Traumatic Brain Injury and Concussion Prevention

In Connecticut, the 2023 age-adjusted mortality rate was slightly less, at 16.6 people per 100,000 Connecticut residents, ranking the 13^th lowest rate in the nation (ranging from 36.3 to 9.9 per 100,000).

Those who survive TBI can face effects that last a few days to a lifetime. Effects of TBI can include impaired movement, vision, hearing, memory, thought processing or emotional functioning (e.g., personality changes, depression).  These issues not only affect individuals but can have lasting effects on families and communities.

What is TBI?

TBI refers to a brain injury that is caused by an outside force. TBI can be caused by a forceful bump, blow, or jolt to the head or body, or from an object entering the brain. Not all blows or jolts to the head result in TBI. The severity of TBI may range from “mild” (i.e., brief changes in mental status or consciousness, often referred to as concussion) to “severe” (i.e., an extended period of unconsciousness, memory loss, or permanent injury).  

Mortality codes for death data combine TBI with unspecified head injury that includes injury to blood vessels, muscles, tendons, ears, the face, and the nose. This full spectrum of injury to the head will be referred to as “head injury.”

• Of the 34,703 Connecticut residents treated for a head injury in 2023, 90% (n=31,338) were treated in the emergency department, another 7.8% (n=2,689) were admitted to the hospital for care, and an additional 1.9% (n=676) died from an injury to the head.

• Connecticut hospitals billed over $526 million for treating head injuries in 2023; 44.7% ($235.3 million) for emergency department, treat and release cases and 55.3% ($290.8 million) for hospital admissions. This averages nearly $1.5 million per day.

• The burden of risk for these head injuries is higher for males than for females and for non-Hispanic Blacks in all age categories than for their counterparts. The rate at which non-Hispanic Blacks are dying from head injury has been decreasing since 2021, but the change is not statistically significant.

What Causes TBI?

Common causes of head injury include unintentional falls, transportation crashes, sports-related activities, and interpersonal violence.

Nationally, CDC data from 2021 showed the leading cause of TBI was falling. Falls accounted for 40% of all TBI-related ED visits, hospitalizations, and deaths in the United States.

In Connecticut, data from 2023 indicate the leading causes of death with TBI were from:

• falling (37.4%),

• motor vehicle crash (29.3%),

• suicide (17.2%), or

• homicide (7.8%)

Causes of TBI-related ED visits and hospitalizations in Connecticut were from:

• falling (45.6%),

• being struck by or against an object like with sporting injuries (15.6%), or

• motor vehicle crashes (11.1%)

TBI-related hospitalization charges in 2023 (including unspecified head injuries and concussions) averaged $812,313 daily, with an additional $653,410 daily for ED treat and release visits. 

Concussion

Concussions are caused by a blow or jolt to the head or body that results in rapid movement to the head, disrupting brain function. The severity of a concussion 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. All concussions are serious even though many do not result in loss of consciousness. 

Increasingly, Connecticut residents are taking part in sports and recreational activities. Unfortunately, some of these activities can lead to serious head injuries unless precautions are taken.

The federal Centers for Disease Control and Prevention (CDC) estimate that at least 7 million sports and recreation-related injuries occur in the United States each year. More than half of these injuries occur among children, youth and young adults aged 5 to 24 years.

According to results from the 2023 Connecticut School Health Survey, administered by the Connecticut Department of Public Health (CT DPH) and the state Department of Education, 15.2% of high school students reported concussions from injuries requiring medical treatment while playing sports, exercising or being physically active during the previous year.

Parents, coaches and athletes should learn the signs and symptoms of a concussion and seek medical attention right away. In 2023, for the Connecticut population under age 19, there were 28 hospital inpatient discharges and 2,344 emergency department encounters. These visits totaled over $8.2 million.

State Health Officials encourage safe participation in sports and recreational activities as an important part of a healthy, physically active lifestyle at any age. The CT DPH recommends taking the following steps when taking part in sports and recreational activities to help keep you safe and prevent injury:

• Use appropriate protective gear, such as helmets, wrist guards, knee and elbow pads for all sports activities.
• Helmets do not prevent concussions but can help protect from serious brain or head injury and skull fractures.
• Helmets should fit properly and be well maintained, age appropriate, worn consistently and correctly, and be appropriately certified for use.
• Reducing exposure to head impacts and increasing coach training and rule changes are important in reducing concussion risk.
• Make sure that playground equipment is installed over shock absorbing surfaces.
• Learn and practice the skills relevant for each sport or activity.
• Follow safety rules for each sport or recreational activity.
• Adults should model safe behavior for children, including wearing helmets and following the rules.

What You Need to Know about Concussions

Most people with concussion recover well from symptoms experienced at the time of the injury. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens. Those who have had a concussion in the past are also at risk of having another one. Some people may also find that it takes longer to recover if they have another concussion. (CDC, Injury Prevention & Control: Traumatic Brain Injury).

Some of the Signs and Symptoms of Concussions

When to Seek Immediate Medical Attention

Danger Signs in Adults

In rare cases, a person with a concussion may form a dangerous blood clot that crowds the brain against the skull. Contact your health care professional or emergency department right away if you experience these danger signs after a bump, blow, or jolt to your head or body:

• Headache that gets worse and does not go away.
• Weakness, numbness or decreased coordination.
• Repeated vomiting or nausea.
• Slurred speech.

The people checking on you should take you to an emergency department right away if you:

• Look very drowsy or cannot wake up.
• Have one pupil (the black part in the middle of the eye) larger than the other.
• Have convulsions or seizures.
• Cannot recognize people or places.
• Are getting increasingly confused, restless, or agitated.
• Have unusual behavior.
• Lose consciousness.

Danger Signs in Children

Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

• Have any of the danger signs for adults listed above.
• Will not stop crying and are inconsolable.
• Will not nurse or eat.