Who doesn’t remember Sidney Crosby’s head concussion that kept him out of hockey for months? But how many know about the hazards of mild traumatic brain injury (TBI)? A report from Johns Hopkins University says it doesn’t always take a hockey blow to trigger a brain concussion.
The skull normally provides protection against brain injury. But there’s a limit to this protection and at times just a bump or a jolt to the head can cause severe damage to brain nerve cells, called neurons.
TBIs can be mild, moderate or severe depending on the degree of injury. It’s estimated that 1.7 million occur each year in the U.S. and 75 per cent are mild concussions.
But there’s a disturbing trend. The number of cases of TBIs in older people is increasing each year. For instance, according to a report from the Centers for Disease Control and Prevention, in a recent four-year period there was a 46 per cent increase in emergency hospital visits and a 34 per cent increase in hospitalizations among those 65 and older for TBIs. It warns people not to be misled by the term "mild TBI." Specialists in this disorder say that, although most people recover in a few days, 15 per cent suffer from persistent and disabling problems that can affect relationships and employment. One reason is that older people often suffer from chronic problems such as heart disease, hypertension, diabetes and general fragility. These make recovery more difficult.
The most common cause of TBI in those 65 and older is falling and striking the head. In the past 10 years, fall-related deaths increased by a whopping 56 per cent, according to the CDC. The majority of those requiring hospitalization were 75 and older and they accounted for the most deaths.
Those with elderly parents should realize that many of these falls are preventable. So make sure you remove needless clutter from their homes, tape down or get rid of loose rugs, add non-skid mats for the bathtub, install grab bars and above all, use night lights, as many falls occur while getting to the bathroom.
Check with their doctor to see if medication could be a factor in falling. Remember that poor vision is a particular hazard and that regular exercise helps to maintain co-ordination.
But what are the precautions once a fall happens? If the person has lost consciousness or blacked out for even a few seconds, make sure they get medical attention. And whatever the outcome of medical care, never leave that person alone for the next 24 hours. You can never be sure that a dramatic change won’t occur.
Today many seniors are also taking blood thinners. They increase the risk of brain hemorrhage. Studies show that anyone taking this medication is three times more likely to suffer a brain hemorrhage than those not on these drugs, even after a minor head injury.
So what should you be looking for if a parent calls to say they’ve struck their head? Make sure they see a doctor if they have any of the following problems: confusion, dizziness, blurred vision, headache, difficulty concentrating, ringing in the ears or memory loss.
For more severe injuries, such as loss of consciousness, vomiting, worsening headache, abnormal breathing, seizures or convulsions, weakness of the arms or legs, amnesia slurred speech or bleeding from the mouth, nose or ears, call an ambulance. Be aware that even a minor injury may have a delayed response. For instance, some surveys reveal that as many as 80 percent may not be aware they have had a concussion!
So how should TBI be treated? Most with mild concussion recover fully within six months. But 40 per cent develop post-concussion syndrome with symptoms appearing about 10 days following the injury. These people suffer from fatigue, headaches and memory loss which normally last a week.
Tylenol can be used to control pain. But not Aspirin or an anti-inflammatory drug such as Motrin or Advil. These can cause internal bleeding.
And Sidney Crosby would tell you it requires lots of rest to heal a damaged brain, even a mild TBI.
» Dr. Gifford-Jones is a graduate of The University of Toronto and The Harvard Medical School. He took post-graduate training in surgery at the Strong Memorial Hospital in Rochester, McGill University in Montreal and Harvard. During his medical training he has been a family doctor, hotel doctor and ship's surgeon. His medical column is published by 70 Canadian newspapers, several in the U.S. and the Epoch Times which has editions in a number of European countries.
Republished from the Brandon Sun print edition November 2, 2013