mTBI: A Silent Epidemic

Statistics show that approximately 1.4 million people suffer from a traumatic brain injury (TBI) each year. Of those injuries, three out of four are minor TBI (mTBI), such as a head injury that causes a temporary change in mental status or perceived behavioral impairment. 

A review of literature reviews from in October 2013 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) shows that motor vehicle accidents are often responsible for most cases of mTBI and also very common due to bone and joint injuries.

"Musculoskeletal injuries are often seen concurrently with some studies estimating that 50 percent of patients with orthopaedic injuries also sustain a mTBI," said lead study author Richard L. Uhl, MD, an orthopaedic surgeon at Albany Medical Center in Albany, N.Y., via a press release. 

 As up to 80 percent of patients who sustain a mTBI can be safely discharged from the emergency room with a full recovery, the problem often goes undiagnosed, according to the study, as symptoms do not appear until after the patient resumes every day life. it's only with advanced imaging of the head via CT scans that more of the story can be told. 

The Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control declared mTBI a major public health issue and a silent epidemic.
For instance, patients with multisystem trauma and mTBI are almost twice as likely to have persistent cognitive impairment and report symptoms of depression, anxiety and post traumatic stress disorder.

The study shows that males are more likely than females in all age groups to sustain mTBI, with symptoms ranging from a headache and fatigue to memory deficits. In fact, it's estimated that 15 to 25 percent of those who suffer from mTBI have residual symptoms that can sometimes lead to compromised function. 

Lead study author and orthopaedic surgeon Andrew J. Rosenbaum, MD, showed that after mTBI, patients must be counseled regarding vulnerability to second-impact syndrome--what's otherwise known as sustaining a second concussions before any impairment symptoms might begin. 

"Second-impact syndrome can have devastating consequences, including rapid-onset swelling of the brain; worsening function of the brain, spinal cord, muscles or nerves; and instability of normal body functions."

The study suggests that orthopaedic surgeons may play a crucial role in helping diagnose mTBI and the beginning of any necessary long-term care.