THE Challenge! Spring 2011

Classifying
Brain Injury
And indeed, diseases can be caused by external forces such as
injuries. An individual sustaining a severe chemical burn to the
lungs will develop chronic lung disease that may then cause
or accelerate cardiac disease. Although the phenomenon is not
clearly understood, following chemotherapy, many patients
may develop disabling problems with memory, attention,
multi-tasking and other domains of cognitive function, known
as “chemo brain.”
In a 2004 study on mortality one year post TBI among 2,178
individuals with a moderate-to-severe TBI, it was reported that
individuals with a TBI were twice as likely to die as a similar
non-brain-injured cohort and had a life expectancy reduction
of seven years. Follow-up studies on causes of death revealed
that individuals surviving more than one year with a TBI
are 37 times more likely to die from seizures, 12 times more
likely to die from septicemia, four times more likely to die
from pneumonia, and three times more likely to die from other
respiratory conditions than a matched cohort from the general
population. The greatest proportion of deaths in the study –
29 percent – was from circulatory problems.
Several neurologic disorders are associated with TBI, all of
which present a level of disability, with varying degrees of
severity. TBI is a major cause of epilepsy, accounting for
five percent of all epilepsy in the general population. Visual
disturbances are common with TBI, as are sleep disturbances
and hypersomnia. TBI can be a risk factor for the development
of Alzheimer’s disease. It also can cause Chronic Traumatic
Encephalopathy (CTE).
Classification of TBI as the beginning
of a disease process would facilitate
treatment as outlined for the full
continuum of care, which should
be paid for by medical insurers and
managed on a par with other diseases.
A moderate-to-severe TBI is associated with a host of
neuroendocrine disorders, including hypopituitarism; growth
hormone (GH) deficiency/insufficiency; hypothyroidism; and
gonadotropin deficiency in both men and women. Each of these
disorders has negative effects associated with them; each of
which leads to a progressive disease process.
Incontinence, both of the bladder and bowel, can occur with TBI
because it frequently affects the cerebral structures that control
bladder storage and emptying functions. TBI also causes sexual
dysfunction. Additionally, it causes musculoskeletal dysfunction
(Continued on pg. 28)
THE Challenge! | Spring 2011
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