A Comparison of Brain Injuries from Vehicle Crashes, Violence, and Falls

Past Studies

Past Studies, including one investigation by 5 of the Traumatic Brain Injury Model Systems, indicate that the leading causes of traumatic brain injuries are vehicle crashes, falls, and violence. Teenagers and young adults are more likely to be injured in vehicle crashes. Violence and sports are the most frequent causes of brain injuries for young males. Falls are the leading cause of injury for older adults.

Past studies indicate that younger adults tend to recover better upon completing rehabilitation. Young adults with brain injuries appeared to have some difficulty returning to work and community life after rehabilitation. Researchers believed this might be associated with the limited work, education, and social experiences of the young adults prior to getting a brain injury.

Former researchers found that individuals with violence-related brain injuries tend to be male, less educated, nonwhite, and have a history of substance abuse. Researchers reported that individuals injured by violence experience similar recoveries as individuals who received brain injuries by other ways. However, it appeared that after rehabilitation, individuals who were injured by violence tended to experience greater difficulties with employment, taking care of themselves, and having relationships with others. It is suspected that these limitations existed to some extent before the individuals received their brain injuries.

Past researchers found that traumatic brain injury rates nearly doubled for women after age 60. Older individuals appeared more likely to be injured in falls. Older adults with brain injury seemed to experience a greater difficulty with returning to work. However, older women in particular appeared to be more likely to return to their pre-injury lifestyles.

This Study

This Study examined information about 1,170 individuals who sustained moderate to severe traumatic brain injuries. Reports were obtained from seventeen Traumatic Brain Injury Model Systems. The researchers reviewed the participant’s data at the time of hospitalization, rehabilitation, and one year after the time of injury. The participants were grouped by the cause of their brain injury, such as vehicle crashes, violence, falls, or by other ways.

The researchers found that individuals who received vehicle-related traumatic brain injuries were most often in their early thirties, white, and were involved in productive activity (working, going to school, homemaking) before the injury. They did not have significant histories of drug use, behavior problems, or psychological difficulties. Individuals with vehicle-related traumatic brain injuries tended to have more severe traumatic brain injuries and other bodily injuries. Overall, individuals with vehicle-related traumatic brain injuries faired better at one year after their injury than those participants who received brain injuries from another cause. They were more likely to live at home, have successful relationships, and be engaged in productive activity. The researchers suspect a factor for their success may be related to their good support systems and healthy lifestyles prior to their traumatic brain injuries.

Individuals with violence-related traumatic brain injuries tended to be male, nonwhite, unemployed, and single. They had a history of substance abuse and arrest. Individuals with violence-related traumatic brain injuries received moderate to severe traumatic brain injuries. At one year after their brain injuries, these participants reported increases in unemployment, from 42% at the time of injury to 70%. Similarly, they reported increased rates of divorce and separation at one year after their injury. These findings were in agreement with what earlier studies revealed about individuals with violence-related brain injuries.

Individuals with fall-related traumatic brain injuries were generally older, white, married, and retired. They tended to receive moderate to severe brain injuries. At one year after their brain injuries, this population made the most improvement for physical abilities, but made less improvement in the area of thinking skills, such as memory, problem solving, and judgement. It appeared that individuals with fall-related traumatic brain injuries had difficulty continuing to improve on the skills learned in rehabilitation and had the same level of difficulty with returning to their original home environment as the group with violence-related traumatic brain injuries. Individuals with fall-related traumatic brain injuries displayed higher levels of social abilities than the violence-related group, but lower levels than the vehicle-related group. This group reported the highest rate of having a previous brain injury and the researchers suspect the prior brain injuries and older age may play a role in contributing to their decrease in thinking skills recovery.

Individuals with traumatic brain injuries as a result of other causes, such as being hit by a car or injured in sports, tended to be African American, unemployed when injured, and received moderate to severe brain injuries. Their abilities after one year from their injuries were similar to those of the other groups studied.

Who May Be Affected By These Findings

Individuals with traumatic brain injuries, health care providers, public health and prevention specialists, and researchers.

Caveats

In this study, individuals with violence-related brain injuries tended to receive moderate to severe traumatic brain injuries. Past studies had reported such individuals as typically receiving less severe brain injuries. The researchers note that “physical abuse” is not currently included as a specific cause of violence-related traumatic brain injury in the Traumatic Brain Injury Model Systems database. The researchers state that physical abuse should be considered as a category in future versions of the Traumatic Brain Injury Model Systems database.

Bottom Line

The researchers found that there are important differences between individuals who sustain violence-related traumatic brain injuries and those who receive traumatic brain injuries by other means. Individuals with violence-related traumatic brain injuries appeared to experience difficulties with life, such as unemployment, substance abuse, and poor social relationships before their injuries. Their pre-injury problems appear to continue and possibly increase after their traumatic brain injuries. Individuals with fall-related brain injuries appeared to be older and it is expected that the aging process and having a history of prior brain injuries could effect their recoveries. Individuals with vehicle-related brain injuries tended to be younger and seemed to make better recoveries. Further research will examine the need for specialized rehabilitation programs designed to address the specific issues of individuals injured by violence.

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