Severe Traumatic Brain Injury in the Youth

Sadly, accidents remain the top cause of death in young people. Traumatic brain injury sustained in accidents is one of the leading factors of mortality from an accident. Several studies on brain trauma, considered moderate to severe, were performed to understand the outcome of brain injuries over time.

In the first study, patients were studied for 3 to 5 years and were researched using neuropsychological functioning testing, namely the Paced Auditory Serial Addition Test, the California Verbal Learning Test, emotional tests and the symptom inventory. Then the patient’s functional status was examined as well as their perceived quality of life.

The study showed that significant limitations in structure were found in all areas studied.
Recovery to their pre-injury levels reached about 65 percent when looking at personal care to about 40 percent when looking at cognitive competency, leisure, recreation and major activities. The severity of the brain injury as measured by the modified Abbreviated Injury Scale, seemed related to functional status as well as to neuropsychological function, but did not relate to quality of life measures or emotional measures. The length of the person’s unconsciousness related to the outcome more than the anatomic lesion the person had.

The study concluded by saying that the magnitude of the morbidity of the TBI individual is high. The direct costs were listed in the study. However, the study was emphatic that besides an economic strain, there was great personal cost these injuries caused the survivors, to the public subsidy system and to the families of the survivors of a TBI injury.

In another study, three hundred forty-four individuals, all under the age of 18 years, were studied. All had what is considered a severe closed head injury and all were comatose for more than 24 hours. Each patient was followed for at least a year to gauge their ability to function. Most of these patients (82%) had suffered their traumatic brain injury from motor vehicle accident.

A total of 73 percent of the patients were able to ambulate independently after a year and were able to manage their self care. Ten percent remained partially dependent in managing their self care and were able to achieve minimal or partial ambulation. Nine percent regained consciousness but remained completely dependent on others. Eight percent continued to be comatose after a year’s time.

The most favorable prognosis for a recovery of motor function was if the patient was in a coma for less than three months. Complications included prolonged high blood pressure, ventricular enlargement, and epilepsy or seizures which subsequently decrease the chances of obtaining physical independence.

While mortality after severe head injury has gone down, the neurological changes after an injury has remained unchanged since the 1970’s. Statistics have shown that better neurosurgical management has not altered the percentage of severely disabled people over time.

Severely disable people from TBI do exist and must make their way in society with significant problems getting around and taking care of themselves.