![]() ![]() Another primary injury, traumatic axonal injury (also referred to as diffuse axonal injury), occurs with shearing forces in white matter and is not consistently seen on imaging. The primary injury, including cerebral contusions of gray matter, vascular injuries, contusions, and lacerations, occur at the moment of impact. TBI can be divided into primary injury at the moment of impact and secondary injuries that occur after the initial insult. 18 Approximately a third of all injury-related deaths involve a TBI. 5 In a longitudinal study examining brain-injured patients five years after acute rehabilitation, 12% required long-term care. From 2006 to 2010, TBI patients (not including multitrauma) made up 3.9% of patients in acute rehabilitation and had an average length of stay of 17.5 days. In 2004, 22% of hospitalized patients with TBI were transferred to a rehabilitation or nursing facility. 2010 National Trauma Data Bank findings reveal that Hispanic and black patients were less likely to be discharged to high level rehabilitation than were non-Hispanic white patients despite comparable TBI severities, even after adjusting for insurance status. 16 Racial and ethnic minority groups are less likely to receive post-TBI medical care and rehabilitation than non-Hispanic white patients. 14Īmerican Indian/Alaska Native children and adults are at higher risk of TBI-related hospitalization and death compared to other ethnic groups. Men were more than four times as likely as women to be hospitalized for TBI due to assault, and twice as likely to be hospitalized for TBI due to motor vehicle crash, unintentionally being struck by/with an object, or intentional self-harm. Males are four times more likely to experience a TBI 18 and are at higher risk of TBI-related hospitalization than females across all mechanisms of injury. 14 Suicide (34.7%) and unintentional falls (28%) caused most TBI-related deaths, which reflects an overall increase in suicide rates in the U.S. 4.5% of all TBI deaths were among children under age 18. 14,15 In 2013, TBI-related death rates were highest among adults over age 55, with the highest rates among those 75 and older. In 2017 61,000 people died of TBI-related causes in the U.S, representing an increase from 56,000 in 2013. ![]() 14 Among children hospitalized for TBI, falls and motor vehicle crashes were the most common mechanisms of injury. ![]() 14 Hospitalization rates were highest among those age 75 or older, followed by 65-74, then 55-64. 18 In 2017 224,000 people were hospitalized in the U.S. 17 Epidemiology including risk factors and primary preventionĪt least 5.3 million people in the U.S. 14 Among post-9/11 military veterans, 17.3% sustained a TBI during military service, with blast (33.1%), object hitting head (31.7%), and fall (13.5%) as the most common causes of war-related TBI. 2,13 In 20, unintentional falls were the primary etiology of TBI-related hospitalizations among both men and women. 13 Falls were the most frequent cause in young children and older adults, while motor vehicle collisions were most common in patients 15-24 years old. 13 Falls (47.9%), unintentional strike by or against an object (17.1%), and motor vehicle/traffic (13.2%), were the main causes of TBI-related emergency department visits. reported 2.5 million TBI-related ED visits, of which 812,000 were pediatric. ![]() Traumatic brain injury (TBI) is a disruption of brain function due to an external force or blow to the head resulting in any of the following: decreased level of consciousness, memory loss before or after injury, alteration of mental status, neurologic deficits, or intracranial lesion. ![]()
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