HD72 - The Needs of Head and Spinal Cord Injured Citizens and The Need for Research Pursuant to House Joint Resolution No. 135
Executive Summary: The study of the needs of head and spinal cord injured citizens and the need for research was authorized by the 1988 General Assembly via House Joint Resolution No. 135. This resolution represents a consolidation of HJR No. 135 (Marks) and HJR No. 149 (Mayer) to provide a broader examination of the issues and to assist the Commonwealth in developing a sound, efficacious health policy which better serves the needs of such citizens. HEAD INJURY Head injury is defined as a "physical injury to living brain tissue caused by an external force. Head injury is commonly caused by accidents, motor vehicle accidents, sports or a fall. However, cardiac arrest, stroke, and accidents such as drowning can result in anoxia" (loss of oxygen to the brain) and traumatic head injury. There are two basic types of head injury: closed head injury (CHI) and open or penetrating head injury (OPI)" (National Head Injury Foundation, 1988). A. National In the United States, head injury is a major health problem from which "more than 1.9 million people suffer and trauma and head injuries are the fourth leading cause of death" (National Statistics Show Seriousness of Head Injuries, 1984). According to data provided by the National Institute of Neurological and Communicative Disorders and Stroke, persons most at risk for head injuries include young people between the ages of fifteen and twenty-four, the elderly and infants. Young men are more than twice as likely as women to suffer a head injury. The elderly, infants and children are likely to be injured from falls and accidents. Abused children also may suffer from head injuries (Head Injury: Hope Through Research, 1984). B. Virginia In Virginia, nearly 14,000 Virginians suffer head injuries each year. Males account for 62% of head injuries and females for 38%; whites account for 70% of head injuries, Blacks 29%, and other nationalities 10%. By age group, head injuries are represented as follows: • 15 - 29 years 33% • 61 and older 20% • 14 and younger 17% • 30 - 45 years 17% • 46 - 60 years 13% C. Manifestations of Head Injury The symptoms of head injury are partly determined by the area of the brain that is injured. The following symptoms are common: • Physical Impairments - speech, vision, hearing and other sensory impairments, headaches, lack of coordination, spasticity of muscles, paralysis of one or both sides and seizure disorders. • Cognitive Impairments - short-and long-term memory deficits, concentration, thinking, attention, perception, communication, reading and writing, planning, sequencing and judgment; • Psycho-Social-Behavioral-Emotional Impairments - fatigue, mood swings, denial, self-centeredness, anxiety, depression, lowered self-esteem, sexual dysfunction, restlessness, lack of motivation, inability to cope, agitation, excessive laughing or crying and difficulty in relating to others (NHIF, 1988). D. Needs of Head Injured Persons. Although advances in medical technology have enabled physicians to save and prolong the lives of many individuals who have sustained life threatening injuries, the rehabilitative technology has not evolved commensurately to enable clinicians to ameliorate permanent brain damage. The cognitive, neurological and other physical disorders which result from such injury require that many of these individuals receive long-term, expensive medical and rehabilitative care. The following represents the critical needs of head injured persons: • Prompt, Quality Emergency Medical Care • Rehabilitation • Education • Vocational Services • Housing • Family Services E. Research The increased success of rehabilitative techniques in improving the quality of life and survival rates for head injured patients is largely attributable to research on the brain. At the Medical College of Virginia, a NINCDS-funded study conducted to determine what happens to patients who survive a severe head injury concluded that aggressive surgical and medical therapy enables some patients who would have died to make a good recovery without increasing the proportion of severely disabled patients. Other studies concerning patients with minor head injuries indicate that subtle consequences may be more frequent and more lasting than previously believed. Scientists hope to identify the structural and functional changes in the brain produced by a head injury to relate such changes in the condition of the patient after the injury and possible methods of treatment. |
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