What You Need to Know About
Traumatic Brain Injury
Thomas Gennarelli, MD
Medical College of Wisconsin Neurosurgeon;
Chairman of Neurosurgery
Named one of the “Best Doctors in America” 2001 by
Best Doctors, Inc.
“Traumatic brain injury, or TBI, as it’s now known, is a large epidemic in the United States.”
Traumatic brain injury goes beyond car crashes. It’s the fastest growing and most expensive cost to society today. Thomas Gennarelli, MD, puts traumatic brain injury in perspective and details initiatives to slow its growth.
Q: How pervasive is traumatic brain injury?
Traumatic brain injury, or TBI as it’s now known, is a large epidemic in the United States. About two million people each year receive a traumatic brain injury. Of those, about 40-50,000 people die as a result of those injuries and several hundred thousand are left with permanent impairments of some type. It’s the largest cause of death from age one through age 40 in the United States. So, we’re really talking about a major public health problem here.
Q: Is there a profile for traumatic brain injury — a typical type of accident causing or individual receiving most injuries?
No, not at all. Anyone can get a traumatic brain injury — it cuts across all ages, races, socio-economic groups and both sexes. Also, there is an almost unlimited number of ways you can experience a traumatic brain injury — car crashes, skiing accidents, playing football — I can go on and on. Virtually any kind of accidental event can cause a brain injury.
Now, motor vehicle accidents are the most common cause of TBI, however they are no longer the most common cause of death from brain injury. That distinction has recently been taken by gun shots, including unintentional accidents, intentional attacks and suicide.
Q: What are some of the things being done to counter this epidemic?
Here at Froedtert & Medical College we’re doing a number of things. Our Level 1 Adult Trauma Center, which is the only one of its kind in Eastern Wisconsin is involved in generating new ways to monitor what occurs in the brain in terms of physiology and biochemical changes at the onset of injury. That knowledge will be a great help in treatment.
We’re also involved in the search for new medications that correct the delayed effects of brain injury. It’s a common misconception that “all” of the injury happens at the time of the accident. In fact, a good portion of the damage occurs sequential to that over the next several days. We believe we can develop new medications and treatments to avert the cascade of events that happen from the point of accident over time.
Froedtert & Medical College is also participating in research funded by the Department of Transportation that seeks to understand the mechanisms that cause brain injuries in car crashes today. There is a lot of data in this field that was gathered before cars came equipped with air bags as standard equipment. Now we need to see how this translates into modern cars. Statistically, we are seeing that air bags are making a difference, but we need better details.
Q: What about patients with brain injuries? What kind of progress are we seeing here?
Our primary initiative here is to deliver the highest level of comprehensive care we can. It starts with pre-hospital care, such as our efforts to instruct paramedics on the latest developments, and moves through innovations like our new intensive care unit, which is situated next to our accredited rehabilitation facility for a continuity of care.
Q: As you said, this is really a major public health problem. What should people know about traumatic brain injury?
The biggest message is that traumatic brain injury can touch you and your family if you don’t take precautions. Be aware of your surroundings, drive attentively, get and use safety equipment. Nearly every type of sport has protective helmets available, and when they’re used they can really be effective. The bottom line is — don’t think it can’t happen to you. It can.
Center to Study Vehicle Crashes
Studying causes, patterns, types, and severity of injury can lead to better prevention and treatment tactics. Froedtert & Medical College has made it possible to begin studying vehicle crashes at the Crash Injury Research and Engineering Network (CIREN) Center, recently established at the Medical College. Investigators have begun gathering data from crash scenes, pre-hospital and in-hospital care, and recreating crashes to learn from them. Eventually, they'll develop strategies designed to reduce deaths and injuries in crashes. Researchers will share results with industry, regulatory and public agencies to help improve public infrastructure.