Epidemiology of Traumatic Brain Injury

It is often stated in the literature that traumatic brain injury (TBI) is a silent epidemic with an estimated 64–74 million new cases presenting each year. It is called silent because the impairments suffered by many TBI patients, such as memory loss, cognitive dysfunction, or behavioral disturbance, are often not visible. However, the silence is gradually being broken as the global healthcare implications for the management of TBI patients become increasingly visible. Low- and middle-income countries have seen a marked increase in motorized transportation, for both two- and four-wheeled vehicles. This has often not been accompanied by concomitant improvements in safety legislation, and this has led to a significant increase in the incidence of motor vehicle-related TBI. In high-income countries (HICs), improvements in healthcare have led to considerably extended life expectancy, which has increased the risk of fall-related TBI. In addition, the increasing recognition that there are long-term consequences of sports-related repetitive minor TBIs may present substantial governance issues for some sporting authorities. Finally, it is becoming apparent that military personnel returning from conflict zones such as Iraq and Afghanistan are suffering from the long-term consequences of their trauma-related injuries. Given the global disease burden of TBI, there is a need to obtain accurate epidemiological information regarding the true incidence, especially in low- and middle-income countries, in order to target resources and institute appropriate preventive measures.