Brain Injury Overview

Slip and Fall

A Traumatic Brain Injury (TBI) results from a powerful jerk or strike to the head that affects the brain's ability to function. However, not all intense impact to the head causes a TBI. The TBI scale ranges from mild (slight change in mental condition or consciousness) to severe (lengthy period of unconsciousness or memory loss). Falls are the primary cause of TBI in the United States.

Causes of falls

The causes of falls are called risk factors. The more risk factors that someone encounters, the more likely they are to fall, and the chances that the fall will negatively impact their health and physical ability increase as well.

• Age groups most prone to falls that result in head injury are children younger than four years and seniors older than 75.
• The risk of suffering a serious fall rises as people age and is more prevalent in females than males.
• About 67 percent of people who fall will have another episode within six months.
• At least 33 percent of falls among the elderly are due to obstacles in their living quarters.

Dim lights or throw rugs make falls more probable because it is easier to trip or slip. The natural aging process (e.g., vision deterioration, hearing) is also a contributor to falls. Weakened bones can lead to falls and some of the serious injuries that they produce.

Sickness and physical disorders can affect stamina and balance at any age and factor into falls. Lack of exercise can trigger falls as well because inactivity causes poor muscle definition, less energy, and a decrease in bone density and flexibility.

Various medications for depression, insomnia, and high blood pressure cause side effects that encourage falls. Medicine for diabetics or those with ailing hearts can result in instability too. Someone who is taking a combination of medications or has increased their intake in the past couple weeks is also more apt to fall.

You have a very good chance of falling if you:

• Have fallen before.
• Have physical disabilities (includes problems with eyesight).
• Have contracted multiple long-term diseases.
• Are currently prescribed more than four medications or take psychoactive drugs like antidepressants.
• Have a mental disability.
• Have unstable legs.

Even though falls seem to be related to increasing age, the majority of them can be avoided if people are alerted to the risk factors involved and take measures to avoid them. The more risk factors that describe you on the following list, the more likely you are to fall:

• You have fallen on numerous occasions within a year.
• You are on medicine to address heart disease, high blood pressure, arthritis, anxiety attacks, and/or depression.
• You experience vertigo after standing up or bending over.
• You have had seizures or blackouts in the past.
• You have been diagnosed with stroke, Parkinson's disease, or other neurological complications that have impacted your equilibrium.
• You have a lack of feeling or numbness in your legs and/or feet.
• You require personal assistance or are forced to use a walker, cane, or wheelchair to maintain mobility.
• You work out less than the suggested three times weekly for 20 or 30 minutes at a time.
• You feel like you may lose your balance as you climb stairs.
• You have difficulty rising from a seated or reclined position.

Fall prevention

Here are some steps that will reduce your chances of suffering a debilitating fall:

• Fall-proof your home.
  About 50 percent of falls occur at a residence. Heed the following advice to make your habitat safer.
  • Pick up items that people can stumble over (e.g., loose paper, books, clothing, shoes) off stairs and walking areas.
  • Install handrails and add lighting to stairwells.
  • Discard small throw rugs, or stabilize them with double-stick tape.
  • Put items that you frequently access in cabinets or storage areas so that they are easily reachable.
  • Furnish your bathroom with grab bars by the toilet, tub, and shower.
  • Use nonslip mats in the bathtub and shower.
  • Add more bright lights around your home, and always turn them on upon entering a dark room.
• Start a workout regimen.
  Exercise is a great way to build strength and flexibility, each of which helps decrease your potential to fall. Consult a physician about a workout plan best tailored to your needs.
• Examine your medication.
  As you age, the physical side effects of drugs--or a combination of them--can change. Some medications may cause you to feel lightheaded or like you might pass out, and this dizzying effect can result in a fall due to a lack of concentration. Find out from your physician or local pharmacist whether you are taking any medication (prescription and over-the-counter) that may be causing a conflict. Then, inquire about any modifications to your drug program that could diminish your risk of falling.
• Get an eye exam.
  Bad eyesight increases the likelihood of falling. If you fail to get annual eye checkups, it is highly probable that your prescription has changed. You could be wearing an inadequate pair of glasses or have a condition that hinders your vision. If this is the case, set up an appointment with an ophthalmologist today.

Fall response

If someone falls and becomes unconscious, an ambulance should be called immediately to avoid a life-threatening delay. On the other hand, if the victim does not lose consciousness, an intense sock to the head still may have permanent consequences. The prospect of a TBI should not be ruled out because you cannot discern what level of brain damage someone has simply by looking at them. Symptoms often do not come to light until quite awhile after the accident.

If a fall victim exhibits any of these symptoms, they need to be rushed to the hospital:

• Headaches, nausea, drowsiness, or difficulty focusing
• Behavioral changes like mood swings or confusion
• Dilated pupils or a pupil bigger in one eye than the other
• Problems walking and talking
• Bloody or transparent liquid seeping from ears or nose
• Vomiting
• Convulsions
• Weakness or tingly feeling accompanied by numbness in the extremities

Consequences of fall-related TBI

Numerous concussions that take place over the course of a few months or even years can cause multiple problems, while repeated head injuries occurring over the duration of weeks, days, or just hours can prove deadly.

Long-term damage caused by TBIs can be split up into three groups:

Physical

• Speech, eyesight, hearing, and other sensory disabilities
• Headaches
• Clumsiness
• Muscle spasticity (muscle tightness, especially in the extremities, causing motor functions to be choppy and painful)
• Paralysis
• Convulsions
• Sleep disorders
• Dysphagia (trouble swallowing)
• Dysarthria (trouble speaking)

Cognitive

• Difficulty recalling recent and past events
• Delayed thought process
• Trouble reading and writing
• Short attention span
• Difficulty with comprehension, articulation, and rationalization
• Inferior problem-solving, planning, classification, and intuition skills

Behavioral

• Sudden changes in temperament
• Depression
• Lack of self worth
• Lack of ambition
• Impotence
• Socialization problems
• Anxiety
• Oversensitivity
• Inappropriate communicative responses
• Extreme highs and lows
• Anger management problems
• Random violent outbursts
• Hallucination