An Acquired Brain Injury (ABI) is a non-degenerative injury to the brain that has occurred since birth. It can be caused by an external physical force, by disease or by an internal physiological event. There are therefore both:
Traumatic Brain Injury (TBI)
- which includes open, closed or penetrating head injury – and occurs as a result of road traffic accidents, sport or leisure pursuits, assaults, falls or battle; and
Non-Traumatic Brain Injury – which may be caused by:
- strokes and other vascular events, including subarachnoid haemorrhage;
- infectious diseases (eg, encephalitis, meningitis);
- hypoxia (lack of oxygen), often accompanied by ischaemia (lack of blood supply), resulting in a “hypoxic-ischaemic” brain injury after cardiac arrest;
- metabolic derangement, most commonly due to severe hypoglycaemia (low blood sugar); and
- toxic products taken into the body through inhalation or ingestion, for example due to carbon monoxide poisoning.
More is known about the numbers of people with TBI and stroke than those with ABI from other causes.
According to the Department of Health’s National Service Framework for Long Term Neurological Conditions (NSF) (2005) and the National Stroke Strategy (2007):
- about 8000 people of working age are hospitalised in London with a TBI each year
- about 3000-3500 people under 65 (approx 1000 under 50) suffer a stroke each year in London
- there are approx 55,000 people of working age living with the long-term effects of a TBI in London. (there are no comparable estimates for stroke or other forms of ABI.)
Cost to society
Not only the personal but also the economic consequences of ABI are enormous. In the UK the annual costs of direct and informal care and lost productivity after stroke have recently been estimated at £7.0 billion .
The cost of TBI in the UK in 2010 was estimated as approx £4.1 billion (Gustavsson A, Svensson M, Jacobi F, et al). They comment that their estimates were lower than comparable estimates from the USA.
A new report by the Centre for Mental Health – ‘Traumatic brain injury and offending. An economic analysis’ estimates that traumatic brain injury costs £15 billion a year in the UK. This results from lost work contributions, premature death and health and social care costs. It does not, however, include the human costs of head injury on survivors’ and their families’ wellbeing and quality of life, which is clearly the biggest cost.
According to the Centers for Disease Control and Prevention (CDC) in the USA, the annual cost of TBI to society exceeds $76.5 billion – see http://www.cdc.gov/TraumaticBrainInjury/severe.html – and the estimated cost of stroke in the USA was $53.9 billion in 2010. On a simple comparison population basis, the annual cost of TBI in the UK would be about £8.8 billion, and stroke about £6.2 billion.
National Service Framework for Long-Term Neurological Conditions. 2005. Department of Health. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4106042
National Stroke Strategy. 2007. Department of Health. http://clahrc-gm.nihr.ac.uk/cms/wp-content/uploads/DoH-National-Stroke-Strategy-2007.pdf
Gustavsson A, Svensson M, Jacobi F et al. Cost of disorders of the brain in Europe 2010. European Neuropsychopharmacology 2011; 21(10): 718-779.
Traumatic brain injury and offending. An economic analysis, Centre for Mental Health, 2016. https://www.centreformentalhealth.org.uk/traumatic-brain-injury