Causes

Traumatic brain injury (TBI) is caused by a bump, blow, or jolt to the head or a penetrating head injury that results in the disruption of normal brain functioning. TBI is a preventable injury. It results in death and disability for thousands of people each year and remains a serious public health concern. TBIs were identified in 25% (N=60,134) of all injury-related deaths that occurred during 2017 in the United States. BI-related deaths were obtained from the National Vital Statistics System (NVSS), which captures data for all deaths registered in the 50 U.S. states and the District of Columbia.

Types of injuries causing TBIs

• Traumatic brain injuries can be the result of a skull fracture (skull crack). A broken or cracked skull may cut into the brain and cause injury. A penetrating injury, such as a gunshot to the head, is also considered as a TBI.
• Bruising of the brain, contusion, occurs when swollen brain tissue combines with blood from broken blood vessels, increasing pressure on the brain. This bruising can be caused by a bump, blow, or jolt to the head, resulting in the brain banging back and forth against the skull. Major blood vessels in or around the brain are damaged and begin bleeding. The pooling of blood exerts pressure on the brain and is called an intracranial hematoma.
• Most common causes of TBIs are from a fall, firearm injury, motor vehicle crash, or an assault.

Video: Teen Athlete Shares Recovery Story after Traumatic Brain Injury (5:02)

The more generic form of TBI is the result of a concussion, or series of concussions. A concussion occurs when the head or body is quickly moved or jolted back and forth. Concussions are considered mild TBIs and are usually non-life threatening. Successive concussions can cause serious problems and may result in moderate to severe TBIs.

A stroke is also a bleeding of the brain and may cause the same symptoms as a person who has a TBI. The Centers for Disease Control and Prevention (CDC) notes that people at the highest risk for a TBI are:

Older adults

This group has the highest rates of TBI hospitalizations and deaths. As people age, they are more prone to falls and accidents, accounting for a higher rate of TBIs.

Racial and ethnic minorities

Native American /Alaska Native children and adults have higher rates of TBI-related hospitalizations and deaths than other racial or ethnic groups. Contributing factors include higher rates of motor vehicle crashes, substance use, and suicide, as well as difficulties in accessing appropriate healthcare. Other than the difference in rates of TBIs, racial and ethnic minority groups are less likely to receive follow-up care and rehabilitation.

Service members and veterans

Members of the armed services are at risk for TBI when engaged in active military combat. However, statistics show most TBIs happen when the person is not deployed, for example, a vehicle crash. The military has its own Veterans Administration health- care, but depending on where veterans live, they may not have easy access to such care.

Video: Veterans & Effects of TBI (2:24)

People who experience homelessness

People who are homeless are up to 10 times more likely to have a history of a moderate or severe TBI. In addition, people who are homeless and have a TBI have worse overall physical and mental health. They also have a higher incidence of having experienced violence or trauma in their childhood, substance abuse, and suicidal thoughts. Access to health/trauma care is limited, if nonexistent.

People who are in correctional and detention facilities

Statistics show that 46% of people in correctional or detention facilities have a history of TBI. There are also high numbers of people with mental health problems, substance abuse issues, difficulty controlling anger, and suicidal thoughts and/or attempts. The environment of these facilities place people in confined areas, resulting in exacerbation of their individual issues. Trauma care may not be available in all facilities.

Survivors of intimate partner violence

Survivors of intimate partner violence and assault are at high risk of TBI and are more likely to be diagnosed with Post-Traumatic Stress Disorder (PTSD), insomnia, and depression, along with overall health issues. Victims of partner assault may be hesitant to seek out healthcare due to cost or fear of reporting the abuser (e.g., retribution).

People living in rural areas

People in rural areas have a higher risk of death from TBI, compared to urban areas. They may have further to travel for emergency care, have less access to a Level-1 trauma center, and have difficulty getting specialized TBI services.

Video: TBI: Traumatic Brain Injury in Kids (2:16 minutes)