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An ABI is an injury to the brain that has occurred after birth and is not hereditary, congenital or degenerative. The injury commonly results in a change in neuronal activity, which affects the physical integrity, the metabolic activity, or the functional ability of the cell. The term does not refer to brain injuries induced by birth trauma.

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Includes TBI and injuries caused by an internal insult to the brain.

Causes of ABI:

  • TBI

  • Tumor

  • Blood clot

  • Stroke

  • Seizure

  • Toxic exposure (e.g., substance abuse, ingestion of lead, inhalation of volatile agents)

  • Infections (encephalitis, meningitis)

  • Metabolic disorders (insulin shock, diabetic coma, liver and kidney disease)

  • Neurotoxic poisoning

  • Lack of oxygen to the brain (airway obstruction, strangulation, cardiopulmonary arrest, carbon monoxide poisoning, drowning)

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TBI is an insult to the brain, not of a degenerative or congenital nature but caused by an external physical force, that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment.

Causes of TBI

  • Falls

  • Motor Vehicle Crashes

  • Gunshot Wounds

  • Sports Injuries

  • Workplace Injuries

  • Child Abuse

  • Domestic Violence

  • Military Actions

  • Other injuries caused by trauma



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In 2013, falls were the leading cause of TBI. Falls accounted for 47% of all TBI-related ED visits, hospitalizations, and deaths in the United States. Falls disproportionately affect the youngest and oldest age groups:

  • More than half (54%) of TBI-related ED visits hospitalizations, and deaths among children 0 to 14 years were caused by falls.

  • Nearly 4 in 5 (79%) TBI-related ED visits, hospitalizations, and deaths in adults aged 65 and older were caused by falls.

  • Being struck by or against an object was the second leading cause of TBI, accounting for about 15% of TBI-related ED visits, hospitalizations, and deaths in the United States in 2013.

  • Over 1 in 5 (22%) TBI-related ED visits, hospitalizations, and deaths in children less than 15 years of age were caused by being struck by or against an object.

  • Among all age groups, motor vehicle crashes were the third overall leading cause of TBI-related ED visits, hospitalizations, and deaths (14%). When looking at just TBI-related deaths, motor vehicle crashes were the third leading cause (19%) in 2013.

  • Intentional self-harm was the second leading cause of TBI-related deaths (33%) in 2013.

Check out the CDC TBI: Get the Facts website for more information.



  • Every 23 Seconds, one person in the U.S. sustains a Traumatic Brain Injury

  • 1.7 million people sustain a TBI annually

  • 1.4 million are treated and released from an emergency department

  • 275,000 per year are hospitalized

  • 52,000 per year die with TBI

  • 80,000 per year result in long term disability

  • 5.3 million Americans are living with TBI

  • 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.


  • Population of Vermont: 623,000 (2018)

  • 9,000 Vermonters are currently living with a TBI

  • 4,530 Emergency Room/Hospitalizations related to brain injury in 2014

  • Falls are the number one cause of disability and death.

  • In every age group, TBI rates are higher for males than for females.

The number of people with TBI who are not seen in an emergency department or who receive no care is unknown.

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  • The total cost of ED visits, hospitalizations, and deaths related to TBIs, either alone or in combination with other injuries, exceeds $82 billion annually— this includes medical and work loss costs (Centers for Disease Control and Prevention : data & statistics)

The Centers for Disease Control and Prevention estimates that at least 5.3 million Americans currently have a long-term or lifelong need for help to perform activities of daily living as a result of a TBI. According to one study, about 40% of those hospitalized with a TBI had at least one unmet need for services one year after their injury. The most frequent unmet needs were:

  • Improving memory and problem solving

  • Managing stress and emotional upsets

  • Controlling one's temper

  • Improving one's job skills

TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy and increase the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more prevalent with age.



  • Low-grade headache that won't go away

  • Having more trouble than usual remembering things, paying attention or concentrating, organizing daily tasks, or making decisions and solving problems

  • Slowness in thinking, speaking, acting or reading

  • Getting lost or easily confused

  • Feeling tired all the time, lack of energy or motivation

  • Change in sleep pattern, sleeping much longer than before, having trouble sleeping

  • Loss of balance, feeling light-headed or dizzy

  • Increased sensitivity to sounds, lights, distractions

  • Blurred vision or eyes that tire easily

  • Loss of sense of taste or smell

  • Ringing in the ears

  • Change in sexual drive

  • Mood changes like feeling sad, anxious, or listless, or becoming easily irritated or angry for little or no reason


  • A headache that gets worse or does not go away

  • Repeated vomiting or nausea

  • Convulsions or seizures

  • Inability to wake up from sleep

  • Dilation of one or both pupils

  • Slurred speech

  • Weakness or numbness in the arms or legs

  • Loss of coordination

  • Increased confusion, restlessness or agitation


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  2. Emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and

  3. Prevention, National Center for Injury Prevention and Control; 2006.

  4. Defense and Veterans Brain Injury Center (DVBIC). [unpublished]. Washington (DC): U.S. Department of Defense; 2005.

  5. Ivins BJ, Schwab K, Warden D, Harvey S, Hoilien M, Powell J, et al. Traumatic brain injury in U.S. army

  6. Paratroopers: prevalence and character. Journal of Trauma Injury, Infection and Critical Care 2003;55(4):617-21.

  7. Finkelstein E, Corso P, Miller T and associates. The Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press, 2006.

  8. Thurman D, Alverson C, Dunn K, Guerrero J, Sniezek J. Traumatic brain injury in the United States: a public

  9. health perspective. Journal of Head Trauma Rehabilitation 1999;14(6):602-15.

  10. Corrigan JD, Whiteneck G, Mellick D. Perceived needs following traumatic brain injury. Journal of Head Trauma Rehabilitation 2004;19(3):205-16.

  11. National Institute of Neurological Disorders and Stroke. Traumatic brain injury: hope through research.

  12. Bethesda (MD): National Institutes of Health; 2002 Feb. NIH Publication No. 02-158. Available from:

  13. Ylvisaker M, Todis B, Glang A, et al. Educating students with TBI: themes and recommendations.

  14. Journal of Head Trauma Rehabilitation 2001; 16:76-93.