Traumatic Brain Injury (TBI) is a disturbance of normal operations of the brain caused by a blow, bump, or violent shaking of the head. It also happens when the head abruptly hits an object or when an object hits or penetrates through the skull and damages brain tissue. There are two major types of TBI: open TBI refers to situations where the skull breaks, while closed TBI means the skull remains intact. TBI can also be classified according to severity. It can be mild, moderate, or severe. 

Among older adults (65 years and older), TBI is a major problem. In fact, brain injuries were responsible for nearly 350,000 hospital admissions in 2016-17. Sadly, mortality rates after traumatic brain injury increase with age, so older people are more at risk.

This article explains the causes and treatment of traumatic brain injury in older adults, plus gives support and advice. 

Causes of Traumatic Brain Injury

As mentioned, a blow to the head, jolting, or piercing by an object can cause traumatic brain injury. Some of the events that may lead to TBI among older adults include the following:

Falls are by far the leading cause of TBI among older adults. They account for more than half (51%) of all cases. Older adults often fall from the bed or when going up or down the stairs. Sometimes they fall in the bath or from a ladder. These falls can cause mild or moderate TBI. 

Vehicle-related collisions are the second-most-common event resulting in TBI among older adults. They account for nearly one in ten (9%) of all cases and include car, motorcycle, or bicycle collisions. Also under this group are cases of pedestrians involved in vehicle accidents.

Assault stories among older adults are not often in the news. But they still make up around 1% of TBI cases among older adults. The primary causes are gunshot wounds, domestic violence, and other assaults. There are also reports of TBI caused by violent shaking as a form of elder abuse. 

Sports such as boxing, football, rugby, and other high-impact pastimes often lead to TBI. But these are more prevalent among younger adults and youth. 

Combat activities and explosive blasts can also result in Traumatic Brain Injury. But these causes are not common among older adults. Flying debris or falling objects can hit the head and injure the brain.

Types of Injuries

When there is a sudden blow to the head or violent shaking, a person can experience “mass lesions” in the brain and other complications. There are different types of complications that may arise due to TBI. They include the following:

• Hematoma: a blood clot within the brain. 
• Contusion: bruising of brain tissue. 
• Intracerebral Hemorrhage (ICH): bleeding within the brain tissue. 
• Subarachnoid Hemorrhage (SAH): bleeding into the subarachnoid space. 
• Diffuse Injuries. These are microscopic changes to the brain that do not appear on CT scans and are scattered throughout the brain. 
• Diffuse Axonal Injury: Disruption of axon function and the gradual loss of axons.
• Ischemia: Insufficient blood supply to certain parts of the brain. 

Depending on the type of injury, a doctor would prescribe surgical treatment, pharmaceutical treatment, or a combination. In most instances, patients also go through physical therapy to restore lost or impaired brain functions. Below are some of the treatments available for TBI. 

Treatment and Recovery

Older adults often ignore symptoms of mild TBI and go without treatment. It is not a surprise to hear one say, “I’m just a little shaken, but I’ll be alright after I rest.” However, even mild TBI, especially when it is regular, could result in degenerative brain disorders. It can also be fatal. That’s why it’s so important to see a doctor if you suspect you may have any kind of brain injury. The doctor can prescribe either surgical treatment or medications, or a combination of the two, and follow-up physical therapy for recovery. 

Medication 

When a patient visits A&E with a case of suspected TBI, the doctor will first seek to assess the extent of the injury. They will then stabilise the patient to prevent further brain damage. To achieve this and control symptoms, the doctor could administer drugs to sedate the patient or give pain relief, diuretics, or anti-seizure medication. If the patient requires less oxygen in the brain, doctors can administer coma-inducing medication. 

Surgery

In some cases, surgery may be necessary to remove hematoma, repair skull fracture, or create an opening in the skull to relieve pressure on the brain. 

Recovery

Due to the nature of traumatic brain injury, patients often require prolonged treatment and therapy for recovery. The first step in successful recovery from TBI is to avoid exposure to high-risk behaviour, occupations, and environments. Avoid activities or events that are likely to cause another blow or jolt to the head. Even if the activities are part of your norm, avoid them. Also, avoid other risky activities like driving or cycling.

Second, follow the doctor’s instructions. Mild and moderate traumatic brain injury is a silent epidemic because the effect of the injury is often not immediate or apparent. It is easy to ignore symptoms and doctors’ instructions. But the long-term effects could be fatal. 

Finally, take proactive measures to aid in brain recovery. This includes getting plenty of sleep, avoiding risky habits, and engaging in gentle exercise. 

A final word on TBI

Traumatic brain injury can be life-altering or even fatal. Avoid the main causes of TBI and take measures to protect yourself. If you have experienced any blow to the head or a jolt, consult a doctor and seek treatment. Remember to follow the doctor’s instructions even when the injury is not apparent.

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