Traumatic brain injury (TBI) can range from mild concussions to life-threatening trauma. This issue of the NCMJ discusses various issues related to TBI, including the impact of North Carolina’s motorcycle helmet law, prevention and management of sports-related concussions, the need for behavioral health care for TBI survivors, the effect of TBI among North Carolina’s veterans, management of TBI among older adults, and advances in prehospital care for TBI.
Another Silent Epidemic
Could yet another silent epidemic be going unnoticed in our midst? This epidemic has an annual death toll rival to influenza, but it has no vaccine, no immunization to protect the vulnerable. This epidemic is traumatic brain injury.
You could argue that the media is full of stories about concussions among athletes—amateurs and professionals alike. You could argue that the terrible price of concussive injuries sustained by soldiers in Iraq, Afghanistan, and elsewhere creeps into the headlines. We certainly read personal testimonials of injury and recovery in the pages of newspapers and magazines. Still, we miss the epidemic.
Like with influenza, it is young and old individuals who are most likely to sustain a traumatic brain injury. The most common mechanism of injury is simply a fall.
This issue of the NCMJ exposes the silent epidemic of traumatic brain injury. There are articles about sports and the military, among others. We deplore the circumstances of injury in war and decry the dangers of sport, and we are grateful that good work is being done to prevent such injuries. We are “packaging” our troops, teams, riders, and drivers in armor, padding, helmets, and air bags.
We do not yet “package” our children and senior citizens. Infant and child car seats in vehicles are seldom supplemented by childproof furniture in homes, but even the best-supervised child can wander and fall without warning. We are also often too late to remove the throw rugs and replace the sharp-cornered furnishings that make seniors’ homes so risky. In addition to nodding our heads to prevention and raising our voices in support of protection, we have expected and gotten improvements in rapid response and treatment of the injured. If we cannot prevent these injuries, we can at least mitigate the damage they cause.
Most forgotten, though, are the challenges faced by brain injured individuals and their loved ones. Traumatic brain injury presents protean obstacles to recovery and the resumption of activities of daily living. The epidemic of injury grabs the headlines, but the prevention and consequence of these injuries still demand attention.
Peter J. Morris, MD, MPH, MDiv
Editor in Chief