What is the incidence of traumatic brain injury, and how is it caused?
In Greece, every year, approximately 35,000 people are admitted to the hospital with severe traumatic brain injuries (TBI). In high-income countries, 5% of all deaths can be attributed to traumatic brain injury, and in Greece, it is estimated that 1,600 patients die each year.
In Greece, severe traumatic brain injuries due to traffic accidents are among the leading causes of death and permanent disability at all ages and are by far the most common cause of death in young people, especially between the ages of 19 and 25.
Work-related accidents are also a common cause of TBI.
How is traumatic brain injury treated?
Modern concepts for the effective treatment of traumatic brain injury involve two interconnected fields: emergency treatment and rehabilitation treatment.
The initial general assessment and treatment begin immediately, at the scene of the injury, continue during the transport of the patient, and are completed in a specially equipped and staffed Emergency Department (ED) or Trauma Center. During examination, a specific assessment is made to determine the extent and severity of the head injury and the level of consciousness, and to classify the severity of the injury.
Patients who are in a coma (unable to open their eyes, speak, or even follow simple commands) are classified as having severe TBI.
Patients who have moderate mental dysfunction (are in a state of confusion or agitation) are classified as having moderate TBI.
It has been found that elderly patients with severe TBI, combined with the presence of cerebral edema and/or intracranial hematoma and displacement of the midline of the brain, recover at significantly slower rates and to a significantly lesser extent.
Patients with mild TBI are usually sent home with clear instructions for their relatives to monitor them over the ensuing 48 hours. If they present with peritraumatic memory loss or neurological symptoms or vomiting or indirect signs of skull base fracture (i.e., rhinorrhea or otorrhea indicating loss of cerebrospinal fluid which persists more than 7 days), they undergo an urgent brain CT scan and are admitted to the hospital for at least 24-hour monitoring. A small percentage of these patients have brain contusions or an intracranial hematoma (blood clot), which requires surgery.
Patients with moderate and severe TBI, after urgent assessment and stabilization of their vital functions, undergo an urgent brain CT scan. A significant percentage of these patients will have developed an intracranial hematoma, requiring surgical operations of craniotomy and drainage.
The majority of patients who remain in a coma one month after a brain injury either recover or die, within the first year; for the rest, recovery usually occurs within three months. One in three patients who fail to regain consciousness dies within that first year.
