The National Head Injury Foundation (NHIF) describes traumatic brain injury as, “an insult to the brain caused by an external force that may produce diminished or altered states of consciousness, which results in impaired cognitive abilities or physical functioning”. In other words, injury caused by things such as a blow from a blunt object, a bottle, a wall, or an object like a bullet penetrating the skull, will cause injury, sometimes permanent, that affects the way we think and behave. It may cause no loss of consciousness, or may result in death or a coma or what has become know as a persistent vegetative state.
The Facts in Brief
* It is estimated that 2-3 males sustain a traumatic brain injury for every one female.
* The peak age range is 15-24 years. Also a high incident in the very young and elderly.
* It is estimated that for every one person admitted to hospital, three will be seen in hospital emergency departments and allowed to go home.
* Estimates of hospitalization following head injury in Britain, the United States and Australia is between 200 to 300 per 100,000 of the population.
* Recovery may be complete or partial. Some people will require periods of hospitalization and rehabilitation.
* Improvement following severe brain injury can take up to 10 years, or even longer.
* More people are surviving severe brain injury resulting in a rapid growth of young disabled who more often than not will require some sort of support for decades.
* More people are requiring specialist services.
* Trauma is the most common form of acquired brain injury.
* Approximately half to 70% of all traumatic brain injury are caused by motor vehicle accidents.
* Other common causes involve falls (particularly in the very young and elderly), assaults and sporting accidents.
* There is a high association of brain trauma with lower socio-economic status.
So Why More Men?
The peak age for Traumatic Brain Injury (TBI) is between 15 and 24 years. The reason for this is that men are more likely to engage in activities that make them more vulnerable. It is estimated that between 50%-70% of TBIs are the result of road traffic accidents, cars crashes, motor bikes, push bikes. Motor vehicle insurers know that men are more likely to make a claim than women as a result of accidents, hence premiums are often higher for men under the age of 30 or sometimes 40+.
Young men are also more likely to get into fights involving weapons and fire arms, often after drinking too much alcohol. Men are also more likely to engage in high risk or contact sports such as karate, football, hockey, etc.
The last of the main contributors to head injury in men involves work. Men are far more likely to be employed in occupations that carry some form of industrial risk and that often involve heavy equipment or manual labor. The likelihood of accidents increase where proper safety precautions are not followed, or when for any number of reasons such as illness or fatigue, men lose concentration.
One clear implication of the statistics is that most incidents of traumatic head injury are avoidable.
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Psychosocial Consequences of Head Injury
Traumatic brain injury can mean many long-term psychological and behavioral difficulties. Because every head injury is different, it is impossible to predict the exact outcome for the survivor. While generalizations can be made, it is important that treatment professionals and other concerned persons note that individuals may present few problems or a combination of several problems. Some deficits following head injury are painfully obvious; others are extremely subtle and become evident only during intensive clinical evaluation (Lezak 1978b). Alcohol and other drug abuse professionals working with head injury survivors commonly deal with clients who appear to function normally in most settings but who are unable to understand the concepts of alcohol or other drug addiction or to benefit from traditional treatment modalities.
To work effectively with survivors of traumatic brain injury, it is vital that alcohol and other drug abuse professionals acquaint themselves with the unique problems these clients present. The following discussion of the more common consequences of head injury is drawn from general knowledge in the field of brain injury rehabilitation. For more detailed information, the reader is directed to Levin and colleagues (1982), Edelstein and Couture (1984), Lezak (1978a, 1978b, 1983), and Brooks (1984).
Impairment of memory-Post-traumatic amnesia is one of the most common consequences of head injury. For many survivors, memory for events and conditions prior to their injury is generally intact while short-term memory for recent events is disrupted. In practical terms, this means that brain injury survivors might remember the events of their high school prom in great detail but forget what was served for breakfast this morning. Some survivors may try to fill in the gaps with confabulation, a usually sincere attempt to mask memory deficits that is sometimes misinterpreted as dishonesty. Impairment of recent memory makes it difficult for many survivors to retain information and generalize new learning from one setting to another.
Decreased self-awareness and insight - Many survivors of traumatic brain injury experience a reduced capacity for insight, self-monitoring, and awareness. They may have difficulty seeing the relationship between their behavior and the resulting consequences and may experience confusion or frustration in their attempt to understand situations.