Injuries are the leading cause of death in persons less than 45 years old with up to 50 percent of these due to head trauma. This chapter discusses all aspects of head injuries, but focuses on the more severe category of injuries now referred to as traumatic brain injuries (TBI). According to national data, approximately 1.5 million people per year sustain a nonfatal TBI. More than 370,000 persons are hospitalized annually with TBI, and 52,000 per year sustain a fatal TBI. 1 In 1996, there were more than 750,000 ED visits for intracranial head injuries and 2.6 million visits for open wounds to the head. 2 TBI is also the major cause of traumatic disability in the United States, leading to 80,000 annual cases of residual neurologic disability. The costs for treatment of both acute and chronic TBI have been estimated to be $4 billion dollars annually.3

The most commonly affected groups are young male adults. The elderly and young children are also at greater risk because of underlying anatomic and physiologic factors. In addition, alcoholics are at an increased risk for TBI. Ethanol-intoxicated individuals have a 40 percent greater chance of sustaining a head injury than sober individuals.4 The causal agent for TBI a mortality varies greatly by age and other demographic factors. For example, the leading cause of TBI-related deaths in the 15-to 24-year-old age group is gunshot wounds, while for those over 65 years it is falls.

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