Traumatic brain injuries (TBI) may vary significantly in severity. Some TBIs are relatively minor concussions, while others cause permanent damage to the brain, and may even be fatal. Roughly 2.5 million people visit emergency rooms annually as a result of TBIs. David Okonkwo is the clinical director for the Brain Trauma Research Center at the University of Pittsburgh.
This research group is conducting ongoing work to improve TBI outcomes by conducting research projects, evaluating therapies, and performing testing in their head injury labs. Okonkwo recently suggested that the lack of follow-up care is a clear example of a failure in adherence to medical standards and is becoming a “public health epidemic” in the U.S.
Lack of Resources
An ongoing nationwide study known as Track-TBI has uncovered this trend of insufficient follow-up treatment on those with reported head injuries. Track-TBI seeks to determine why these failures in medical care are occurring and the long-term implications. Dr. Okonkwo feels that a critical factor is the significant lack of economic resources being devoted to this aspect of medical care.
The Glasgow Coma Scale is used to determine the severity of coma and losses of consciousness by calculating a score of up to 15 that indicates the least severe trauma level. In this study, emergency room patients were given a CT scan to assist with diagnosis. These patients were then tracked for a one-year period and they provided feedback two weeks later and three months later. The results were as follows:
- 42% were provided materials to educate themselves about TBIs
- 44% either received a follow-up phone call from the hospital or had a follow-up appointment within three months
- Only 52% of those shown to have moderate to severe symptoms had an appointment for follow-up within three months
- Only 40% of those who had a head wound, often a sign of a severe head injury, had an appointment for follow-up within three months
Seth Seabury, a director of health policy at the University of Southern California, has analyzed how TBI victims often develop financial and social problems. He says that medical providers are far too inconsistent in TBI follow-up care. He further explained that if many of these providers handled patients with heart disease or diabetes as poorly as they do with TBI patients, they would be essentially demonstrating medical malpractice. Seabury's findings also suggest that TBI sufferers tend to be at an increased risk for unemployment, poverty, and incarceration.
TBI Symptoms & Side Effects
One challenge in treating those who incur brain injuries is that the indications tend to vary considerably. Those with relatively mild concussions may only notice mental changes for days or weeks. Often symptoms may take several days to appear.
Some of the commonly reported symptoms include an inability to clearly think, insomnia, amnesia, anxiousness, speech or vision problems, and headaches. When medical providers assess a head injury, such as with the Glasgow Coma Scale, they will also evaluate the motor skills, speaking skills, and visual responsiveness. Scans such as CT & MRI are also potentially effective ways to evaluate brain damage.