Long-Term Risks of Traumatic Brain Injury

Packed full of baseball games, pool parties, and bike rides; summer is a time where the weather is warm and physical activities are at a peak. Unfortunately, so is the risk for injury.

WOWT reported a story about a local softball player who suffered a brain injury after diving head first for a ball. The 15-year old caught the ball, tossed it to her teammates, and seemed to be fine. However, as the game progressed her vision became blurry. She started to have trouble hearing and soon began to cry uncontrollably. This outpouring of emotion was something out of the norm for the notoriously tough ball player.

As she made her way over to the team trainer, she lost all motor function. Unable to walk or talk, she was sent to the emergency room, put into a medically induced coma, and placed on a ventilator. Luckily, the young player has since been discharged from the hospital and is back in the stands cheering on her team.

While the WOWT article didn’t clarify exactly what kind of brain injury the young leady endured, concussions are the most common type of traumatic brain injury (TBI), and the severity can range anywhere from a minor to a major concussion. A concussion can be initiated by a direct or indirect blow to the head that causes the brain to strike the inner skull. It is estimated that nearly 53% of high school athletes have sustained a concussion prior to playing high school sports, and 36% of collegiate athletes have a history of multiple concussions. Managing concussions very closely in youth is vital because the frontal lobe of the brain, which is home to our personality and emotional control center, does not finish developing until age 25.

Long-term consequences from a brain injury can include many psychological problems including depression, mania, and anger. Research has shown that even psychiatric disorders can develop years after the initial injury has occurred. This variety of mental disorders includes schizophrenia, major depressive disorder, alcohol and substance abuse disorders, obsessive compulsive disorder, dysthymia, panic attacks, and phobias. These risks greatly increase with additional brain injuries, and the consequences of these behavioral and emotional changes can be so severe that they increase the individual’s risk of suicide up to two to three times higher than the general population.

Dr. Pirzada Sattar, Director of Psychiatry at Methodist Jennie Edmundson Hospital in Council Bluffs Iowa explains that, “When a TBI is relatively mild and does not have immediate recognizable consequences such as visible bleeding, loss of consciousness, high level of pain, exedra; parents or individuals may dismiss the injury as not requiring immediate medical attention. However, these mild injuries, especially when occurred repeatedly, can have a delayed impact on the functional capacity of the part of the brain that is injured.”

While a mild concussion may sound less dangerous than a major concussion, research tested on Military Veterans may prove otherwise. The U.S. Defense Department estimates that 266,810 of the 1.6 million service members, who served in Iraq and Afghanistan between 2000 and 2012, received traumatic brain injuries. Although the military and other researchers believe many more remain undiagnosed. While the majority of these injuries were diagnosed as mild, research conducted by Craig Bryan, assistant professor at the University of Utah and associate director of the National Center for Veteran Studies, found that mild concussions are more likely to lead to suicidal thoughts than severe ones. While there isn’t an exact reason why this is, one theory is that people assume that since their injury is ‘mild,’ they should be able to heal quicker and do not take the time to allow themselves to heal, unknowingly imposing more stress as a result.

Since many military members have a history of playing athletics, a vast majority already had endured one or more previous brain injuries. Those with multiple TBIs were at an increased risk for developing posttraumatic stress and depression. An average of 22 Military Veterans die by suicide every day – could multiple brain injuries be responsible for some of these deaths?

“When the injured area of the brain controls our ability to regulate emotions, like our ability to feel happy, ecstatic, angry, sad, horrified, we lose the ability to control and appropriately feel the correct emotions,” says Dr. Sattar. “This could lead to exaggerated and excessive anger outbursts, laughing hysterically even when given devastating news, or crying even when we should be happy.”

Playing sports is a great way for children and teens to learn teamwork, commitment, and to stay active, but we must make sure they stay safe while participating. Always be sure that helmets and other safety gear fits correctly, and is worn. A large percentage of injuries are caused by automobile accidents, so set a good example for your kids and always wear a seatbelt. Bathrooms can also be a dangerous place where many slip accidents happen. To avoid dangerous falls, install grab bars next to the shower or tub. Make sure staircases are properly lit and have adequate railings.

Does your child or teen play contact sports? If so, here are some tips from Dr. Sattar about what to watch for if you think they may have endured a head injury:

• When parents or coaches encounter a child with a concussion, the first thing obviously is to get them the appropriate medical attention. However, the risks to cognitive and emotional functioning can remain even after the appropriate acute medical treatment has been provided.

• Parents and/or coaches should look for any changes in emotions from baseline. If a child is excessively moody, if they start to have anger outbursts in situations that would not or should not bother them, or if they are crying in situations which previously would not have bothered them, a referral for formal psychological assessment is necessary.

• Parents and/or coaches should also look for any changes in the child’s cognitive abilities. If the child is having trouble remembering simple tasks or events that they previously could, or if they are unable to think of and come up with strategies and solutions to problems that they were able to previously, a referral for formal psychological testing and assessment is recommended.
• For parents and coaches of children that have already received a concussion, it is imperative that they try to prevent or avoid as much as possible the activities that would lead to subsequent injuries to the brain.
Resources:
http://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/basics/complications/con-20029302
http://www.wowt.com/home/headlines/Local-Softball-Player-Recovering-Following-Brain-Injury-306080651.html
http://ezinearticles.com/?How-Brain-Injuries-Can-Affect-You-Years-Later&id=6198536
http://www.concussiontreatment.com/resources
http://neuroskills.com/brain-injury/frontal-lobes.php
http://www.pbs.org/wgbh/pages/frontline/foreign-affairs-defense/a-new-link-between-traumatic-brain-injury-and-suicide/
http://www.orleanshub.com/news2014/Take-precautions-to-protect-yourself-from-brain-injuries.htm

About Jill Sauser, The Kim Foundation Project Coordinator
Jill graduated with a degree in Journalism and a minor in Speech Communication from the University of Nebraska at Omaha in 2009. During her time at UNO, she completed a two year PR practicum program where she worked with numerous nonprofit clients including the MS Society, The Archdiocese of Omaha, The Omaha Food Bank, and YWCA. Since becoming Project Coordinator at The Kim Foundation in April 2014, she has become an active member of the Nebraska State Suicide Prevention Coalition, The Omaha Metro Hoarding Taskforce, the Early Childhood Mental Health Coalition, the Metro Area LOSS Team, and is helping lead a community-wide health improvement initiative with the Douglas County Health Department called, “Just Reach Out,” which is focused on improving the people’s view on mental and behavioral health treatment.