This was the patient lecture of ISCOMS 2019, check back soon for updates on ISCOMS 2020.
Bram Jacobs MD PhD, neurologist
Every year more than 60,000 patients with traumatic brain injury (TBI) are admitted to emergency departments in the Netherlands. TBI incidence world-wide is estimated at more than 200/100,000, making TBI one of the most frequent neurological disorders. TBI represents a heterogeneous patient population of all ages, from infants to the elderly, with large variability in injury severity, pathophysiology, (long term) outcome and post-traumatic sequelae. TBI is the leading cause of death and disability among children and young adults in the Western world and incidence numbers in the elderly are rising. In a report on neurological disorders the World Health Organization (WHO) concludes that there is a silent and neglected epidemic of TBI, even more prominent in developing countries, with devastating consequences. The outcome after TBI varies across the different TBI severity categories. In mild TBI mortality is low (about 1%), but in severe TBI the mortality rates can be as high as 40%.
TBI results from an abrupt external mechanical force acting upon head and brain. The impact and successive energy of the force transfer cause (temporary) injury to the skull, brain and adherent tissues. The main causes of non-penetrating or blunt head injury are, predominantly represented in the younger population and road traffic related (more than half of all cases): motor vehicle accidents, injuries of cyclists and pedestrians. The second category of trauma mechanisms is falls, especially the elderly are at a higher risk: fall from standing height or from stairs. Assaults and head injuries related to sports represent the smaller incidence groups.
In this patient lecture on Wednesday the 5th of June, a patient that suffered or still suffers from TBI will join the teacher to illustrate the consequences of TBI.