Chapter 10: Is There a Link to Traumatic Brain Injury?

A common question that arises is whether or not traumatic brain injury (TBI) or concussion can lead to Alzheimer’s disease. Indeed, there has been much recent coverage in the press regarding the effect of repetitive concussions on the brain. First, to clarify, a TBI includes any type of injury to the head. This may be severe with hemorrhages (bleeds) and coma, or it may be mild. Mild TBIs are very common and include concussions, which are defined as any transient change in sensorium after an impact to the body. Sensorium refers to the perception of the body’s senses, and includes the sensation of consciousness. The impact does not necessarily have to hit the head, and there does not have to be a loss of consciousness. Patients sometimes describe a mild TBI, or concussion, as “stars before their eyes” or a being in a “daze” after the injury. Conservative estimates place the number of emergency room visits for TBI to be in excess of 2.1 million per year in the United States. The majority of these are for mild TBI or concussions. There has been a great deal of interest in concussion in young athletes. The fastestgrowing category of TBI in the civilian population, however, is occurring in the population over the age of 65. These patients may suffer a mild TBI from a ground-level fall. This presents a particular problem to the medical field, as these folks often have comorbidities and a diminished reserve for tolerating a TBI…