Skip to Content
All Media
All Media

Traumatic Brain Injury in Latin America

Categories: ACBIS Insider

By Juan Carlos Arango Lasprilla, PhD and Melina Longoni Di Giusto, MD

In contrast to the US and Canada, no national records exist on the incidence of traumatic brain injury (TBI) in Latin American countries. Public health TBI studies based in Mexico, Ecuador, Argentina, and Brazil have provided an opportunity to understand the incidence in Latin America1-4. For every 100,000 individuals, roughly 70-360 new individuals sustain a TBI with most occurring due to road-traffic accidents as well as violence5-8. Trauma-related deaths in Latin America are estimated to be 75.5 per 100,000 people6.

Many Latin-American countries experience a number of risk factors that exacerbate the increasing mortality rate, such as under-staffed and under-resourced health systems, lack of preventative measures, socioeconomic disadvantage, and residing in areas plagued with sociopolitical conflicts. Poor health care systems result in disparate access to hospitals due to the lack of regionalization, which causes an unequal distribution of patients across the available hospitals9. An emergency transport system is not well organized, which results in delays in receipt of needed care. In contrast to the US, where air transport is the norm for the most severe trauma cases, most Latin American countries rely on land transport causing significant delays. Under-staffed and under-resourced hospitals may not have sufficient beds available in their intensive care units (ICU), enough qualified medical personnel and specialists (e.g., neurosurgeons) to provide the highest level of care, and financial resources to provide needed treatments or use the latest diagnostic tool or intervention technologies. Similar to the US, urban settings have greater access to staff and resources, while suburban and rural areas experience significant disparities to healthcare and access to care. Without long-term care follow-up or specialty neurotrauma care, the risk for severe disability and increasing costs to all involved – the person with TBI, the family, the healthcare system, and the society as a whole10.

Universal public healthcare is nearly nonexistent in most Latin-American countries. Countries that are working towards universal healthcare, include but are not limited to Argentina, Colombia, Brazil, and Mexico, but often do not have the needed financial protections to keep medical bills low11. Panama has one of the highest levels of healthcare coverage with 85% coverage. One of the challenges is that each country decides on how they will work towards universal healthcare coverage. The reality is that a high percentage of people are without healthcare coverage in Latin America. Places like Bolivia (35%), Paraguay (46%), Argentina (48%), and Uruguay (53%) have the lowest coverage within a public healthcare system. As one can imagine, economically disadvantaged individuals within these countries are at the lowest likelihood of receiving rehabilitation12. Not until recently have physical medicine and rehabilitation physicians (physiatrists) been incorporated into select hospitals in a few Latin American countries.

With significant cognitive, behavioral, emotional, and physical changes following TBI, rehabilitation services are scarce and result in a major financial burden for family members. Since there are limited rehabilitation hospitals specialized for brain injury, the vast majority of patients return home to be cared for by their loved ones. Family is an important value of the Latin American culture, and families assume responsibility for the care and well-being of their loved one with TBI. Caregivers assume a significant burden due to the lack of financial resources and social supports13. Access to health information and support from their community or healthcare professionals are highly-rated family health needs mentioned by caregivers14-16. Brain injury professionals must collectively advocate for improved TBI prevention and care in Latin America and across the globe. Below we provide examples of four core areas to implement strategies to improve TBI care and outcomes in Latin American countries that could also serve as a guide to better support individuals of Latin American descent around the world:

  • Improve TBI prevention and early intervention through legislation of public health measures (e.g., helmets and seatbelts) and workplace safety, finance the improvement and maintenance of road infrastructures, expand pre-hospital services (e.g., ambulance services), and strengthen neurotrauma care and personnel (e.g., CT scanners and neurosurgeons).
  • Improve in-hospital and follow-up TBI care through an increase in the rehabilitation workforce (e.g., physiatrists, psychologists, occupational therapists, physical therapists, and speech and language pathologists), develop more specialized inpatient/outpatient rehabilitation services, and create national trauma registries.
  • Build workforce development within the neurotrauma and neurorehabilitation professional community to share best practices, offer quality brain injury training, and develop specialized post-graduate and continuing education programs.
  • Guide and advance the field on the development, testing, and research of culturally appropriate and culturally relevant assessments, tools, and interventions for use by Latin American individuals with brain injury.

The Academy of Certified Brain Injury Specialists strives to improve the quality of care for individuals with brain injury. Are you interested in becoming certified as a brain injury specialist? Learn more.



  1. Murray CJL, Lopez AD, World Health Organization, World Bank, Harvard School of Public Health. Global health statistics : a compendium of incidence, prevalence and mortality estimates for over 200 conditions. 1996.
  2. Ortiz-Prado E, Mascialino G, Paz C, et al. A Nationwide Study of Incidence and Mortality Due to Traumatic Brain Injury in Ecuador (2004-2016). Neuroepidemiology. 2020;54(1):33-44. doi:10.1159/000502580
  3. Marchio PS, Previgliano IJ, Goldini CE, Murillo-Cabezas F. [Head injury in Buenos Aires city: a prospective, population based, epidemiologic study]. Neurocirugia (Astur). 2006;17(1):14-22.
  4. Ferreira de Andrade A, Marino R, Ciquini O, Gadelha Figueiredo E, Guelman Machado A. Guidelines for neurosurgical trauma in Brazil. World J Surg. 2001;25(9):1186-1201. doi:10.1007/s00268-001-0081-9
  5. Bárcena-Orbe A, Rodríguez-Arias CA, Rivero-Martín B, et al. Revisión del traumatismo craneoencefálico. Neurocirugia. 2006;17(6):495-518. doi:10.1016/s1130-1473(06)70314-1
  6. Charry J, Cáceres J, Salazar A, López L, Solano J. Trauma craneoencefálico. Revisión de la literatura. Rev Chil Neurocir. 2017;43:117-182.
  7. Pueblo D. Daño cerebral sobrevenido en España: un acercamiento epidemiológico y sociosanitario. Inf del Defensor, Madrid. 2005.
  8. Jaramillo FJ, González G, Vélez P, Bran ME, Restrepo D, Duque A. Factores de riesgo asociados con letalidad y complicaciones tempranas en pacientes con trauma craneoencefálico cerrado. Colomb Med. 2001;32(1):49-56.
  9. Gosselin R. Injuries: The neglected burden in developing countries. Bull World Health Organ. 2009;87(4):246.
  10. Rubiano AM, Puyana JC, Mock CN, Bullock MR, Adelson PD. Strengthening neurotrauma care systems in low and middle income countries. Brain Inj. 2013;27(3):262-272. doi:10.3109/02699052.2012.750742
  11. Gilardino, R.E., Valanzasca, P. & Rifkin, S.B. Has Latin America achieved universal health coverage yet? Lessons from four countries. Arch Public Health 80, 38 (2022).
  12. Bonow RH, Barber J, Temkin NR, et al. The Outcome of Severe Traumatic Brain Injury in Latin America. World Neurosurg. 2018;111:e82-e90. doi:10.1016/j.wneu.2017.11.171
  13. Coy AE, Perrin PB, Stevens LF, et al. Moderated mediation path analysis of Mexican traumatic brain injury patient social functioning, family functioning, and caregiver mental health. Arch Phys Med Rehabil. 2013;94(2):362-368. doi:10.1016/j.apmr.2012.08.210
  14. Arango-Lasprilla JC, Quijano MC, Aponte M, et al. Family needs in caregivers of individuals with traumatic brain injury from Colombia, South America. Brain Inj. 2010;24(7-8):1017-1026. doi:10.3109/02699052.201 0.490516
  15. Leibach GG, Trapp SK, Perrin PB, et al. Family needs and TBI caregiver mental health in Guadalajara, Mexico. NeuroRehabilitation. 2014;34(1):167-175.
  16. Stevens LF, Perrin PB, Hubbard R, Díaz Sosa DM, Espinosa Jove IG, Arango-Lasprilla JC. Using multiple views of family dynamics to predict the mental health of individuals with TBI and their caregivers in Mexico. NeuroRehabilitation. 2013;33(2):273-283. doi:10.3233/NRE-130955


Stay connected with the brain injury community!

The Brain Injury Association of America has many educational opportunities, events, and resources that are shared throughout the year. Be sure to stay in the know by joining our mailing list.

Sign up for updates