In 2016 I was in bed sick while my family was outside playing basketball in the driveway. Initially, I thought nothing of the cessation of noise from outside the house. As my husband walked into our room, his face full of concern, he preceded to recount how my father’s bad knee gave out on him and he fell hitting his head on a brick that lined our flower beds. He got up, with no blood, and no obvious sign of trauma. My mother encouraged him to get medical attention to be certain there was no problem. He refused. Almost an entire week went by before, as a family, we went through the trauma of my father’s two craniotomies, seizures, nearly 6-month hospitalization, intense physical and occupational therapies, the pain of my dad not knowing who certain family members were, and the list goes on. Brain injury is traumatizing. Not just to the brain, and not just to the individual who suffers the injury directly.

Amanda’s father on a family vacation before his TBI

March is Brain Injury awareness month. It’s important because there is a lot we can do to prevent brain injuries. There are two classifications of brain injuries. One is traumatic brain injury (TBI) – such as my father experienced. TBI’s are external forces that cause brain function to be altered or other evidence of altered brain pathology. This includes concussions, Second Impact Syndrome, and coma. The second type is non-traumatic brain injury which are things like strokes, infectious diseases, seizures, metabolic disorders, drug overdose, etc. Brain injuries can vary in severity. For example, a concussion – the most common type of brain injury – can be mild and is commonly found in certain sports. Severe brain injuries, on the other hand, can be life-altering. They can result in the loss of functions such as speech and movement. It can cause personality changes. With all that the brain controls and signals throughout our body, the various outcomes can affect the rest of the body in some pretty extreme and surprising ways. It is important to note, however, that a lot of research is going into the long-term impact of concussions. Especially situations where an individual has experienced multiple concussions.

Protecting Against Brain Injury

So, how do we protect against brain injury? First, let’s talk about the prevention of TBI’s. TBI’s can happen through a variety of circumstances: falls, car accidents, sports, play, etc. About 10 percent of the 1.7 to 3.8 million TBI’s that happen yearly in the U.S. are sport and recreational activity related. Among kids, that percentage is higher (21%)! If you really want to limit your chances of brain injury in sports, chose sports that have the lowest incidents of brain injury. If you must participate in sports that have a higher risk of brain injury take seriously your risk for head trauma, wear proper headgear, avoid plays that make it even more likely to incur brain injury, and seek advice about what age is more appropriate to allow children to play such sports.

When it comes to play for children, make sure they wear appropriate and properly fitting helmets when riding a bike, scooter, or roller skating. Pay attention to playground equipment and the surrounding environment. To prevent injury, brain or otherwise, on a playground, there should be ample mulch or other appropriate ground covers to act as padding in the event of a child falling off equipment. According to the National Safety Council, these ground covers should have a minimum of 12 inches of material. For more information on Playground hazards check out this NSC link and the American Academy of Pediatrics webpage on playground safety.

The following sports/recreational activities represent the categories contributing to the highest number of estimated head injuries treated in U.S. hospital emergency rooms in 2018.

  • Cycling: 64,411
  • Football: 51,892
  • Baseball and Softball: 24,516
  • Basketball: 38,898
  • Powered Recreational Vehicles (ATVs, Dune Buggies, Go-Carts, Mini bikes): 30,222
  • Soccer: 26,955
  • Skateboards: 10,573
  • Exercise & Equipment: 37,045 
  • Horseback Riding: 6,141
  • Golf: 6,357
  • Hockey: 7,668
  • Trampolines: 8,956
  • Rugby/Lacrosse: 10,901
  • Skating: 7,143
  • Playground Equipment: 38,915

The top 10 sports-related head injury categories among children ages 14 and younger:

  • Playground Equipment: 35,058
  • Football: 31,277
  • Basketball: 20,242
  • Cycling: 19,921
  • Baseball and Softball: 12,065
  • Soccer: 12,709
  • Swimming: 9,265
  • Trampolines: 7,921
  • Powered Recreational Vehicles: 6,036
  • Skateboards: 3,101

Source: American Association of Neurological Surgeons
https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Sports-related-Head-Injury

Non-traumatic Brain Injuries

What about the non-traumatic brain injuries brought on by strokes, infectious diseases, and other events and illnesses? Risk for many of these can be reduced or prevented altogether. Things like drug overdose, metabolic diseases, strokes, and infectious diseases can be prevented through living a healthy lifestyle, good nutrition habits, and self-care. This is true even in circumstances where individuals may have a higher hereditary risk for things like strokes and metabolic disorders. Seeking help from professionals if you are struggling with substance abuse can help you work through personal and interpersonal conflict, but it can also help with the cessation of health behaviors that can lead to serious physical consequences such as brain injury.

We Can Take Action

My family has walked through both non-traumatic brain injury and TBI. None of them were easy. Though not all brain injuries are preventable we can take action to greatly reduce our risk for most of them. If you want to learn more about brain injuries check out these resources:

If you are a caregiver to someone suffering from brain injury and need support you may find these resources helpful in addition to those your local medical providers may have already mentioned:

Interested in UGA’s contributions to the field of brain injury and related/similar neurosciences?