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A Message From
Jeff Stern
Best viewed on Windows Media Player 9.0
Houston Office:
4909 Bissonnet Street
Suite 100
Bellaire, TX 77401
Phone: 713-661-9900
Toll Free: 1-877-661-9900
Mc Allen Office:
721 East Esperanza Ave, Suite C
Mc Allen, Tx 78501
956-226-4236
Fax 956-992-971
*By Appointment only
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What causes a traumatic brain injury?
A brain injury can be caused by:
- The head being struck by an object,
- The head striking an object, or
- The brain undergoing an acceleration/deceleration movement (i.e., whiplash) without direct external trauma to the head. (From The Journal of Head Trauma Rehabilitation 1993;9(3):86-87)
Over 50% of all brain injuries are sustained in motor vehicle accidents. Closed head injury followed by post-concussion syndrome is the most common serious neurological disorder in the United States today. Each year, about two million people in the United States sustain a brain injury. About eighty-five percent are considered to be "mild" TBI‘s. However, many of these minor head injuries have significant, long-lasting results. In many cases, the injuries which result in traumatic brain injury may be bloodless, require no medical care, and initially seem non-disabling. The victim does not have to lose consciousness at the accident scene for a TBI to be present. In many cases, physical and neurological examination, x-ray, CAT scan, and MRI scan will reveal no objective problems. Microscopic research has shown that irreversible brain damage can occur even when the head does not strike an object, but instead is only shaken violently as in a whiplash incident. A person can suffer organic brain damage without having sustained skull fractures, coma, or loss of consciousness. Many head-injury victims are treated only at the emergency room, a time before the victim manifests obvious signs of post-concussive syndrome. There are usually no medical pictures of the brain injury. Victims generally have trouble remembering the accident, and may be unaware of the effects of the brain injury. Disturbing short-term and potentially long-term problems caused by closed head injuries are often not recognized by the medical care providers, since they are treating the obvious physical injuries caused by the trauma. Subtle symptoms later voiced by a victim may be dismissed as a degree of hypochondria. For all of these reasons, TBI is called the silent epidemic.
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Medically speaking, what exactly is a traumatic brain injury?
It is the inertial force transmitted by sudden deceleration that causes a diffuse axonal injury (DAI) and/or vascular injury. More force means more injury.
Axonal Injury
The primary neuropathology of TBI is diffuse axonal injury (DAI) caused by shearing forces generated in the brain by sudden deceleration. These shearing forces disrupt fragile structures running in the long axis of the brain, primarily axons and small vessels. Axonal injury causes swelling and often lysis of the axon with wallerian degeneration. The role of release of excitatory neurotransmitters from the synapses of damaged axons as a cause of downstream cell loss in uncertain.
Vascular injury
Vascular injury causes disruption of small veins, producing petechial hemorrhages or local or focal edema. The primary distribution of injury seems to be parasagital deep white matter spreading from cortex to brainstem. This pattern may be responsible for the eventual predominance of attentional and executive deficits in even the mildly impaired. (From NEUROLOGY 1995; 45:1253-1260)
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What are the factors that tell when a mild brain injury might have occurred in an accident?
According to the American Congress of Rehabilitation Medicine, a patient with traumatic brain injury is a person who has had a traumatically induced physiological disruption of brain function, as manifested by at 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 the 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.
A mild brain injury is one that meets the above 4 factors BUT:
- Loss of consciousness (LOC) is 30 minutes or less;
- After 30 minutes, an initial Glosgow Coma Scale (CGS) is 13-15; and
- Post-traumatic amnesia (PTA) lasts not longer than 24 hours.
A mild traumatic brain injury may be overlooked in the face of more dramatic physical injury, 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 symptoms that, when linked to a traumatic head injury, can suggest the existence of a mild traumatic brain injury. (From the Journal of Head Trauma Rehabilitation 1993;9(3):86-87.)
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Can a mild TBI result in any permanent disability?
Yes. The mild TBI occurrence rate is 180 mild TBI's each year for every 100,000 persons (over 450,000 persons per year in the U.S.). The incident rate for Mild TBI patients who will be persistently symptomatic is 27 TBI victims each year for every 100,000 persons (over 67,500 persons per year in the U.S.). This means that 15% of all persons who sustain a mild brain injury will exhibit some disabling symptoms that persist one year after injury. Mild TBI does not affect life expectancy. The average TBI victim who is persistently symptomatic is a male in his 20's or 30's. This means that the Mild TBI patient generally faces decades of disability. (From NEUROLOGY 1995; 45:1253-1260)
As a family member, what can I do if I suspect my loved one has sustained a mild TBI?
If you will contact us, we will provide you with a "Summary of Symptoms Form" that is a brain injury fact sheet that enables you to prepare a before and after snapshot of your loved one. This information provides the information needed to begin the process of determining if the client received a brain injury. It also provides the factual basis for beginning the process of obtaining treatment/rehabilitation for post-concussion disorders. We are prepared to quickly help our clients obtain the needed testing, treatment, and rehabilitation. The process of helping brain injury victims takes time, money, and know-how. Brain injury cases are very difficult, but it is rewarding to help people so they learn to cope with this disabling injury.
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