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Friday, May 31, 2013


Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force traumatically injures the brain.

Men are at higher risk for violence in our society, and therefore, they are also at higher risk for traumatic brain injury (TBI). TBI results from a sudden blow to the skull do to collision( causing a concussion), sudden penetration of the skull, blast pressure waves, or the head being thrust out of position. The injury may damage a specific part of the brain or diffuse throughout the brain tissue.

TBI symptoms can be subtle and thus go unrecognized in many people; moreover, the symptoms are often similar to those caused by other problems, resulting in misdiagnosis. TBI symptoms may last only a few days or weeks, or they may be permanent. Even mild TBI can produce long-lasting cognitive and behavioral effects that significantly impair substance abuse recovery. For instance, a person's ability to except and integrate information in treatment may be compromised by TBI. The injury may also cause the person to act impulsively without being able to explain why.

TBI is a major cause of death and disability worldwide, especially in children and young adults. Males sustain traumatic brain injuries more frequently than do females. Causes include falls, vehicle accidents, and violence. Prevention measures include use of technology to protect those suffering from automobile accidents, such as seat belts and sports or motorcycle helmets, as well as efforts to reduce the number of automobile accidents, such as safety education programs and enforcement of traffic laws.

TBI symptoms can include:

  • Motor, sensory, and emotional effects
  • Dizziness, lightheadedness, or vertigo
  • Fatigue or lethargy
  • Gait disorder
  • Headaches or other pain symptoms
  • Nausea
  • Difficulty regulating emotions
  • Sleep disturbances
  • Weakness
  • Cognitive problems
  • Executive function problems affecting one's ability to organize thoughts and plans, following through on intentions, do abstract reasoning, some problems, make judgments, or read
  • Impaired attention and concentration
  • Language and communication impairments
  • Reduce cognitive speed and endurance
  • Reduced multitasking ability
  • Worsening memory
  • Impulsive, disruptive, or inappropriate behavior
  • Aggression and irritability
  • Apathy or lack of spontaneity
  • Personality changes
  • Anxiety
  • Lack of self-awareness ( including lack of awareness of cognitive deficits)
  • Sensory impairments ( blurred vision, sensitivity to light, ringing ears, and itching)

Treatment should be adapted to meet the specific needs of clients with TBI:

  • Modify psychoeducational and cognitive-behavioral counseling approaches to be sure that clients with TBI are able to incorporate the information.
  • Adapt treatment to accommodate the shorter attention span of clients with TBI.
  • Help clients develop and implement coping strategies to manage everyday functioning, such as making lists, managing stress, and asking for the support of others.
  • Note that inappropriate affective responses (e.g., anger disproportional to stimulus) may be symptoms of TBI.
  • Educate the client about TBI, it symptoms, and its effects.
  • Work with families to assist clients in their recovery from both TBI and substance abuse disorders.

These resources provide more information on recognizing and treating clients with TBI:

Family Issues:
TBI of any severity can disrupt families, in no small part because of family members' changing roles in response to the patient's difficulties, even if these problems ultimately improve. Immediate family involvement and education about the course of illness is crucial, and ongoing attention should be paid to family needs as time passes. Supporting families can improve outcomes by ensuring that the patient's recovery is not hampered by a deteriorating family situation. Many providers will not have the time or expertise to include families in all phases of treatment; again, clinicians should not hesitate to seek out available expertise and support groups early in the course of illness.

Background Information:
The conflicts in Iraq and Afghanistan have resulted in increased numbers of Veterans who have experienced traumatic brain injuries (TBI). The Department of Defense and the Defense and Veteran's Brain Injury Center estimate that 22% of all combat casualties from these conflicts are brain injuries, compared to 12% of Vietnam related combat casualties. 60-80% of soldiers who have other blast injuries may also have traumatic brain injuries. This fact sheet provides information on the classification and natural history of traumatic brain injury; comorbidities in the Veteran population; challenges in the diagnosis and treatment of these disorders; and special issues for families living with traumatic brain injury.