Brain Injury Facts

Last updated on 10-22-2017
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Stranger than anything imaginable

Understanding Brain Injury

What should you know about brain injury and recovery? Watch a series of informative videos produced by the Shepherd Center. They feature some of the nation's top physicians, neuroscientists, and brain injury experts to help you understand brain injury and gives you practical advice for coping with brain Injury.

Some statistics:

  • 1.7 million Americans sustain a traumatic brain injury each year. Approximately 475,000 of these cases are children. (CDC)
  • Each year nearly one-third of all injury deaths involve a TBI, approximately 275,000 Americans are hospitalized, and 1.4 million are seen in an emergency department. (CDC)
  • From 1997 to 2007:
    • On average, 53,000 Americans died each year as a result of a TBI,
    • The overall rates of TBI-related deaths decreased by 8.2 percent, and
    • The rates for all causes of TBI decreased, with the exception of those related to falls.
  • Georgia averages 57,000+ traumatic brain injuries each year with 20,000+ Georgia children either treated in an emergency department or hospitalized. (BSITFC Central Registry 2008)
  • Nearly one-third of all injury deaths annually involve a TBI and approximately 275,000 Americans are hospitalized and 1.4 million are seen in an emergency department.
  • The leading causes of traumatic brain injury in Georgia are Falls (49.88%), Motor Vehicle Crashes (24.36%), Being struck by an object or person (14.3%), Violence (11.4%). (Brain and Spinal Injury Trust Fund Commission)
  • People with traumatic brain injury are at a higher risk for psychiatric disorders. (Brain and Spinal Injury Trust Fund Commission)
  • The prevalence of depression in the general population is around 5%, while the prevalence of depression in head trauma patients can reach an astounding 40%. (Science Daily)
  • Professional sports programs like the National Football League have been leading efforts to prevent concussions sustained on the field. These and other prevention initiatives have followed claims that numerous cases of depression and suicide, such as that of Philadelphia Eagles player Andre Waters in November 2006, are linked to a series of concussions. (NYTimes)

My Shepherd Connection is an educational website for patients, caregivers, and professionals that covers many aspects of brain injury and spinal cord injury. Areas of the website include: Affect and Emotion, Behavior Issues, Cognitive Issues, Family Issues, Bowel Care, Bladder Care, Support and Resources, and much more.

What Causes Depression After TBI?

Many factors may contribute to depression after TBI, and these may vary from person to person:

  • Physical changes in the brain due to injury of the areas that control emotions and/or changes in the level of natural chemicals.
  • Emotional responses to injury as the person struggles with adjustment to the disability, losses or role changes within the family and society.
  • Factors unrelated to the injury itself due to inherited genes, personal and family history, and other influences that were present before the injury.

If you have symptoms of depression, it is important to seek professional help as soon as possible with a health care provider who is familiar with TBI. Depression is not a sign of weakness, and early treatment can prevent needless suffering.

Source: Traumatic Brain Injury Model System Consumer Information 2010

Classifying Seizures | Beyond Adversity

After brain injury of any type, including stroke, the survivor is sometimes left having seizures. Read on to learn about the various types of seizures and their generalized accompanying symptoms as presented by Barrow Neurological Institute.

10 Early Signs and Symptoms of Alzheimer's

  1. Memory loss that disrupts daily life.
    One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.
    • What's a typical age-related change?
      Sometimes forgetting names or appointments, but remembering them later.
  2. Challenges in planning or solving problems.
    Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
    • What's a typical age-related change?
      Making occasional errors when balancing a checkbook.
  3. Difficulty completing familiar tasks at home, at work or at leisure.
    People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
    • What's a typical age-related change?
      Occasionally needing help to use the settings on a microwave or to record a television show.
  4. Confusion with time or place.
    People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
    • What's a typical age-related change?
      Getting confused about the day of the week but figuring it out later.
  5. Trouble understanding visual images and spatial relationships.
    For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.
    • What's a typical age-related change?
      Vision changes related to cataracts.
  6. New problems with words in speaking or writing.
    People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock").
    • What's a typical age-related change?
      Sometimes having trouble finding the right word.
  7. Misplacing things and losing the ability to retrace steps.
    A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.
    • What's a typical age-related change?
      Misplacing things from time to time and retracing steps to find them.
  8. Withdrawal from work or social activities.
    People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
    • What's a typical age-related change?
      Making a bad decision once in a while.
  9. Withdrawal from work or social activities.
    A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
    • What's a typical age-related change?
      Sometimes feeling weary of work, family and social obligations.
  10. Changes in mood and personality.
    The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
    • What's a typical age-related change?
      Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Source: Alzheimer's Association®

10 Ways to Help Your Brain Heal

There are a number of self-care techniques you can use to help your brain heal. First and foremost, you should protect yourself from injuring your brain again. People who have had repeated injuries to their brain (like professional football players) may experience serious long-term problems and, in rare cases, it can cause brain swelling and even death.

  1. Get plenty of sleep at night, and rest during the day.
  2. Increase your activity slowly.
  3. Write down the things that may be harder than usual for you to remember.
  4. Avoid alcohol, drugs and caffeine.
  5. Eat brain-healthy foods.
  6. Stay hydrated by drinking plenty of water.
  7. Ask your doctor when it’s okay for you to drive a car, ride a bike, or operate machinery.
  8. Avoid activities that are physically demanding (sports, and housework, for example).
  9. Avoid activities that require a lot of thinking or concentration (like playing video games or balancing a checkbook).
  10. Be patient! Healing takes time.

Source: Amen Clinics Blog

Amen Clinics' NFL Work Featured in Washington Post

Washington Post logoDaniel Amen cringed when he heard the news that former NFL linebacker Junior Seau had taken his life by pointing a gun at his chest.

"He did what players think you're supposed to do: Save your brain," said Amen, a California-based physician and psychiatrist. "They have to learn there's another way. Don't give up on your brain while you're alive. Try to fix it."

Read More

Assessing the Impact of Traumatic Brain Injury-related Deaths: a New CDC Report

brain x-ray

Traumatic brain injury (TBI) remains a major public health problem in the United States, contributing to many deaths and permanent disability. Each year, nearly one-third of all injury deaths involve a TBI and approximately 275,000 Americans are hospitalized and 1.4 million are seen in an emergency department.

CDC's newly released "Surveillance for Traumatic Brain Injury–Related Deaths — United States, 1997–2007" report, published in the May 6th issue of CDC's Morbidity and Mortality Weekly Reports, Surveillance Summaries provides key insights to help assess the impact of TBI. This study shows that during the reporting period:

  • On average, 53,000 Americans died each year as a result of a TBI,
  • The overall rates of TBI-related deaths decreased by 8.2 percent, and
  • The rates for all causes of TBI decreased, with the exception of those related to falls.

The goal of this report is to help inform TBI surveillance, education, or programmatic strategies, and to improve prevention efforts to protect Americans at greatest risk.

To download a free copy of the report or to learn more about TBI and CDC's research, clinical guidelines, education, and programmatic resources, please visit www.cdc.gov/TraumaticBrainInjury.

Learn More

CDC "Ask the Experts" Facebook Page on Concussion

CDC: Centers for Disease Control and Prevention, Your Online Source for Credible Health Information

New "Ask the Expert" activity on the CDC HEADS UP Facebook Page

http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTcwMTMwLjY5MzM3NzIxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE3MDEzMC42OTMzNzcyMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MTIxMjMyJmVtYWlsaWQ9YWJvcmlza2llQGJyYWluaW5qdXJ5cGVlcnZpc2l0b3Iub3JnJnVzZXJpZD1hYm9yaXNraWVAYnJhaW5pbmp1cnlwZWVydmlzaXRvci5vcmcmZmw9JmV4dHJhPU11bHRpdmFyaWF0ZUlkPSYmJg==&&&100&&&https://www.facebook.com/cdcheadsup

Have you ever wanted to ask CDC’s experts a question about concussion and brain injury among kids and teens? Well, now you can! CDC’s new HEADS UP Facebook "Ask the Expert" activity allows CDC’s top subject matter experts to connect with fans by encouraging them to be active on the Facebook page by posing their questions to CDC experts.

How Does It Work?

The #AskTheExpert activity will occur at 1pm ET on the second Tuesday of each month and will feature responses from CDC experts. Fans should post questions about concussion and brain injury safety among kids and teens by commenting on the CDC "Ask the Expert" post each month. CDC’s experts look forward to answering your questions about concussion and brain injury safety. It’s up to you to ask!

Please note: CDC cannot provide individual or specific medical advice. It is important to talk with your doctor or nurse about any concerns you may have.

Spread the Word

Help us spread the word about CDC’s #AskTheExpert activity by posting these social media messages on Facebook and Twitter:

Twitter: You ask, CDC answers! Questions about #concussion & brain injury safety? Get #CDCHEADSUP & #AskTheExpert your questions on Facebook!

Facebook: Do you have questions about concussion and brain injury safety in youth sports? #AskTheExpert your questions in the comments on the CDC HEADS UP Facebook page. The second Tuesday of each month, a CDC expert will go LIVE to answer! Check back to get #CDCHEADSUP about concussion safety!

Concussion Danger Signs

Adults

In rare cases, along with a concussion, a dangerous blood clot may form on the brain and crowd the brain against the skull. Contact your doctor or emergency department right away if, after a blow or jolt to the head, you have any of these danger signs:

  • Headaches that get worse
  • Weakness, numbness, or decreased coordination
  • Repeated vomiting

The people checking on you should take you to an emergency department if you:

  • Cannot be awakened
  • Have one pupil — the black part in the middle of the eye — larger than the other
  • Have convulsions or seizures
  • Have slurred speech
  • Are getting more and more confused, restless, or agitated

Children

Take your child to the emergency department right away if the child has received a blow or jolt to the head and:

  • Has any of the danger signs for adults
  • Won't stop crying
  • Can't be consoled
  • Won't nurse or eat

Although you should contact your child's doctor if your child vomits more than once or twice, vomiting is more common in younger children and is less likely to be an urgent sign of danger than it is in an adult.

Source: Centers for Disease Control and Prevention (CDC), Facts About Concussion and Brain Injury, Where to Get Help

Cyclists

Cyclists and drivers both have a right to use the roads — but sometimes they need to give a bit more thought to each other. The Department of the Environment (Northern Ireland) website's Cyclists page contains information, general guidance, and advice for cyclists and motorists alike.

On April 4, 2006, at the age of 23, Saul Raisin crashed in a professional bicycle race. He fell into a coma, sustaining substantial bodily damage and a traumatic brain injury. His outlook was bleak. Medical professionals did not know if he would survive, and if he did, what kind of life he would lead. Read more about Saul's remarkable comeback and his mission in life, the Raisin' Hope Foundation.

Don't Text and Drive!

There is no such thing as safe texting and driving. Texting while driving is dangerous and is one of the leading causes of traffic injuries and deaths across North America, especially with younger drivers.

Mobile phones are essential to everyday life — many of us like to keep ours within reach at all times. But we can't allow them to be a distraction behind the wheel. As part of Verizon's commitment to safer communities, they continue to take the lead in educating the public and supporting legislation and new technological solutions for driving responsibly. Read more about the dangers of texting and driving on the Verizon Wireless website.

Molly Welch, both a survivor and a Brain Injury Peer Visitor, was part of a very compelling Public Service Announcement and request for NOT TEXTING WHILE DRIVING in which she shares her own story of injury and recovery.

Dr. Sanjay Gupta Explains Concussions

Sports Illustrated logoHere is a great video done recently for Sports Illustrated with Dr. Sanjay Gupta — often appearing on CNN — explaining the physiology of concussions. Dr. Gupta goes over some common causes of concussions and does a really good job of explaining what exactly happens to the brain that results in concussions. He also talks about common symptoms, what the recovery process is like, and the long-term effects of concussions.

Watch the video here.

Facts About Aneurysms and Brain Tumors

WHAT IT IS HOW IT FEELS WHY IT HAPPENS
ANEURYSM A weak spot on a blood vessel in your brain that balloons out and fills with blood. It may leak or burst, causing severe brain damage or even death. One in 50 people is at risk. Sufferers usually have a sudden onset of severe headaches, double vision, neck stiffness, nausea, vomiting, pain above and behind the eyes, and/or a change in mental functioning or awareness. Most aneurysms are due to an artery-wall abnormality that you're born with, or are prompted by trauma or injury to the head, vascular disease, or high blood pressure. The problem is thought to run in families.
BRAIN TUMOR Abnormal cells grow into a mass that interferes with brain activity. About 22,000 Americans are diagnosed with cancerous brain tumors every year. Common symptoms are frequent headaches, especially ones that wake you up at night or in the morning, blurry vision, nausea and/or vomiting, personality or cognitive changes, and seizures. The causes are unknown.

Source: Health.com

Facts About Aphasia

3 things about aphasia

Imagine having a brain injury or a stroke and then being unable to speak, read, write or understand what is being said to you. This is aphasia.

Aphasia is an impairment of the ability to use or comprehend words. More than 100,000 Americans acquire the disorder each year and the most common cause of aphasia is stroke.

Bill and Kurt, stroke survivors with aphasia
Read more...

It is estimated that 25 to 40 percent of stroke survivors acquire aphasia. Although widely occurring, most people have never heard of it. There are different types of aphasia and no two individuals experience this condition in the same way. For some, aphasia will last a few days or weeks; for others, it will be a lifelong recovery.

Meet Bill and Kurt, two stroke survivors who have dealt with aphasia. Learn more about aphasia and begin to understand the daily struggle of those who experience it.

  • Aphasia is being recognized as a problem that lingers long after a person's stroke. New therapies help stroke patients regain speech functions years after their brain injury. Proof is showing that the brain's plasticity (its ability to change and heal) may last many years after a brain injury; thus, improvements can continue years later. Read the full story here.
  • Read What It Really Is Like To Have Aphasia by Marion Rasmussen, Stroke Survivor.
  • See a list of aphasia support groups in Georgia.
  • Caring for a Person With Aphasia, I will:
    • Encourage the person to speak and praise all efforts. Promote and encourage independence.
    • Give the person every opportunity to express him or herself.
    • Speak in short, simple sentences, using a natural voice and a slow rate of speech.
    • Practice speech exercises during short sessions in the home.
    • Carefully place myself and all objects within the person's visual range, if there is a cut in the person's visual field.

    I will not:

    • Force the person to speak.
    • Speak for the person unless absolutely necessary.
    • Interrupt the person when he or she is speaking.
    • Anticipate the person's every need.
    • Talk about the person in his or her presence; lack of speech does not mean lack of comprehension or lack of intelligence.
  • Aphasia: Tips to remember names and words: Aphasia speech therapy, Part 1 and Part 2

    Watch this two-video series to learn about memory and how those who are quite good at remembering names do it. From Moshe Mark Ittleman, M.S., CCC/SLP, Senior Speech Language Pathologist and author of The Teaching of Talking.

Facts About Concussion and Brain Injury

Traumatic Brain Injury Doubles Risk of Dementia

New research shows that older war vets who suffered traumatic brain injury (TBI) during their lives had more than two times the risk of developing dementia. "A diagnosis of a concussion, post-concussion syndrome, a skull fracture or some non-specific head injuries are considered TBIs," the lead researcher said. The risk of dementia in those with a TBI diagnosis was 15% compared with almost 7% in those who had never had a TBI.

Source: The Amen Newsletter

Facts About Drugs and Overdose

4 Ways to Prevent Accidental Overdose
by Jackie Cortez

Prescription pain medication addiction is an increasingly rampant problem throughout the U.S. Our painkillers are made from highly addictive substances and, if not carefully regulated, can easily become an issue of dependence.

With dangerous medications such as these, it can also become an easy mistake to unintentionally take too many and experience an overdose. Overdose is one of the most common unintentional suicides while simultaneously being easily prevented. One of the most alarming things about painkiller addiction is that overdoses can cause a cessation of breathing, often leading to anoxic brain injury. This can happen even in those taking medications for which they have a valid prescription. Here are a few ways you can ensure you or a loved one does not unintentionally harm yourselves with prescription medications.

Entrust the Medications to Someone Else handful of pills

If you do not feel you can prevent yourself from deviating from your prescription, give the medications to someone you can trust. When you need a dose, the holder will dispense the proper amount. This can also eliminate the risk of addiction or dangerous intermingling with either alcohol or other medications.

Find a responsible person you have fairly easy access to. Tell them the specifics of the medication such as proper dosage, time needed between doses, substances to avoid while on the medication, and so on. This is likely the most foolproof way of eliminating the risk of addiction or overdose.

Know Your Resources

If you feel you are at risk of overdosing or are already addicted, know what your options are for help. Keep an addiction hotline’s number in an accessible place and maybe seek the help of a counselor you can call if you are struggling. Regular counseling is the best way to cope with addiction and limit the risk of unintentional overdose. You should also have a list of contacts near you who can come help in the event you need support. Friends and family that live nearby are the best options.

Have an Emergency Plan

In the event that you do overdose, you should have a clear plan outlined. You should have several emergency contacts who can either call 911 for you or take you to the hospital immediately. Make sure your contacts know important medical information like any medication allergies, what medications you are on, what substance caused the overdose, and any other pertinent information. These individuals should also know overdose first aid.

If Possible, Wean Yourself off the Medication

Of course, some people require their medications to function normally. However, if it is possible, the best way to prevent addiction is to eliminate the substance. See if there is a less-addictive alternative, a form of therapy that might help, or even some form of natural remedy. Or if the medication is left over from a temporary injury, remove it from your home. All medication you take should be essential.

With the types of pharmaceuticals we use in the U.S., addiction to and overdose from prescription drugs are very real threats. While the best way to eliminate the risk is to stop taking the medication, that is not always possible. Be sure to involve a support network of counselors and loved ones that can help regulate your medications or be ready to help in the event of an emergency. Friends and family are your most valuable resource in this situation. Use them.

Jackie Cortez works with the team at The Prevention Coalition to identify authoritative resources on every aspect of substance abuse, ranging from prevention to addiction treatment. In her spare time, Jackie enjoys gardening, reading and walks with her favorite 4-legged pal, Buster the Labrador.

Fatigue After Brain Injury

Fatigue is one of the most common complaints associated with any form of brain injury, including stroke. Read this (PDF) to see how to manage your fatigue levels.

Source: Brain Injury New Zealand

Football, Soccer, and Ice Hockey Dangers to the Brain

Concussions can occur in all sports — not just football. Playing football, soccer, ice hockey, or any contact sport can lead to a brain injury. Read what the sports leagues are doing about it.

How Brain Cysts Can Affect Behavior

by Dr. Daniel Amen

In 1995 my 9-year-old nephew Andrew was exhibiting violent behavior. When we scanned him we found a large cyst occupying his left temporal lobe. At the time it was difficult to get other physicians to take it seriously and connect his aggressive outburst to the cyst. Fortunately, we found Jorge Lazareff, MD at UCLA who agreed to remove the cyst. Almost immediately Andrew went back to being the sweet kid he always wanted to be. Sixteen years later Andrew is a wonderful young man and living a successful and happier life.

I encourage you to watch this short video in which I discuss this topic.

Lending Their Stories to Give Brain Injury a Voice

Stories from a professional athlete, a scientist, and a teenager.

As we close out our Brain Injury Awareness Month activities, CDC's Injury Center would like to share the stories of three individuals who are helping to Give a Voice to Brain Injury.

Photo: Kurt Warner

Share Your Story

Post your story on the Heads Up Facebook Page. Visit the Heads Up Film Festival to share a video and add to the national conversation on brain injury. Read others' posts and view others' videos to learn about facing daily challenges, achieving successes, seeking support, or finding rehabilitation services. Together, we can make some noise about TBI — a once ‘Silent Epidemic.'

Learn more about traumatic brain injury.

CDC footer

Neuroplasticity: How the brain is capable of change

Scientists have historically believed that once a person reaches adulthood, their cognitive abilities are immutable. But beginning in the early twentieth century, that theory has been contested by evidence suggesting that the brain's abilities are in fact malleable and plastic. According to this principle of neuroplasticity, the brain is constantly changing in response to various experiences. New behaviors, new learnings, and even environmental changes or physical injuries may all stimulate the brain to create new neural pathways or reorganize existing ones, fundamentally altering how information is processed.

Read more at lumosity.com!

Play Sports? Take Note!

This is good information for everyone who plays sports, not only NFL players.

NFL poster on Concussion

Prevention

  • Family Safety & Legal Tips
    This is a public service website of Montlick & Associates. Provides important safety information to help you and your family prevent all types of injuries, including head injuries.
  • Help Keep Kids Safe®
    Did you know that preventable injuries are the leading threat to a child's health? This website has tons of information to help you become more knowledgeable about safety and prevent injuries to children.

Ride Your Bike Safely

Riding a bike is a physical activity that has many favorable benefits, two of them being that it is enjoyable and also great exercise. In order to get the maximum benefit of enjoyment and exercise that bike riding provides, it is also fundamental to be safe while doing so. The MotoSport.com website contains many safety tips and riding guidelines to ensure fun while riding your bike, including proper equipment, rules about dealing with motorists, rules of the road, riding at night, special rules for children, special rules for disabled people, what to do if you get stranded, and cycling organizations that promote safety. This is an invaluable biking resource!

TBIs, including Concussions, Among Youth Athletes: New CDC Report

Young AlthetesDuring the last decade, emergency department visits for sports and recreation-related TBIs, including concussions, increased by 60 percent among children and adolescents (from birth to 19 years). Bicycling, football, playground activities, basketball, and soccer are the most common activities involved. One reason for the increase may be a result of the growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected TBI to be seen by a health care professional.

CDC's newly released report, Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged ≤19 Years — United States, 2001–2009, published in the October 7th issue of CDC's Morbidity and Mortality Weekly Report, shows that the number of sports- and recreation-related TBI emergency department visits varied by age group and gender:

  • 71.0 percent of all visits were among males
  • 70.5 percent of visits were among persons aged 10-19 years
  • Children aged 0-9 years commonly sustained injuries during playground activities or while bicycling.

Learn More

Teen Driving

National Teen Driver Safety Week. 10/15-21/2017 Discuss rules of the road with your teen! www.cdc.gov @CDCInjuryMotor vehicle crashes are the leading cause of death for teens.

October 15-21 is National Teen Driver Safety Week! This is a great opportunity to reflect on what can be done to prevent teen crashes and related deaths and injuries, and to spread the word about safe teen driving.

In the United States, motor vehicle crashes are the leading cause of death for teens. In 2015, more than 2,300 teens (ages 16-19) lost their lives in car crashes. That's six teens every day. The main threats to teens' safety are:

  • Driving or riding in a car with a teen driver.
  • Driver inexperience.

Discuss the rules of the road with your teen, why they are important to follow, and consequences for breaking them. Create a Parent-Teen Driving Agreement that puts these rules in writing to set clear expectations and limits.

Learn More

The Rancho and Glasgow Coma Scales

The Rancho Scale is used to rate the severity of comas and levels of cognitive functioning. See a revised Rancho Scale as well as other coma scales from the Northeast Center for Special Care.

Rancho Level of Cognitive Functioning

Level I — No response to stimulation
Level II — Generalized response to stimulation
Level III — Localized response to stimulation
Level IV — Confused, agitated behavior
Level V — Confused, inappropriate, non-agitated behavior
Level VI — Confused, appropriate behavior
Level VII — Automatic, appropriate behavior
Level VIII — Purposeful, appropriate behavior

Glasgow Coma Scale (Score at 30 minutes post-injury)

Eye openings Best Motor Response Best Verbal Response
1 = no response 4 = withdrawal to pain 1 = no response
2 = to pain 5 = localized to pain 2 = incomprehensible sounds
3 = to voice 6 = follows commands 3 = inappropriate words
4 = spontaneously 4 = disoriented but converses
5 = oriented and converses

Unintentional Injuries May Occur After a TBI: a CDC report

Adults with Moderate to Severe TBI are at Increased Risk Unintentional Injury after a TBI

Previous research examining adults with moderate to severe traumatic brain injury (TBI) who participated in rehabilitation showed that they were twice as likely to die from an unintentional injury that occurred following their TBI, compared to individuals in rehabilitation of similar age, sex and race but without TBI. People who have had a moderate to severe TBI may experience changes in cognition and balance, which may put them at greater risk of subsequent unintentional injuries.

The August special issue of NeuroRehabilitation is dedicated to work on unintentional injury after a TBI with a focus on understanding injury risk related to changes in cognition, health, and behavior as a result of the TBI. It includes:

  • A CDC commentary outlining the burden of TBI in our nation and a public health approach to reducing unintentional injuries and TBI.
  • A study describing the higher risk of motor vehicle crashes for veterans with TBI.
  • An article on the risk factors for unintentional injuries after TBI.
  • The development of a patient-centered safety assessment tool.
  • Research on the supports and barriers to returning to work after work-related TBI.

Learn More about TBI

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. In 2010, there were 2.5 million emergency department visits, hospitalizations, and deaths due to a TBI that occurred either as an isolated injury or along with other injuries. Persistent health problems among those with a TBI contribute to limitations in function, disability, and reduced life quality, all of which can lead to increased injury risk.

Other CDC Articles on this Issue