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Violence-Related Penetrating Traumatic Brain Injury Associated with Increased Medical Complications

Categories: Substance Abuse

The Question

How do medical complications from violence-related blunt trauma and penetrating traumatic brain injury compare?

Past Studies

Past Studies show that individuals with brain injury are entering inpatient rehabilitation earlier in the recovery process than before. Rehabilitation clinicians need to identify and treat more medical complications and consider how they influence functional recovery. Clinicians state it appears that individuals with violence-related penetrating brain injuries (such as from a bullet wound) appear to experience more medical complications than those with violence-related blunt trauma injuries (such as from a baseball bat). However, at the time of this study this clinical observation had not been researched.

This Study

This study sought to evaluate the occurrence and type of medical complications that occur in violent injuries. The second purpose of this study was to determine if there was a difference in the type and rate of occurrence of these complications between the different types of violent traumatic brain injuries. This study included 317 individuals with violence-related traumatic brain injury from four Traumatic Brain Injury Model Systems of Care rehabilitation facilities. The researchers collected data from the time the individual entered the emergency department through hospital care and inpatient rehabilitation. The participants were divided into two groups, those with blunt-trauma injury (76%) and those with penetrating injury (24%). The researchers compared the data for the two groups.

The researchers found that the penetrating brain injury group appeared to have a greater number of individuals with moderate and severe injuries. Individuals with penetrating injury experienced significantly higher rates of heart and lung system failure, pneumonia, skull fracture, leaking of the fluid that flows throughout the brain and spinal cord, and decreased muscle strength. Individuals with penetrating traumatic brain injury and more severe injury had the greatest number of medical complications.

Who May Be Affected By These Findings

Individuals with violence-related traumatic brain injuries, rehabilitation providers, healthcare providers, insurers, and researchers


These results only pertain to violence-related traumatic brain injuries and may or may not be generalizable to individuals with nonviolent injuries.

Bottom Line

Individuals with penetrating traumatic brain injuries had higher rates of medical complications, especially to the heart, lung, and nervous systems.

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Find This Study


Black, K. L., Hanks, R. A., Woods, D. L., Zafonte, R. D., Cullen, N., Cifu, D. X., Englander, J., & Francisco, G. E. (2002). Blunt versus penetrating violent traumatic brain injury: Frequency and factors associated with secondary conditions and complications. Journal of Head Trauma Rehabilitation, 17, 489-496.


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