Traumatic Brain Injury causes more than just a headache

The effects of TBI are more
than just a headache.  Though most TBI’s are initially marked by headache,
the important long-term consequences are the loss of the ability to regulate
our thoughts, emotions and behavior.  You may ask, “how can that be,
doesn’t it depend on what part of your head gets hit?” No, it does
not––regardless where contact is made with the head, when the force is
sufficient to cause movement of the brain within the skull, the frontal areas
of the brain are always the most vulnerable to injury.  As a result, the
“fingerprint” of TBI is bruising to the frontal lobes, as well as shearing and
tearing of neuron bundles connecting to the frontal lobes.  The frontal
lobes of the human brain are critical to our learning to control our emotions
and plan goal-directed behavior.  These abilities allow us to manage our
actions and reactions, and determine whether we will succeed in a complex and ever-changing
society.  So, for many, when the headache has stopped, the negative
effects have only just begun.

There is another insidious aspect of
TBI.  The problems that may arise are not just those experienced in the
days, weeks or months immediately following the event.  As is
well-documented in the recent Institute of Medicine report, Gulf War and
Health Volume 7: Long-Term Consequences of Traumatic Brain Injury, some consequences do not
manifest until years after the original injury, in many cases probably triggered
by changes that occur normally with aging. Conditions found to emerge or
re-emerge in later life included cognitive deficits, depression, suicide,
premature death, progressive dementia and Parkinson’s disease.  This list
is certainly incomplete, as many consequences have only been studied soon after
TBI, but not in later life.  For instance, some hormonal problems were
found to develop one to two years after injury but these disorders have not
been examined further out.

The potential debilitating consequences of TBI, and the
resultant costs to society, demand a longer view.  We are encouraging our
children to participate in sports, exposing our military men and women to
blasts and touting an active lifestyle among older adults. These and other behaviors
are merited, but also put us at greater risk of TBI. We would be well advised
to significantly increase the attention we are giving to prevention, treatment
and research dedicated to TBI.  We need to understand much more about the
short and long-term consequences of concussions, as well as more severe TBI’s.
We need to make activities that increase our chances of TBI safer and, when we
cannot, know the most effective treatments possible to mitigate the
consequences of TBI.

John D. Corrigan is a professor in the
department of Physical Medicine and Rehabilitation at The Ohio State University
in Columbus, Ohio.