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The medical profession calls it a Traumatic Brain Injury and it covers some of the most serious of medical conditions. Skateboarders hit their heads often. Most are kids. Most don’t wear helmets. But a person can hit their head _ hard _ while they are doing almost anything. This is an important subject that deals with life and death. According to the Center for Disease Control (CDC):

Traumatic brain injury (TBI) is an important public health problem in the United States. Because the problems that result from TBI, such as those of thinking and memory, are often not visible, and because awareness about TBI among the general public is limited, it is frequently referred to as the “silent epidemic.”

The statistics are scary. According to the CDC Report, each year in the United States:

  • At least 1.4 million people sustain a TBI. Of them, about 50,000 die, 235,000 are hospitalized, and 1.1 million are treated and released from an ED.
  • Approximately 475,000 TBIs occur among children ages 0 to 14 years; ED visits account for more than 90% of the TBIs in this age group.
  • Adults age 75 years or older have the highest rates of TBI-related hospitalization and death.
  • In almost every age group, TBI rates are higher for males than for females.
  • Motor vehicle–traffic causes result in the greatest number of TBI-related hospitalizations.
  • Falls are the leading cause of TBI; rates are highest for children ages 0 to 4 years and for adults age 75 years or older.

When someone hits their head they often suffer a short period of unconsciousness, or they are dazed for a few moments and go through what doctors refer to as a “lucid interval”. Many people in this situation will not go to a doctor because they think that they are okay and that they just got a bump on the head. Any injury to the head can be life-threatening. The head is not like an arm or leg or even your hips. The skull is rigid and protects the brain which is very soft like tofu. The brain itself sits in a fluid that surrounds the soft brain and serves as a shock absorber to protect the brain from injury. The brain is very susceptible to bleeding and when a person’s head is hit hard it bangs against the interior of the skull and sometimes blood vessels rupture. The blood is being pumped by the heart and starts to fill the interior of the skull. There is a small amount of room for expansion but if the bleeding continues the pressure builds up inside the fixed bones of the skull. Initially the patient may feel normal and not experience any signs or symptoms of this internal bleeding. As the pressure builds a number of signs begin to appear. The problem is that oftentimes by the time the patient realizes that they are having a serious problem, the pressure inside their skull is so great that it is just about to crush the brain. At that point there is no time to get to a hospital or doctor and many people die. It can happen the next day, the next week or even months after the head injury.

This scenario happens over and over again in every community in the United States and throughout Hawaii. Workers hit their heads at work, kids hit their heads in athletics, people fall down at home and hit their heads and bicycle, moped, skateboard and automobile collisions oftentimes result in a person hitting their head and developing a small internal bleed inside their skull. If a person hits their head hard enough to be unconscious or dazed, even for a very short time immediately after a blow to the head, he or she should immediately go to an emergency room or doctor’s office.

The Mayo Clinic in Rochester, MN is one of the great medical centers in the world and they do research and treat patients in almost every area of medicine. It is easy these days to go to the website of a major medical center such as the Mayo Clinic and get the list of things to look for in connection with almost any medical condition. Families should do this regularly for all sorts of potential health problems, and in the case of head injuries the Mayo Clinic provides a helpful list of what to look for:

Mild traumatic brain injury The signs and symptoms of mild traumatic brain injury may include:

  • Loss of consciousness for a few seconds to a few minutes
  • No loss of consciousness, but a state of being dazed, confused or disoriented
  • Memory or concentration problems
  • Headache
  • Dizziness or loss of balance
  • Nausea or vomiting
  • Sensory problems, such as blurred vision, ringing in the ears or a bad taste in the mouth
  • Sensitivity to light or sound
  • Mood changes or mood swings
  • Feeling depressed or anxious
  • Fatigue or drowsiness
  • Difficulty sleeping
  • Sleeping more than usual

Particularly troubling are children’s injuries because they are less able to understand medical importance of what is happening. The Mayo Clinic identifies what to look for with infants and young children:

Children’s symptoms Infants and young children with brain injuries may lack the communication skills to report headaches, sensory problems, confusion and similar symptoms. In a child with traumatic brain injury, you may observe:

  • Change in eating or nursing habits
  • Persistent crying and inability to be consoled
  • Unusual or easy irritability
  • Change in ability to pay attention
  • Change in sleep habits
  • Sad or depressed mood
  • Loss of interest in favorite toys or activities

The only test that will determine if a person has a serious problem is a CT scan or MRI. Insist upon having such a test if you are a loved one suffer a hit to the head and have any of the mentioned conditions. Doctors will often send the patient home without those tests. Insist upon the tests. It’s a matter of life and death. A client of mine was trimming a tree in his yard and standing on a ladder trying to reach a high branch. He slipped off the ladder and fell on the ground and banged his head. His wife rushed to his side and she said his eyes were open but he was not responding. After a few seconds he started responding and talking to her. She insisted they drive to the doctor and the doctor asked him a few questions and sent him back home telling him to come back if his headache got worse. He went home and laid down to rest and his wife checked him every 30 minutes. A couple hours after they returned home when she went to check on him at the 30 minute interval, he was dead. He had an internal bleed that within a few hours the pressure up in his brain to the point where it crushed the brain and the brain died. Don’t let that happen to you or a loved one.

One Comment

  1. Gravatar for Doreen Henricksen
    Doreen Henricksen

    These public messages are appreciated by a TBI survivor and Mayo research participant. Awareness is a key issue in understanding.

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