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CDC Injury Center: Director's View Blog

The purpose of this blog is to foster public discussion about injury and violence prevention and response and gain perspectives of those we serve.

Brain Injury – No Longer the “Silent” Epidemic

Categories: Traumatic Brain Injury

For many Native American tribes, the brown bear is a symbol of courage, strength, protection, and life. On November 27, 2009, as I was getting dressed to go out to dinner with my husband Bruce Carmichael and friends, a thought ran through my head that I should wear my Native American bear pin, as I might need courage that evening. Where this feeling came from is unclear, but it certainly proved to be true

Brain CT scan

A CT scan of a brain: TBI is sometimes referred to as the “silent epidemic” because the complications from TBI, such as changes affecting thinking, sensation, language, or emotions, may not be readily apparent.

As I finished getting ready for dinner, I heard Bruce tumble down the stairs, while my friend cried out, “Oh no!”  I ran down the stairs saying, “Call 911!” to find Bruce lying unconscious and moaning at the bottom of the stairs. Fortunately, there was a rapid response by emergency medical services, and the 45 minute trip to the nearest hospital was uneventful. Bruce underwent surgery for his injury, was hospitalized for a week, followed by a week of inpatient rehabilitation, and returned home to complete his recovery.

He gradually resumed his work as a Deputy Dean, but was frustrated that he felt as though his thought processes were a bit slower than they had been, and that he tired more easily. One of the medications that he took produced side effects that resulted in depression and some personality differences, but these effects diminished as he was weaned off the drug. His recovery was progressing well when he died suddenly of a cardiac event.

Having worked with many patients who sustained brain injuries, I am very familiar with the symptoms of the injury and the range of paths to recovery. I know that Traumatic Brain Injury (TBI) impacts daily life for survivors, families, friends, co-workers, and the community. Even a seemingly minor TBI can lead to long-term symptoms such as difficulty concentrating, trouble organizing thoughts, fatigue, memory issues, and headaches.

Because we cannot see a TBI in the same way that we see a broken arm or leg, and do not always notice the long-term effects of TBI in the way that we would see a limp, or weakness in a limb, TBI is sometimes called a “silent epidemic.” But people who are affected by it are definitely lending their voice to end that “silence.” At CDC’s Injury Center, we are hearing these voices through phone calls, emails, comments on our Heads Up Facebook Page, and video submissions to the recent Heads Up Film Festival.

These stories not only give a clear and powerful voice to the cause, but show that the occurrence of TBI is a very real epidemic that impacts the lives of millions.

CDC Injury Center Science and Program

Heads Up to Concussion logo

Heads Up Campaign Logo: The CDC Injury Center works with partners to move science to action through a series of practical, easy to understand programs, called Heads Up.

Since CDC’s Injury Center first began working in TBI, we’ve made great strides in understanding the problem, including knowing who is most at risk and major causes of TBI. Our efforts in injury and violence prevention present opportunities for preventing TBI from occurring in the first place. For example, we know that protective devices such as seatbelts and airbags, as well as bicycle and motorcycle helmets, decrease the risk of TBI. And we know that if a TBI does occur, there are ways to decrease the risks for future TBIs.

To understand the issue better, we have published several reports detailing the incidence and prevalence of TBI in the US, such as:

At the Injury Center, we’ve also worked with partners to move science to action by developing a series of practical, easy to understand programs, called Heads Up. These programs, which focus on sports-related TBI, help educate parents, coaches, teachers, caregivers, and clinicians about the signs and symptoms of TBI; what to do if an athlete has a TBI; and how to prevent further brain damage from repeated TBI. The materials include podcasts, videos, social media tools, and even online training

Our Heads Up programs have also led to strong partnerships that raise the visibility of TBI – helping to end the ‘silence.’ We have active partners including national sports organizations, local health departments, and local athletic groups, who have given Heads Up a life of its own by co-branding CDC’s materials and using them in local concussion awareness and prevention programs.

Together, our advances in science and program have helped family members and caregivers take critical steps to reduce the consequences of a TBI.

Looking Toward the Future

The momentum we’ve built continues to drive progress for TBI prevention and treatment.  Our work in the area of preventing the occurrence of TBI continues as we work to prevent falls in older adults, to prevent injuries in motor vehicle crashes, and to prevent violence that can lead to brain injury.  Pediatricians and other clinicians across the country have identified a need to help diagnose and manage concussions in youth; therefore the Injury Center is beginning work with a panel of experts to develop pediatric TBI guidelines.

State and local partners expressed a need for programs to educate players, parents, and coaches about recently passed “return-to-play” laws for youth sports concussion. We are working with them to share more information from our Heads Up program, and to evaluate these policies to ensure they achieve their intended impact. To reach school professionals, we are also adding a Heads Up to Schools initiative to our Heads Up family.

Let’s Hear About Your TBI Story!

Heads Up Film Festival, Give Brain Injury A Voice

Heads Up Film Festival Logo: In recognition of Brain Injury Awareness Month and CDC Injury Center's 20th anniversary, the CDC Foundation in partnership with CDC is launching the Heads Up Film Festival at YouTube videos can be tagged with “HeadsUpBrainInjury” to be pulled into the film festival.

March is Brain Injury Awareness Month, so we would like to hear your story!

Post your story on the Heads Up Facebook Page. Visit the Heads Up Film Festival to share a video and add to the national conversation on brain injury. Read others’ posts and view others’ videos to learn about facing daily challenges, achieving successes, seeking support, or finding rehabilitation services. Together, we can make some noise about TBI – a once ‘Silent Epidemic.”

Public Comments

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this blog is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. March 19, 2012 at 11:47 am ET  -   Laura Hanlin

    I sustained a TBI during a car accident on 10/30/10 on my way to a Halloween party. My car was struck by a deer (the antlers came thru my driver’s window). Unbelievably, I was fine except for some shock setting in and minor cuts from all the broken glass.
    My boyfriend pulled up behind me, threw his car into park, put on his hazard lights, and jumped out to help me. After several minutes, he got me out of the stuck door, and I sat in the back seat of his Tempo to make phone calls. Before 5 minutes passed, we were struck from behind by a van going about 50 mph. I was in the back seat with no seat belt. I was knocked unconscious for quite some time; no one is sure how long. During this time, I had a near-death experience. The emergency room took an xray and an MRI and said that since there was no bleeding in the brain, that I could go home. “Just a concussion…. You’ll feel beat up for awhile, and then you’ll be fine”.
    I went home and thought that given a few days, I could shake the fuzzy and slow thought processes. The headaches were excruciating and so painful that it caused nausea. Along with the bruises, whiplash, and aggravated back problems, it has been 17 months and I’m still not back to work. If this weren’t enough, there is a chance I will not recover the skills lost in this accident. Only time will tell.
    I’ve gone through many doctors, and the insurance company has blocked several therapies that could have helped my focus, attention and processing speed. On top of all of the physical problems, there is a nagging feeling that I’m not the same person. I think differently, I feel differently, yet the people who know me say “You are looking great!”. The medicine has caused me to lose 50 pounds so far, and my appetite and sleep are affected. So, okay, I “look” better, but how can I explain and how could they possibly understand that there are unseen changes, unknown problems and an unclear forecast for my future. I don’t react the same, I see things differently, and the pain level changes daily in different parts of my body. It is a difficult process and I don’t expect anyone but the doctors to be able to understand.
    On top of this, I’m still on medical leave, I have no income, I’ve lost my insurance, and there is a waiting period before lawyers can get involved. Until then, my doctors tell me to just “be patient”.
    I am working on my own home remedies, including inching up my computer time daily, physical therapy, yoga, pilates, anything that makes me feel good (hobbies, arts, crafts), and I refuse to believe the doctors that tell me that the 18-month mark signifies a slowing down point in healing. I’m nearing the 17-month mark, and my formal rehab has not yet begun.
    So far it has taken me almost an hour to type this little post (with many breaks). I’ve had friends and family read/edit for me. I use spell check. I use tools I never used before. Before the accident, my computer skills were good and I typed 90 wpm and could multi-task like nobody’s business.
    How different life can change in a matter of minutes. Never take your skills for granted. And listen closely when a person close to you who has a brain injury says “I feel like a different person.” Because they now are.

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  2. March 19, 2012 at 9:07 pm ET  -   Jackie Goodwin

    My father suffered a traumatic brain injury one year before I did, he fell and slipped on some ice getting out of his truck. He was put on life support two days later he had passed away as I was holding his hand. I was iin the back seat of a International Scout riding with friends and the back tire blew, we flipped I had suffered a broken back and a tramatic brain injury that left me in a coma for two months I woke up from the same injury that my daddy did not survive from hitting his head. I have come a long way in my recovery I have learned traumatic brain injury’s come in many ways it does’nt always have to be the way it happened to me. Since my injury I decided I might as well make what happened to me useful and help people understand the effects of a brain injury and how it can happen to anyone at any time.

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  3. March 27, 2012 at 9:26 pm ET  -   Sandra

    My father fell from his van on a Saturday in Nov 2012. He had a bump on the back of his head, one over his eye, and a black eye. The following Wednesday his pacemaker started firing so he went to the ER. We told the Dr about his fall and figured his leads in his pacemaker had moved. They X-rayed his chest but never checked his head. We asked for him to be transferred to a larger hospital but was told it would be an unnecessary transfer. They put him in ICU for the night until his GP could come in the next day. He stopped responding around 4:30am the next morning. It was then they did a CT scan on his head and found the TBI. He was placed on a vent and flown to the larger hospital we had ask to go to the day before. Once at the new hospital the neuorologist let us have some time with him to say goodbye. My father was brain dead.
    It is my hope that every bump on the head, every black eye gets noticed and scanned, and that no sick person gets put into a hospital room to rest until the doctor can come in the next day.

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  4. April 10, 2012 at 12:41 pm ET  -   Cerry

    Normally I don’t learn article on blogs, but I wish to say that this write-up very forced me to try and do it! Your writing style has been surprised me. Thanks, very nice article.

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  5. May 12, 2012 at 4:46 pm ET  -   marilyn klein

    My adult child had a metabolic brain injury 1 year ago would like to communicate with other parents about how they are coping and just talk to someone else who is going thru what we are. thanks

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