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Emergency and Trauma

Trauma Injuries

Traumatic Brain Injury

Traumatic brain injury (TBI) is a serious public health problem in the United States.  Each year, traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability. Recent data shows that, on average, approximately 1.7 million people sustain a traumatic brain injury annually.1

A TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. The majority of TBIs that occur each year are concussions or other forms of mild TBI.2.

Severe Traumatic Brain Injury 
Each year, TBIs contribute to a substantial number of deaths and cases of permanent disability. In fact, TBI is a contributing factor to a third (30.5%) of all injury-related deaths in the United States.1 On average, of the 1.7 million people who sustain a TBI each year in this country: 52,000 people die and 275,000 people are hospitalized.

A severe TBI not only impacts the life of an individual and their family, but it also has a large societal and economic toll. The estimated economic cost of TBI in 2010, including direct and indirect medical costs, is estimated to be approximately $76.5 billion. Additionally, the cost of fatal TBIs and TBIs requiring hospitalization, many of which are severe, account for approximately 90% of the total TBI medical costs. 2,3

Types of Severe TBI

There are two types of severe TBI, each described below by associated causes:

Closed – an injury to the brain caused by movement of the brain within the skull. Causes may include falls, motor vehicle crash, or being struck by or with an object.

Penetrating – an injury to the brain caused by a foreign object entering the skull. Causes may include firearm injuries or being struck with a sharp object.

The Glasgow Coma Scale (GCS)4, a clinical tool designed to assess coma and impaired consciousness, is one of the most commonly used severity scoring systems.  Persons with GCS scores of 3 to 8 are classified with a severe TBI, those with scores of 9 to 12 are classified with a moderate TBI, and those with scores of 13 to 15 are classified with a mild TBI.  Other classification systems include the Abbreviated Injury Scale (AIS), the Trauma Score, and the Abbreviated Trauma Score.  Despite their limitations5, these systems are crucial to understanding the clinical management and the likely outcomes of this injury as the prognosis for milder forms of TBIs is better than for moderate or severe TBIs.6-8

 Potential Affects of Severe TBI

 A non-fatal severe TBI may result in an extended period of unconsciousness (coma) or amnesia after the injury. For individuals hospitalized after a TBI, almost half (43%) have a related disability one year after the injury.9 A TBI may lead to a wide range of short- or long-term issues affecting:

•Cognitive Function (e.g., attention and  memory)
•Motor function (e.g., extremity weakness, impaired coordination and balance)
•Sensation (e.g., hearing, vision, impaired perception and touch)
•Emotion (e.g., depression, anxiety, aggression, impulse control, personality changes)
Approximately 5.3 million Americans are living with a TBI-related disability and the consequences of severe TBI can affect all aspects of an individual’s life.10 This can include relationships with family and friends, as well as their ability to work or be employed, do household tasks, drive, and/or participate in other activities of daily living.

Fast Facts

 Falls are the leading cause of TBI and recent data shows that the number of fall-related TBIs among children aged 0-4 years and in older adults aged 75 years or older is increasing.

Among all age groups, motor vehicle crashes and traffic-related incidents result in the largest percentage of TBI-related deaths (31.8%).1

People aged 75 years old and older have the highest rates of TBI-related hospitalizations and death.1

Shaken Baby Syndrome (SBS), a form of abusive head trauma (AHT) and inflicted traumatic brain injury (ITBI), is a leading cause of child maltreatment deaths in the United States.

**Information from the CDC