Traumatic Brain Injury (TBI) or Head Injury is a major cause of death and disability worldwide especially in children and young adults. It is seen that males suffer more frequently than females and the causes are mostly vehicular accidents, falls, sports, and violence. Preventive measures include use of helmets, seat belts, and driving safely. The Brain is the CPU of the body, so we always must protect it.
Head Injury results mostly from an accident where the head suffers a hit and the force of the hit could be violent enough to cause permanent or temporary brain damage and could lead to disruption of brain and bodily functions.
Sometimes, even minor injuries which are often overlooked, could lead to serious after effects and must not be ignored. These effects of injury which could be cognitive (thinking, understanding, learning, reasoning and remembering), social, emotional and behavioral. Depending on the type and level of injury, and the time elapsed from time of injury to time of reaching hospital, the outcome could range from complete recovery to permanent disability or even death.
According to the National Institute of Health (US) and Mayo Clinic, there are six main brain functions that may get affected by an accident involving the headand they all show some form of symptoms.
When an injury occurs to the Nerves in and around the skull, the following may be noticed:
- Facial muscle paralysis or loss of sensation
- Double vision
- Loss of sense of smell
- Loss of vision
- Problems with swallowing
Depending on the severity of Injury, there could be changes in normal functioning abilities like:
- Learning and reasoning
- Attention or concentration span
- Problem solving and decision making capability
TBI could cause disruption in communication skills and social problems like:
- Difficulty in understanding speech or writing
- Disorganized thinking
- Confusion, awkwardness and slurring of speech.
Behavioral changes as follows may be noticed after a head injury:
- Lack of self control
- Risky behavior
- Verbal or physical outbursts
- Loss of confidence
Emotional changes may include:
- Depression and anxiety
- Mood swings and increase in irritability
- Changes in self esteem
- Insomnia and other sleep related problems
Affect on Senses
- Ringing in the ears
- Hand eye coordination
- Tingling, pain or, itching of the skin
- Difficulty in recognizing objects
- Abnormal posture
It is important for parents to know that small children with moderate to severe head injury may have some of these symptoms, but may not be able to communicate them. Children also show other signs like persistent crying, refusal to nurse or eat, and irritability. In adults, TBI is mostly caused due to Road Accidents, but in small children, it is mostly accident, falls and child abuse. If any of the foregoing symptoms are noticed in children or adults, have them examined by a doctor immediately. As far as possible, a Head Injury victim must be seen by a Doctor in the golden hour.
The incidence of TBI is increasing globally and India is leading the pack. The largest bracket is in the age group of 15 to 25 and thereafter it is 26 to 45. The age groups at most risk of mortality are adults over 70 year age and children between 5 to 9. In a country like India where there are large tracts of poverty, especially in the rural areas, there is a tendency to ignore mild or moderate cases of Head Injury as the people often do not understand the significance of such injuries. It is important for the Government, various informed groups and NGOs to educate our masses through all methods at our disposal including the PanchayatSystem and District Hospitals on how to recognize irregular behavioral patterns in their wards and in case of any doubt, have them examined at a hospital. The earlier the better.
Ranbir Talwar :
Ranbir Talwar is an Ex Navy Personnel. Currently he is the Executive Director of Indian Head Injury Foundation (IHIF), a “not for profit” charitable institution and his work involves fostering the development of a comprehensive brain trauma prevention and care system in India through awareness programmes, improvement of pre- hospital care and provision of rehabilitation to the needy.
Chitra Sony is a Scholar in Social Work at MVGU, Jaipur. She is actively involved with Indian Head Injury Foundation (IHIF) to help preventing road traffic accidents and providing neuro rehabilitation. Her area of interest is public awareness in road safety and neuro rehabilitation.