TBI
Each year in the United States:
• Approximately 1.5 million
Americans sustain traumatic
brain injuries, ranging from
mild to severe;3
• 50,000 people die from TBIs;3
• 230,000 people are hospitalized
due to TBIs and survive;3
FACTS
MTBI
• Data suggest that as many as 75% of all brain-injured people
sustain MTBIs.7
• MTBIs cost the nation nearly $17 billion each year.6
• An unknown proportion of those who are not hospitalized may
experience long-term problems, such as:2, 8
• In most cases of diagnosed MTBI, the
patient recovers fully.2, 8, 9
• Some research indicates that up to 15%
of patients diagnosed with MTBI may
have experienced persistent disabling
problems.8, 9                       
- Persistent headache,
- Confusion,
- Pain,
- Cognitive and/or memory problems,
- Fatigue,
- Changes in sleep patterns,
- Mood changes, and/or
- Sensory problems such as changes
in vision or hearing (post-concussion
syndrome).
Data suggest that as many
as 75% of all brain-injured
people sustain MTBI.7
• More than 1 million are treated in emergency departments for TBIs;4
• An estimated $56 billion is spent in direct and indirect costs as a
result of all TBIs;5 and
• 80,000 to 90,000 Americans experience onset of long-term disability
from TBIs.6

In the past 20-30 years the medical term for concussion has changed and will no doubt continue to change. Concussion, MTBI Mild Traumatic Brain Injury, Brain Injury, etc... continues to have essentially the same meaning. Concussion can take on a wide variety of causes, treatments, and prognosis. I personally think that our society has under estimated the full effect of such Brain Injuries. Football, boxing, soccer, and many other sports can cause a acute brain injury. Auto accidents are one of the leading causes of Brain Injury. Unfortunately, health care professionals, patients and coaches under diagnose these injuries. It is easy to see why these injuries are overlooked. First, in sports no one wants to be out of the competition. They under report their symptoms in an effort to get back onto the field. Second, coaches want there athletes on the field. So pressure for the athletic trainer to get them back out as soon as is possible is extreme. Regarding auto accidents, the medical profession is looking for an active bleed in the brain to acknowledge a concussion. Bruising of the brain may occur and not be recognized unless an MRI is done. These tests run over a thousand dollars and so they are not done routinely (nor should they be). The government is looking in to increasing the requirements for anyone in a high school level or lower to be cleared by a physician, prior to returning to the field of play, if there are any signs of a brain injury.
What are the signs of a brain injury? obviously if the person is knocked out. But there are levels of injury below loosing total consciousness. Being dazed for a few moments, forgetting what happened at the time of impact, not being able to think clearly or remember phone numbers, the date, etc...
I have had many patients who following an auto accident were unable to call 911. They were awake, they remembered what had happened, but they could not make the decision and carry out the act of calling 911 or there loved ones. I have had many patients who were "dazed", life was sort of fuzzy. They were able to walk, speak and knew where they were, but had to really focus their attention to the task at hand. This is a brain injury. If the patient has an impact that causes them to go from 100% to less than 100% cognition, they have a loss of consciousness. This is a basic definition of MTBI or brain injury.
What should be done if you or a loved one has been involved in such an injury? well if medical or health care provider is easily accessible, let them evaluate you. If you have this injury in an area where no immediate help is available try to determine if there are any neurological symptoms a doctor should see you for. If you have visual disturbances, headache, dazed or dizzy feelings, memory loss, black outs, extreme weakness, or vomiting. If you have any of these, you should seek attention. Most mild concussions will improve and not cause long term loss. If you notice a persons symptoms getting worse with time, it becomes more of an emergency. There may be bleeding or swelling that can become life threatening. Call 911 or get to an ER immediately. Better safe than sorry in these type situations. As a Chiropractic Orthopedist I see many patients with concussion. I diagnose most I see as MTBI Mild Traumatic Brain Injury. Most will not require specialized treatment. But if I found someone who's condition was deteriorating, I would immediately call 911 or send to an ER. Please if your loved one has been injured and seems to "just have a Concussion" according to the athletic trainer... don't hesitate to rush them to the ER, If the neurological signs get worse.
I will list some information that is considered the current standard for handling a brain injury and what to expect. Please see below and watch the videos for additional information.
What is a mild TBI? The severity of TBI is defined by its acute injury characteristics, not by the severity of symptoms. Mild TBI is characterized by the following:
1. Head trauma may be due to contact forces or to acceleration/deceleration trauma. This includes motor-vehicle collisions and assaults.
2. The duration of unconsciousness is brief, usually seconds to minutes, and in some cases there is no loss of consciousness (LOC) but simply a brief period of dazed consciousness.
3. When the patient was evaluated in the emergency room or at the scene, the Glasgow Coma Scale (GCS) must have been 13 to 15. The GCS is scored between 3 and 15, 3 being the worst, and 15 the best. Only a score of 15 probably represents true mild TBI. A score of 13 or 14 is due to confusion or disorientation and will usually be associated with a longer period of amnesia.
4. Whether the patient is briefly unconscious or not, confusion with amnesia is present for minutes to a few hours.
5. When evaluated, the patient has no focal signs of neurologic injury, although in the immediate post-traumatic period, patients may be pale, diaphoretic, nauseated, and ataxic.
6. Neuroimaging studies are negative.</strong>

Some symptoms of a more severe brain injury may be present. The evaluation and workup of TBI patients should include more than an evaluation of their thinking skills. Physical evaluation is also very important. The physical examination list for TBI includes • vital signs;
• mental status evaluation; • orientation—time, place, person, and situation; • concentration—recite the months of the year backward; • memory—current events and previous events; • provocation of symptoms with exercise; • eye examination including pupils (anisocoria) and reactions to light; • coordination—finger to nose, tandem gait, Romberg; • superficial sensation; and • ortho/neuro examination of the spine as indicated.
Instructions should be provided to the acute mild TBI patient on when to contact you or when they should report to an emergency room. Following is an example.
1) Avoid strenuous activity for 24 hours after the injury. 2) Do not take mediations without consulting your physician. 3) Eat a light diet such as soup, toast, or crackers for 24 hours after the injury. 4) Avoid alcohol. 5) Do not take aspirin, sleeping pills, or ibuprofen.

Patients should also contact you or go to the ER if they • become sleepy or are difficult to awaken; • vomit; • have trouble with balance; • experience odd eye movement, have difficulty focusing, or show unequal pupil size; • have persisting or increasing headache; • experience restlessness, irritability, or personality changes; • have convulsions or seizures; • experience new swelling at the area of the head injured; • have increased neck stiffness; • experience numbness; • experience ringing in the ears; • experience shortness of breath; • experience confusion; or • experience visual problems.</strong>

If you have any questions please email me at backe2009@yahoo.com
If you live in the Colorado Springs area and need any advice or treatment for a sports injury or car accident injury, give me a call at 719-573-2225 or visit us at Back Essentials Chiropractic at 4742 Barnes Road. You can also visit us at CSBACK.COM

http://www.youtube.com/watch?v=d-TOzS4CWpA&amp;feature=related
http://www.youtube.com/watch?v=yIqZDbk3M40
http://www.youtube.com/watch?v=lypi-mY4vvw

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