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The global incidence of TBI is estimated to be 27 to 69 million a year <ref name="Arti20">Dewan, M. C., Rattani, A., Gupta, S., Baticulon, R. E., Hung, Y. C., Punchak, M., Agrawal, A., Adeleye, A. O., Shrime, M. G., Rubiano, A. M., Rosenfeld, J. V., & Park, K. B. (2019). Estimating the global incidence of traumatic brain injury. Journal of Neurosurgery, 130(4), 1080–1097. https://doi.org/10.3171/2017.10.jns17352</ref> <ref name="Arti21">James, S. L., Theadom, A., Ellenbogen, R. G., Bannick, M. S., Montjoy-Venning, W., Lucchesi, L. R., Abbasi, N., Abdulkader, R., Abraha, H. N., Adsuar, J. C., Afarideh, M., Agrawal, S., Ahmadi, A., Ahmed, M. B., Aichour, A. N., Aichour, I., Aichour, M. T. E., Akinyemi, R. O., Akseer, N., . . . Murray, C. J. L. (2019). Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 18(1), 56–87. https://doi.org/10.1016/s1474-4422(18)30415-0</ref>. Across all severities of TBI, mortality is quite low at 3% <ref name="Arti22">Georges, A., & Das, J. M. (2022). Traumatic Brain Injury [Internet]. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459300/</ref> this was determined in the United States of America, a country where the healthcare system is quite developed. While mortality is low, the long term effects of TBI can be detrimental to a person’s quality of life. Some of the acute symptoms lessen or resolve over time, such as dizziness or nausea. Other consequences do not become apparent until a long period of time has passed, for instance psychiatric conditions.<ref name="Arti23">Seel, R. T., Macciocchi, S., & Kreutzer, J. S. (2010). Clinical Considerations for the Diagnosis of Major Depression After Moderate to Severe TBI. Journal of Head Trauma Rehabilitation, 25(2), 99–112. https://doi.org/10.1097/htr.0b013e3181ce3966</ref>
Currently, the Glasgow coma scale (GCS) is the only standardized way to assess patients with a suspected TBI. The GCS provides a practical method for assessing impairment of conscious level in response to defined stimuli.[[File:The glasgow coma scale.png|thumb|290px|The Glasgow coma scale.<ref name="Arti24">https://smhs.gwu.edu/urgentmatters/news/keep-it-simple-acute-gcs-score-binary-decision</ref>]] Depending on the final score, the TBI can be classified as minor, moderate or severe.
While the GCS score describes the current condition of the patient, its usage has many shortcomings, one of which is the fact that physicians seem to struggle with remembering the exact levels of the scale.<ref name="Arti25">Riechers, R. G., Ramage, A., Brown, W., Kalehua, A., Rhee, P., Ecklund, J. M., & Ling, G. S. (2005). Physician Knowledge of the Glasgow Coma Scale. Journal of Neurotrauma, 22(11), 1327–1334. https://doi.org/10.1089/neu.2005.22.1327</ref> Although there is a dose-response relationship with regard to the severity of the TBI and the severity of the outcome, the GCS does not effectively and uniformly predict mortality rate. <ref name="Arti26">Institute of Medicine (US) Committee on Gulf War and Health: Brain Injury in Veterans and Long-Term Health Outcomes. (2008). Gulf War and Health: Volume 7 (Vol. 7) [Internet]. National Academies Press. https://doi.org/10.17226/12436</ref> <ref name="Arti27">Cho, D. Y., & Wang, Y. C. (1997). Comparison of the APACHE III, APACHE II and Glasgow Coma Scale in acute head injury for prediction of mortality and functional outcome. Intensive Care Medicine, 23(1), 77–84. https://doi.org/10.1007/s001340050294</ref>
Other ways for diagnosing TBI can include various imaging tests like a CT scan or an MRI scan. However, these imaging techniques are often not sensitive/specific enough for milder TBI. According to experts, only 5-10% of mild TBI patients have abnormal CT/MRI scans. The problem with these scans is that they can only detect damage on a macroscopic level, whereas mild TBI manifests primarily at a microscopic level. Therefore, doctors can mistakenly believe that patients with a standard CT or MRI scan have not suffered a TBI.<ref name="Arti28">McKinlay, A., Lin, A., & Than, M. (2018). A comparison of emergency department medical records to parental self-reporting of traumatic brain injury symptoms. Concussion, 3(1), CNC52. https://doi.org/10.2217/cnc-2017-0017</ref> All in all, improvements are needed to objectively and effectively determine whether or not a patient is suffering from a TBI.
== References ==
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