Understanding traumatic brain injury
The incidence of TBI is much higher in Sub Saharan Africa (150-170/100,000) vs. the global average (106/100,000)
By Dr Francois van Niekerk, Neurosurgeon from Life Cosmos Hospital
Traumatic brain injury (TBI) is the leading cause of disability in South Africa and often results in significant long term consequences which can severely affect both the patient as well as the family.
The incidence of TBI is much higher in Sub Saharan Africa (150-170/100,000) vs. the global average (106/100,000).
TBI is often divided into the primary injury (e.g. assault, car accident etc.) and secondary injury (e.g. hypoxia, hypotension etc.) which can occur later.
Once a TBI has occurred the prognosis is dependent on the amount of damage or injury to the brain and, the current medical and surgical treatment of TBI is only aimed at preventing the secondary injuries.
The treatment of a TBI patient is always comprised of a multidisciplinary team which often includes: Neurosurgeon, Physiotherapist, Occupational Therapist, Speech Therapist, Dietician, Psychologist and even Cognitive therapy.
In 2010, the USA spent $77 billion yearly on TBI patients with a $400,00 lifetime cost per case of severe TBI. There has also been a 47% increase in the number of emergency room (ER) visits for TBI from 2007 to 2013 and 53,000 deaths each year from TBI in the USA (roughly 153 deaths per day).
Common causes across the globe include motor vehicle accidents (MVA) and pedestrian vehicle accidents (PVA) (50%), falls (25%), and violence (20%) – however a recent study South Africa found that up to 40% of cases of TBI are often due to interpersonal violence, MVA accounted for 16% and PVA for 14%.
In general, TBI is seen twice as often in males compared to females.
TBI can be classified in numerous ways with a wide range of pathology ranging from a simple concussion to more severe and life threatening brain haemorrhages.
It also has a range of consequences from negligible to severe (seizures, cognitive impairment, Alzheimer’s, Parkinson’s and even death).
Risk factors include alcohol, drug abuse, contact or extreme sports, speeding, not wearing seat belts or helmets when necessary as well as construction work.
Symptoms from TBI can vary rather extensively but common complaints are confusion, disorientation, nausea, vomiting, speech problems, loss of balance, visual complaints, depressed level of consciousness and even mood swings.
With regards to TBI, prevention truly is better than cure and simple preventative measures can have a significant impact on patient outcome e.g. wearing a seatbelt, using a child seat or booster seat, avoiding Etoh when driving, wear a helmet when cycling or partaking on contact sports, having good lighting on stairwells and using railing when climbing stairs.
Should you need more information regarding Neurosurgery services at Life Cosmos Hospital, please contact the marketing and communication coordinator, Christelle Matthee on christelle.matthee@lifehealthcare.co.za.
