Overlooking Mild Traumatic Brain Injury Concussion

Recognizing Mild Traumatic Brain Injury Concussion

By Marilyn Lash, M.S.W.

Lash and Associates Publishing/Training, Inc.

Mild traumatic brain injury is often described as a “hidden” condition because too often it is not diagnosed by medical professionals. Consequently, many individuals are unaware that their brain has been injured and do not seek help. Changes in their executive functions and social skills are often confusing to these individuals and their families with no clear cause or explanation for altered abilities and behaviors. Fortunately, the effects are brief for most people and they soon “get back to normal.” For others, however a so called “mild” brain injury has life long consequences that directly contribute to educational, vocational and economic difficulties.

How many people have mild brain injuries?

It’s difficult to come up with an exact number because many people do not seek medical treatment and are not hospitalized. One of the few estimates comes from a National Institutes of Health Consensus Statement on TBI in 1998 that calculated up to 6.5 million people who have been hospitalized with a traumatic brain injury live with significant changes in their lives. It is estimated that 75-85% of them have mild brain injuries. This results in an estimate of 5.5 million people having a mild traumatic brain injury (Gordon & Brown, 2008).

But this large number still misses people who are not treated in the hospital and those who do not seek treatment. For every person with a mild traumatic brain injury who is hospitalized, 3 to 5 other people are not hospitalized (Gordon & Brown, 2008). This increases the number significantly.

Does a mild brain injury have lasting effects?

Only 15% of people with mild brain injuries will have long-term difficulties (Gordon & Brown, 2008). Yet this group may have serious issues that affect their lives. An important study by Silber and colleagues in New Haven, CT compared people with traumatic brain injuries to people with no disability and to people with a physical disability. The findings were striking. Among people with traumatic brain injuries (mostly mild and unidentified):

  • 1/3 more reported poor physical health
  • 2/3 more reported poor emotional health
  • 2/3 more received welfare or disability payments
  • 4 times as many had attempted suicide (Gordon & Brown, 2008).

How do mild brain injuries affect children?

Even though the Individuals with Disabilities Education Act includes a specific category for traumatic brain injury, the numbers of these children who are receiving special education services in school remains very low across all states. Many educators are not adequately trained to distinguish between the symptoms of traumatic brain injury, learning disabilities and emotional disability. One study of students found that 1/3 of students in a special tutoring program for children with a learning disability were in fact children with traumatic brain injuries (Gordon & Brown, 2008).

What about people who abuse substances?

Another study of 850 enrolled in substance abuse programs in New York were screened for traumatic brain injury with significant results. More than 50% reported one or more brain injuries. Of that group, 40% reported symptoms consistent with a mild brain injury (Gordon & Brown, 2008).

This same study found that people with a history of a traumatic brain injury were more likely to have:

  • more than 2 previous episodes of substance abuse treatment
  • a current or past mental illness
  • history of hospitalization for mental illness
  • a parent with alcoholism
  • used cocaine (Gordon & Brown, 2008).


By helping medical professionals, educators, and community staff become more aware of the large incidence of mild traumatic brain injury, early identification and treatment can be improved. This in turn can lead to providing individuals with appropriate treatment, education and social supports to address the immediate and potential long-term effects.


Gordon, W & Brown, M. (2008). Mild Traumatic Brain Injury: Identification, the key to preventing social failure. Brain Injury/ Professional 5:2(8-11).

Recommended reading

This Fact Sheet is based on a special issue on Pediatrics and TBI of the Brain Injury/Professional (vol. 3, issue 1, 2006). Brain Injury/Professional is the largest professional circulation publication on the subject of brain injury and is the official publication of the North American Brain Injury Society (NABIS). Members of NABIS receive a subscription as a benefit of NABIS. Visit www.nabis.org to order the entire issue or become a member.

Books on mild brain injury and concussion discussing symptoms, treatment and recovery from mild TBI are available from Lash and Associates Publishing/Training, Inc.


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