Decoding brain injury

(BPT) - Sadia Prema, a successful, determined, 37-year-old sales professional from Phoenix, was walking across the street to meet with a client when she was struck by a distracted driver and thrown nearly 40 feet. She sustained multiple injuries, including a traumatic brain injury (TBI).

After being in a coma for two weeks and going through nearly 30 surgeries to repair her injuries, Sadia was transferred to Craig Hospital for inpatient rehabilitation. Still battling amnesia, she worked with physicians and therapists to restore her memory and brain function and was finally able to recognize her family. She continued to work with speech, physical and occupational therapists, and after two and a half months, she returned home to Arizona. Sadia returned to work in an administrative role, and then after just three months, went back to her position in sales and has since worked her way to being named one of the top five sales representatives across the nation among thousands within her company.

Every year, roughly 2.5 million people in the U.S. sustain a TBI, defined by the Centers for Disease Control as an injury that “disrupts the normal function of the brain.”

While the definition of a brain injury (BI) is straightforward, the injury itself is not. There are several different types of BI, as well as different levels of severity — which is why this injury is often very misunderstood. Mild TBIs (or MTBIs) make up about 75% of all brain injuries, but the other 25% are categorized as severe. It’s estimated that 5.3 million Americans live with a long-term disability as the result of a TBI.

Recovery from a BI can take months — even years. Most people require ongoing therapy; however, outcomes are better for those who rehabilitate at a specialty center. For example, 82% of patients at Craig Hospital are discharged to home after their inpatient stay; their patients often have lower long-term costs associated with rehabilitation and have achieved levels of independence that require less at-home attendant care than those who were treated at general rehabilitation centers.

With March being Brain Injury Awareness Month, now is a good opportunity to learn more about BI — what it is, the different types, why some people recover more quickly and why some people require long-term care.

What causes BI?

Damage to the brain can occur in many different ways. It can be caused by something internal, such as a disease or stroke, or by something external, such as a fall or a car accident.

Falls are the leading cause of BI, followed by being struck by or against an object — as often occurs during an auto accident.

Types of BI

There are two main types of BI. A diffuse injury occurs when the brain is shaken or rotated within the skull and causes widespread, microscopic damage throughout the brain. It can impact several brain functions such as movement, sensation, memory, behavior, emotion and more.

A focal injury is more localized, damaging neurons in one or more specific areas of the brain. Focal injuries are most often the result of being struck in the head; however, they can also be caused by non-traumatic conditions, such as strokes and brain tumors.

Brain injuries affect each person differently. Because the brain controls how people think, feel and act, an injury can change many different things about a person, and the effects may vary greatly from person to person.

Treatment and Outcomes

Because each injury impacts different parts of the brain and the level of severity varies from person to person, there is no one, set treatment plan for BI. There are, however, treatment and rehabilitation centers that specialize in BI. Craig Hospital in Denver, Colo., for example, is a specialty, inpatient rehabilitation center for people who have sustained a BI. Patients at specialty centers have access to expertise, resources and therapy programs that aren't often available at general rehabilitation centers, including a full rehabilitation team made up of physicians, rehabilitation nurses, physical therapists, occupational therapists, psychologists, speech/language pathologists, recreation therapists, nutritionists and social workers — all with the goal of helping people who sustain a BI become as independent as possible.

“Injuries to the brain are incredibly complex, and each person’s recovery is different,” says Dr. Eric Spier, physician at Craig Hospital. “While we need to help patients recover from the injury itself, we also need to rehabilitate each person as a whole — helping them find their way in this new situation from all aspects of life. That’s not something that exists in a lot of rehabilitation centers.”

Prevention

While there are many different causes of BI, the most common are also likely the most preventable.

  • Safe Driving: Auto accidents account for about 20 percent of all TBI-related hospitalizations, and many can be avoided by not driving distracted or under the influence — and simply driving safely.
  • Protect the Head: Helmets are the best way to help prevent head injuries while participating in activities like biking, skateboarding, skiing, snowboarding and many sports. While they don’t prevent all types of brain injuries, they are very effective.
  • Mental Health: Intentional self-harm was the leading cause of TBI-related deaths in 2014. Seeking treatment for mental illness is one of the best ways to prevent self-inflicted TBI.