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Traumatic Brain Injury - Description

Page Contents

ICD-9

850.0, Traumatic brain injury

907.0, Late effect of intracranial injury...

850.0 to 859.9 are used for traumatic brain injuries, but 907.0 is used for the late effects. See TBI ICD9 (PDF Document 109 KB) for details on coding and related ICD-9-CM codes.

Description

Traumatic brain injury (TBI) is caused by a sudden trauma to the head resulting in damage to the brain and is sometimes referred to as a head injury or acquired brain injury. TBI is not hereditary, congenital, degenerative, or related to birth trauma. The patient may or may not have experienced a loss of consciousness at the time of the trauma. TBIs are categorized as mild, moderate, or severe and symptoms can range from relatively mild (dizziness, fatigue, headaches) to extremely serious (seizures, slurred speech, confusion, loss of coordination, vegetative state).

Genetics

No genetic factors have been identified.

Prognosis

The degree and impact of post-injury disabilities will depend on the extent of the injury, the area of the brain affected, and the age and general health prior to the injury. Impairments may be temporary or permanent, cause partial or total functional disability, and include mild to major psychosocial maladjustment.

Prevalence

Determining the prevalence of TBI in children is hampered by a number of factors, including inconsistent definitions of TBI and its severity, lack of definitive diagnostic criteria, and inadequate epidemiologic research. Causes of TBI vary with age; inflicted injuries are most prevalent in infants, falls in children aged 0-4, and motor vehicle injuries in older children and adolescents. [Keenan: 2006] In all age groups, boys are more likely than girls to have a TBI, and blacks more likely than whites. [Langlois: 2005] The estimated incidence of pediatric hospitalizations associated with TBI in 2005 was 72.7 per 100,000. [Bowman: 2008] However, a prospective study published in 2008 found the average incidence of TBI in individuals 0-25 years, both hospitalized and non-hospitalized, to be 1.1-2.4 per 100 per year, higher than previous studies have suggested. [McKinlay: 2008] Long-term outcomes of hospitalized children have not been detailed and the cumulative prevalence of symptomatic or disabling TBI is unknown.

The Centers for Disease Control and Prevention report that TBI rates in the U.S. vary by age and by sex. Children aged 0 to 4 years, older adolescents aged 15 to 19 years, and adults aged 65 years and older are most likely to sustain a TBI.

Impact

More than $1 billion dollars per year are spent on hospitalizations for pediatric TBI. [Schneier: 2006]

Pearls And Alerts

On Initial Diagnosis Page

Prediction of recovery

Successive concussions and long term outcome

On Ongoing Assessment Page

Depression is common after traumatic brain injury and may manifest as a deterioration in abilities

On Treatment And Management Page

Mild TBI and concussion

Helpful Articles

PubMed search on traumatic brain injury: articles over the past 2 years

Keenan HT, Bratton SL.
Epidemiology and outcomes of pediatric traumatic brain injury.
Dev Neurosci. 2006;28(4-5):256-63. PubMed abstract

Traumatic Brain Injury Module Authors

Authors: Teresa Such-Neibar DO, 6/2009
Elaine Pollock, 6/2009
Content Last Updated: 7/2011

The authors listed above are responsible for the overall Traumatic Brain Injury Module. Authors contributing to individual pages in the module are listed on those pages.

Page Bibliography

Bowman SM, Bird TM, Aitken ME, Tilford JM.
Trends in hospitalizations associated with pediatric traumatic brain injuries.
Pediatrics. 2008;122(5):988-93. PubMed abstract

Keenan HT, Bratton SL.
Epidemiology and outcomes of pediatric traumatic brain injury.
Dev Neurosci. 2006;28(4-5):256-63. PubMed abstract

Langlois JA, Rutland-Brown W, Thomas KE.
The incidence of traumatic brain injury among children in the United States: differences by race.
J Head Trauma Rehabil. 2005;20(3):229-38. PubMed abstract

McKinlay A, Grace RC, Horwood LJ, Fergusson DM, Ridder EM, MacFarlane MR.
Prevalence of traumatic brain injury among children, adolescents and young adults: prospective evidence from a birth cohort.
Brain Inj. 2008;22(2):175-81. PubMed abstract

Schneier AJ, Shields BJ, Hostetler SG, Xiang H, Smith GA.
Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States.
Pediatrics. 2006;118(2):483-92. PubMed abstract