In the first episode of this excellent docu-byte series, Dr. Theresa Pape discusses the basics of severe traumatic brain injury (sTBI). From how it is defined to what society needs to address in moving forward with this issue, Dr. Pape offers a clear and concise overview of sTBI.
She defines sTBI as an external blow or force to the head, which renders a person unconscious, usually for a long period of time. What are the most prevalent causes? In children, it is usually child abuse (“shaken baby syndrome”); in young adults, it tends to be from motor vehicle accidents; and, in older adults, it comes from falls. In our veterans, about 1% of them have suffered a sTBI since 2000. Regardless of how a sTBI is acquired, the chances of experiencing trauma secondary to the initial insult are high. At the molecular level there is often swelling inside the skull causing life-threatening pressure on the base of the brain. Often within minutes of the initial injury up to years after the injury, there are other problems such as elevated blood pressure and collection of blood in parts of the brain or subdural hematomas. Dr. Pape makes a very important point about sTBIs: when you have seen one TBI, you’ve seen one TBI. Everyone’s brain is unique and everyone’s brain injury is unique.
So, what is the treatment for sTBI? Once the patient is medically stable, they should be admitted into acute rehabilitation where baseline measurements can be taken. However, Dr. Pape makes the point that most people don’t have enough insurance – if any – to pay for the kind of care they really need. Therefore, they wind up in nursing homes or the families become the primary caregivers. This puts everyone in a precarious situation since they are not equipped to offer the care the patient really needs.
Finally, what can we as a society do? Dr. Pape suggests that we focus on treatment research and measuring the effects of that treatment. She personally believes we need to look at our system of care, which is sorely lacking.
For more information on Dr. Pape’s work, click here.