Frequently Asked Questions
How can I enroll in a head injury study at the University of Washington?
What is a traumatic brain injury?
How many people get a TBI each year?
What causes TBI?
Who is at highest risk for TBI?
What are the long-term consequences of TBI?
What is the difference between a concussion and a TBI?
Will I be able to go back to work after my head injury?
How do I get eligible for state vocational rehabilitation assistance?
What happens if there is a long wait for state vocational rehabilitation services? How can I get help?
Should a person who has had a TBI drink alcohol?
When can a person start driving again after sustaining a TBI?
Why can an TBI result in significant personality changes?
How can I enroll in a head injury study at the University of Washington?
The UW TBI Model System conducts a number of research studies that look at different areas of recovery from traumatic brain injury. You may be eligible for one of these studies if you meet the basic eligibility criteria for that study. Criteria are different for all studies, so please visit our Current Studies section for more details. The University of Washington also contacts a large number of research studies that look at many different medical conditions including traumatic and other types of head injuries such as stroke and tumors. To find a complete list of these studies please visit http://www.washington.edu/healthresearch/.
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What is a traumatic brain injury?
A traumatic brain injury (TBI) is defined as a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from "mild," i.e., a brief change in mental status or consciousness to "severe," i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.
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How many get a TBI each year?
Of the 1.4 million who sustain a TBI each year in the United States:
- 50,000 die;
- 235,000 are hospitalized; and
- 1.1 million are treated and released from an emergency department.
- The number of people with TBI who are not seen in an emergency department or who receive no care is unknown.
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What causes TBI?
The leading causes of TBI are:
- Falls (28%);
- Motor vehicle-traffic crashes (20%);
- Struck by/against (19%); and
- Assaults (11%).
- Blasts are a leading cause of TBI for active duty military personnel in war zones.
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Who is at highest risk for TBI?
Those at the highest risk of sustaining a TBI are:
- Males are about 1.5 times as likely as females to sustain a TBI.
- The two age groups at highest risk for TBI are 0 to 4 year olds and 15 to 19 year olds.
- Certain military duties (e.g., paratrooper) increase the risk of sustaining a TBI.
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African Americans have the highest death rate from TBI.
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What are the long-term consequences of TBI?
The Centers for Disease Control and Prevention estimates that at least 5.3 million Americans currently have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI.
According to one study, about 40% of those hospitalized with a TBI had at least one unmet need for services one year after their injury. The most frequent unmet needs were:
- Improving memory and problem solving;
- Managing stress and emotional upsets;
- Controlling one's temper; and
- Improving one's job skills.
TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy and increase the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more prevalent with age.
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What is the difference between a concussion and a TBI?
Concussion is just another term for a TBI. The brain can receive several different types of injuries depending on the type of force and amount of force that impacts the head. The type of injury the brain receives may affect just one functional area of the brain, various areas, or all areas of the brain.
A concussion like all TBIs can be caused by direct blows to the head, gunshot wounds, violent shaking of the head, or force from a whiplash type injury.Both closed and open head injuries can produce a concussion. A concussion is the most common type of traumatic brain injury. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. The blood vessels in the brain may stretch and cranial nerves may be damaged. A person may or may not experience a brief loss of consciousness (not exceeding 20 minutes). A person may remain conscious, but feel “dazed” or “punch drunk”. A concussion may or may not show up on a diagnostic imaging test, such as a CAT Scan. Skull fracture, brain bleeding, or swelling may or may not be present. Most people will fully recover from their concussion within three months of their injury.
Will I be able to go back to work after my head injury?
This is not an easy answer because it varies for each individual based upon the mental and physical results of the injury, the complexity of your job, etc. It is helpful to have a vocational rehabilitation counselor and often a neuropsychologist to work with you on this process. Often it is helpful to do a non-paid tryout for awhile in your former job. Your rehabilitation counselor can work out the details with the company.
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How do I get eligible for state vocational rehabilitation assistance?
An internet search for "state vocational rehabilitation" will bring up your particular state agency contact information. It is important to go to your local office on orientation day and bring with you copies of important medical, neuropsychological, and vocational information that you may have -- this will speed up your services eligibility determination.
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What happens if there is a long wait for state vocational rehabilitation services? How can I get help?
You might visit your local Work Source, one stop, service office (a state employment office). Often there are special employment projects that are housed there for people with disabilities. Some Projects with Industry (PWI) can also be helpful. These no-cost job placement services are funded by the Rehabilitation Services Administration and other sources. Regional Projects include:
Washington Vocational Services
22316 70th Ave, Unit D
Mountlake Terrace, WA
425-774-3338
(serving Washington & Alaska)
SL Start and Associates
Inland NW Jobs Project
25 W Nora
Spokane, WA
509-328-2740
(serving Eastern Washington & Idaho)
Neurology Vocational Services Unit
Box 359744
325 Ninth Avenue
Seattle, WA 98104
206-744-9130
(Serving Greater Seattle Metropolitan Region)
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Should a person who has had a TBI drink alcohol?
Many doctor strictly advise TBI survivors not to consume alcohol (or any other non-prescription drugs) after their brain injury. The negative effects of alcohol and drugs could be magnified several times since the brain may have sustained permanent damage. Permanent brain injury typically results in fewer resources to deal with the additional impairing effects of alcohol. Alcohol can impair judgment which may already be clouded by the brain impairment (in other words, the poor judgment which may be a result of brain injury may be magnified by the dulling effects of alcohol). If alcohol impairs judgment, cognitive abilities and sensory-motor functions, which already may be negatively affected by the brain injury, it can increase the probability of additional traumatic brain injury. In such a case, the brain is more vulnerable to additional impairment.
Alcohol has a direct impairing effect on brain tissue in the following ways:
- It decreases the flow of oxygenated blood to the brain .
- It destroys important vitamin B complexes.
- It disrupts electrolyte balances.
- It has a direct toxic effect on brain tissue (as well as other physiological impacts).
Use of alcohol, typically over long periods of time, can actually destroy brain cells (neurons). It also can directly affect the potency and effectiveness of medications and lower seizure thresholds. For all of these reasons, it is not advisable for anyone with a brain injury to drink alcohol or use other non-prescribed drugs.
When can a person start driving again after sustaining a TBI?
Driving requires a myriad of skills and integration of complex information in very rapid order. In, addition to the visual acuity needed, an individual must have intact perceptual skills, e.g., the ability to judge distances between cars, space in parking lots, interpret very complicated visual information and all this while operating a rapidly moving vehicle. When damage occurs in the frontal lobes of the brain (executive thinking) residual deficits can impair judgment, reasoning, reaction time, planning and organizational skills, impulse control, and decision making skills all of which are essential to safely operate a moving vehicle.
Driving privileges are usually not suspended or revoked when an individual sustains a TBI. However, in cases in which the driver is charged with a traffic violation, e.g., driving under the influence, or other traffic violations, the law may require revocation or suspension of the license as a consequence of the infraction. Some states require that physicians report to the Department of Motor Vehicles (Transportation Department in some states) the names of person’s sustaining injuries that may impair driving skills. This may include such conditions as epilepsy, visual loss (functional blindness), spinal cord injury, and TBI.
Many rehabilitation centers have driver evaluation programs. Also there are professional driving evaluators in private practice in many communities. Driving schools (found under "Driving" in yellow pages) are not usually prepared to do more than teach the mechanics of driving and are unfamiliar with cognitive deficits that present major barriers to driving after brain injury. For further resource information, contact the nearest rehabilitation program that has spinal cord and/or brain injury rehabilitation, these facilities are most likely to have driving evaluations programs.
I have heard that an injury to the frontal lobe of the brain can result in significant personality changes. Why does this happen? Does the injured person ever return to normal?
If by normal you mean exactly the way things were before the injury, then the answer is usually not, although some mild and very focal injuries may diminish completely in terms of their behavioral effects. The frontal lobe is very involved with how we behave. Think of the frontal lobe as the conductor of an orchestra. Without the conductor leading all of the orchestra members, the music probably will not sound too great even though all of the instruments are well-tuned and the musicians are skilled (an over-simplified view but very accurate). So, when the frontal lobe is injured we may exhibit changes in our ability to start activities (i.e., initiation), stop activities (i.e., perseveration), switch from one activity to another, withhold responses that are overly angry, etc. Sometimes medication can be helpful, and many times behavioral therapies can also promote changes. It's always important to separate issues of a personality nature -- there are personality factors which existed before an injury, those which are adjustment concerns, and organic factors relating to the brain injury. This is not an easy task and often requires professional help (i.e., from a neuropsychologist and/or neuropsychiatrist).
Looking for an answer to a question not listed here? Check out our Resources section for more information on specific topics, or send your questions to uwtbi@u.washington.edu.