Causes and Consequences

Causes of Traumatic Brain Injury

The leading causes of TBI are falls, motor vehicle injuries, and being struck by or against an object or person. The most common causes of TBI death are firearms, motor vehicle injuries and falls (23). Although firearms are a major cause of TBI-related death, they account for less than 10% of all TBI-related hospitalization. The majority of the TBIs which required hospitalization were caused by motor vehicle injuries and falls (6).

Child maltreatment involving physical abuse is the leading cause of serious head injury in children of which the majority occurs in children younger than 2 years (24,25). A population-based study of inflicted traumatic brain injury in young children found that the majority of children who were hospitalized with TBI were injured intentionally, and that infant boys were more likely than infant girls to suffer TBI due to physical abuse (26).

Each year in the United States, 567,000 people go to an ED with bicycle-related injuries, of which approximately 350,000 are children under 15. Of those children, approximately 130,000 sustain brain injuries (27). Children ages 10 to 14 are at greater risk for traumatic brain injury from a bicycle-related injury compared with younger children, most likely because helmet use declines as children age (28).

Overall, about 1 in 8 of the cyclists with reported injuries had a brain injury. Two-thirds of the deaths from bicycles injuries are from traumatic brain injury. A very high percentage of cyclists’ brain injuries can be prevented by a helmet, estimated at anywhere from 45% to 88% (29). Most bicycle-related brain injury deaths occur during the summer months (i.e., July, August and September) (30).

Consequences of Traumatic Brain Injury

The problems caused by traumatic brain injury are extensive and complex. The areas of impact include cognitive, physical/perceptual, behavioral, psychosocial, along with an inability to generalize on the part of the injured individual, and a frank denial of deficits.

Cognitive:  There is the inability to self-regulate, impaired memory, impaired judgment, decreased processing skills, and impaired organizational skills.

Physical / Perceptual: The individual has a very real decreased functional capacity and moves on through life with decreased safety awareness.

Behavioral: The individual and family members must deal with their impulsivity, their lack of initiation, their irritability, and lowered frustration tolerance.

Psychosocial: There is a very real impact on all existing relationships and any new relationships over a lifetime. There is a very real inability to sustain relationships.

The consequences of these changes include, with some variability, all of the following:

  • Breakdown of family support systems
  • Withdrawal of friends
  • Physical deterioration
  • Isolation
  • Substance Abuse
  • Unemployment
  • Increased health risk
  • Increased risk of repeat hospitalization