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May 2016

Sponsorship Feature: Advice about Traumatic Brain Injury


Neurologist from Monmouth & Community Medical Centers

   Brain injury is a major cause of death for adults and more U.S. children die of brain injury than any other cause. Each year in the United States, about 1.4 million people sustain a brain injury, according to the Brain Injury Association of America. Of those, 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department.  Currently, there are at least 5.3 million Americans living with a disability because of a brain injury and the cost to society is estimated at $56.3 billion annually.

    Brain injury is unpredictable in its consequences, says Sumul N. Raval, MD, a Board Certified neurologist and neuro-oncologist on staff at Monmouth and Community Medical Centers. Brain injury affects who we are, the way we think, act, and feel. It can change everything about us in a matter of seconds.

   Traumatic brain injury (TBI) can be caused by a blow or a jolt to the head, which causes damage to the brain. TBI occurs when an outside force impacts the head hard enough to cause the brain to move within the skull or if the force causes the skull to break and directly hurts the brain. Injuries can range from a mild concussion to severe injury, coma, and death, Dr. Raval notes.

   Not all blows or jolts to the head result in a TBI, he observes. The severity of such an injury may range from mild, i.e., a brief change in mental status or consciousness to severe, i.e., an extended period of unconsciousness after the injury. A TBI can result in short or long-term problems with independent function.

   If you have a mild concussion, you may have no long-term side effects. If you have a moderate to severe brain injury, side effects can range from headache and confusion to personality changes and seizures, says Dr. Raval.

   TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy.
   Half of all brain injuries are due to transportation-related accidents. These can include car, motorcycle, and bicycle accidents, as well as injuries to pedestrians. About 20 percent of brain injuries are due to violence. This can include firearm use and child abuse. For people age 75 and older, brain injuries are most often caused by falls.


   Severe brain injuries affect both the injured people and their families. It is a period of great trauma and change, Dr. Raval states.
   A brain injury is a true emergency and treatment begins at the time of the accident or incident. Medical personnel try to stabilize the patient and work to prevent further injury. They make sure oxygen gets to the brain, that there is enough blood flow and blood pressure is controlled.
   Many of the severely injured people will need surgery. This may be to remove a hematoma, which is bleeding in or around the brain. Some people may need a ventriculostomy, a procedure that drains fluid from the brain.


   After the emergency treatment, people may receive care in an intensive care unit in a hospital. Once they are stable, they may move to the sub acute unit of the hospital or to a rehabilitation hospital. At this point, people follow many paths toward recovery.

   Fortunately, brain injury is one of the most preventable brain disorders, comments Dr. Raval. Improved use of car safety belts and child car seats has helped reduce the number of brain injuries. So has greater use of helmets in biking and other sports. Efforts to reduce drinking and driving have also helped.

   There have been considerable efforts to recognize and prevent brain injuries in sports. Coaches and parents have learned the signs of concussion. They have also learned that student athletes must get quick medical care.

   Dr. Raval states that a person with a suspected brain injury should contact a physician immediately, go to the emergency room, or call 911 in the case of an emergency.

   The sooner you can get treatment, the greater the chances for a full recover, he says.

For more information about traumatic brain injury or to make an appointment with Dr. Raval, please call his Toms River office at 732-341-0200 or his Long Branch office at 732-229-6200.

Sumul N. Raval, M.D., D.A.B.P.N.
Board Certified Neurologist and Neuro-Oncologist Founder and Director, DSZ Brain Tumor Center at MMC President, Garden State Neurology and Neuro-Oncology, PC Chairman, Board Of Trustees, and Past president, MOCAAPI

Main Office:
100 State Hwy 36 East, Suite 1A
West Long Branch, NJ 07764

Phone : 732-229-6200
Fax:      732-229-6201