Brain Injury Association of Montana

Publications

Violence and Brain Injuries
by Nell Eby and Mary Car

Reprinted with permission from Quality Matters, Spring 2004, TRIC/PLUK Library.
Edited with permission of the authors.
Original article available at www.pluk.org.

We live in a fast-paced world. Every day we venture forth onto the most dangerous place on the planet – our public highway system, where we all purchase our tickets to the traumatic brain injury lottery. These are chances we take and choices we make. According to the Center for Disease Control, vehicle crashes are the leading cause of traumatic brain injury.

However, there is a difference between our free choice and individuals who make no choice. We are referring to the 1.5 million women in the United States who are violently assaulted every year by an intimate partner. One in four women will be raped or physically assaulted by an intimate partner in her lifetime. Women are more likely than men to be murdered by an intimate partner. American Indian and Alaska Native women are more likely than other racial groups to report being raped or physically assaulted. Traumatic brain injury can occur as a consequence of physical violence. Violence has surpassed vehicle crashes as the leading cause of traumatic brain injury related death, and it is the third ranked cause of traumatic brain injuries overall.

Each year, at least 1.5 million Americans sustain a traumatic brain injury and there currently are at least 5.3 million Americans living with a disability as a result of brain injury. A violence-related traumatic brain injury occurs when a physical assault to the head causes injury or damage to the brain. A traumatic brain injury can change the way a person thinks, acts, feels, and moves his or her body. A traumatic brain injury can result in coma or even death.

The prevalence of women with disabilities being physically, sexually and emotionally abused has reached alarming rates. There is a pervasive sense of urgency among disability advocates, victim advocates and service organizations to confront this issue through collaboration and community response to ending violence against women with disabilities.

Head injuries are a common occurrence to women in domestic violence situations. Men who beat women frequently target the back of the head to avoid bruising that would be apparent to onlookers.

Strangulation, often referred to as “choking,” can cause a loss of consciousness, and decrease the amount of oxygen that is delivered to the brain, thereby injuring the functioning of the brain.

Women who suffer a traumatic brain injury present a variety of symptoms. Traumatic brain injury is known as the silent epidemic because many of these injuries are not obvious to others. The degradation and deterioration of the quality of life becomes evident when mothers become unable to care for their children, hold down a job or effectively deal with the emotions of daily life. Some symptoms of traumatic brain injury include: headaches, dizziness, inability to concentrate, irritability, confusion, vision or hearing problems, fatigue, memory loss, depression, sleep difficulties, anxiety and mood swings.

Although loss of consciousness is a typical symptom of traumatic brain injury, there does not have to be loss of consciousness for a mild traumatic brain injury to occur. These symptoms create a disruption in daily living and can be either temporary or permanent. Latent symptoms of brain trauma can appear weeks later when the individual experiences cognitive or emotional problems. Rarely will a woman visit her doctor to report an assault, rather she will present other problematic issues such as depression, keeping her from getting the help that she needs.

Information derived from preliminary studies is just beginning to reveal a correlation between the difficulties reported by women who are physically abused and brain injuries from violence. It is known that women who go to the emergency room may not identify themselves as having been abused because of fear or shame. It is also known that the service providers that intend to help those who sustain physical abuse may not always be able to identify who has been abused if they do not ask, if there are no obvious physical signs of injury, or if the women choose not to disclose how they were injured. According to research conducted in 1992, M.K. Feldman reports, “as many as 35% of women who are treated at emergency rooms show signs of abuse, but only about 5% of them are identified as victims”.

Research on traumatic brain injuries and women who experience physical domestic violence needs to continue. The current level of knowledge of traumatic brain injury by the general public is limited. Subjective methods of investigation by law enforcement personnel and diverse methods of assessment and inconclusive documentation by medical providers all point towards a need for standardization of the methodology used to gather relevant and precise data concerning traumatic brain injury. Knowledgeable service providers would increase the repertoire of medical examinations and criminal investigations. Ultimately, standardized data would contribute significantly to the creation of a universally safe environment for women with disabilities.

For more information on violence and brain injuries, visit the Brain Injury Association of Montana at www.biamt.org or the Brain Injury Association of America at www.biausa.org.

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