman, director
of the stroke program at University Hospital and Medical Center
at Stony Brook. After three hours, the According to the American
options begin to narrow. After Heart Association, the six, they're
starting to close." Too often, patients don't seek treatment.
They may not
recognize the symptoms, or they may simply not be aware of their
sudden deficits. According to a study that appears in this month's Annuals
of Emergency Medicine, nearly 40 percent of stroke patients
said they did not decide to seek help themselves, but only at
the urging of a friend or relative. "We have to teach people
to recognize the stroke in others and then call 911." And, Newman
stresses, "you can't let the patient talk you out of it."
the American Heart Association, the symptoms of stroke are: vision
problems, including sudden dimness, loss of vision in one eye
or double vision, unexplained dizziness, including lightheadedness,vertigo
or sudden falls. Communication difficulties, either slurring
words or trouble talking or understanding language. Sudden weakness
in arm, leg,face or on one side of the body. Sudden, unsteady
walking as if drunk and headaches.--Geiger LIHIA, Commack, NY
brain injury (TBI): is an insult to the brain, not of degenerative
or congenital nature caused by an external physical force that
may produce a diminished or altered state of consciousness, which
results in an impairment of cognitive abilities or physical functioning.
It can also result in the disturbance of behavioral or emotional
brain injury (ABI): injury to the brain which is not hereditary,
congenital or degenerative.
estimated 5.3 million Americans little more than 2% of the US population
currently live with disabilities resulting from brain injury.
estimated that one million people are treated for traumatic brain
injury and released from hospital emergency rooms every year.
Each year, 80,000 Americans experience the onset of long-term disability
following traumatic brain injury.
More than 50,000 people die every year as a result of traumatic
Vehicle crashes are the leading cause of brain injury. They account
for 50% of all traumatic brain injuries
Falls are the second leading cause, and the leading cause of brain
injury in the elderly. The risk of traumatic brain injury is highest
among adolescents, young adults and those older than 75
After one brain injury, the risk for a second injury is three times
greater; after the second injury, the risk for a third injury is
eight times greater.
cost of traumatic brain injury in the United States is estimated
to be $48.3 billion annually. Hospitalization accounts for $31.7
billion, and fatal brain injuries cost the nation $16.6 billion
injury can affect a person cognitively, physically and emotionally.
Cognitive consequences can include: Short term memory loss; long
term memory loss Slowed ability to process information trouble
concentrating or paying attention for periods of time difficulty
keeping up with a conversation; other communication difficulties
such as word finding problems spatial disorientation organizational
problems and impaired judgment unable to do more than one thing
at a time
consequences can include: Seizures of all types muscle spasticity
double vision or low vision, even blindness Loss of smell or taste
speech impairments such as slow or slurred speech; headaches or
migraines fatigue, increased need for sleep; balance problems.
consequences can include: a lack of initiating activities, or once
started, difficulty in completing tasks without reminders increased
anxiety depression and mood swings denial of deficits impulsive
behavior more easily agitated egocentric behaviors; difficulty
seeing how behaviors can affect others
Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G and Sniezek
JE. A method for estimating the prevalence of disability from traumatic
brain injury, in press.
Data from the National Hospital Ambulatory Medical Care Survey,
1995-1996, of the National Center for Health Statistics. Described
in Guerrero JL, Thurman DL and Sniezek JE. Emergency department
visits associated with traumatic brain injury. United States, 1995-1996,
Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G and Sniezek
JE. A method for estimating the prevalence of disability from traumatic
brain injury, in press.
Unpublished data from Multiple Cause of Death Public Use Data from
the National Center for Health Statistics, 1996.
Krause J, Sorenson S. Epidemiology. In J Silver, S Yudofsky, R
Hales (eds.). Neuropsychiatry of Traumatic Brain Injury. Washington,
DC: American Psychiatric Press, Inc., 1994.
Analysis by the CDC National Center for Injury Prevention and Control,
using data obtained from state health departments in Alaska, Arizona,
California, Colorado, Louisiana, Maryland, Missouri, New York,
Oklahoma, Rhode Island, South Carolina and Utah.
Annegers JF, Garbow JD, Kurtland LT et al. The Incidence, Causes
and Secular Trends of Head Trauma in Olstead County, Minnesota
1935- 1974. Neurology. 1980; 30:912-919.
Lewin ICF. The Cost of Disorders of the Brain Washington, DC: The
National Foundation for the Brain, 1992. Special Report CDC Report
Shows Prevalence of Brain Injury April 14, 1999 ATLANTA (CNN) An
estimated 5.3 million Americans, a little more than 2 percent of
the U.S. population, currently live with disabilities from traumatic
brain injuries, according a to a new report by the Centers for
Disease Control and Prevention.
year, approximately 80,000 Americans experience the onset of disabilities
resulting from brain injuries, the report says. The data released
in the CDC study is considered the most complete picture of the
impact of traumatic brain injuries (traumatic brain injurys) in
the United States. The National Center for Injury Prevention and
Control, a division of the CDC, plans to use the data to assess
the availability of proper medical, social and support services
across the country.
traumatic brain injury statistics reported by the CDC indicated
that each year, 1 million people are treated and released in hospital
emergency rooms, and 50,000 people die. The three leading causes
of traumatic brain injury are motor vehicle crashes, violence mostly
from firearms and falls, particularly among the elderly.
risk of traumatic brain injury in men is twice the risk in women.
The risk is higher in adolescents, young adults and people older
than 75 years. The report was prepared for a meeting this week
of 40 experts to discuss public health implications of traumatic
brain injuries. A traumatic brain injury takes place when an external
physical force hits the brain, producing a diminished or altered
state of consciousness. It results in impaired cognitive abilities
or physical functioning, and sometimes disturbs behavioral or emotional
functioning. traumatic brain injury can affect a person cognitively,
physically and emotionally.
person might experience memory loss, lack of concentration, slowed
ability to process information, seizures, double vision or even
loss of vision, headaches or migraines, loss of smell or taste,
speech impairments, anxiety, impulsive behavior, depression and
estimates hospital and fatal injury costs relating to traumatic
brain injury in the United States exceed $48 billion annually.