It is a common misconception that a traumatic brain injury (TBI) is like a broken bone: an injury with an isolated source, easily identifiable physical implications, and short-term impairment of the affected area. In reality, however, a brain injury is far more complicated. As neurologists Brent E. Masel and Douglas S. DeWitt describe it, a TBI is “a disease process, not an event.” This means that a brain injury is not the “final outcome of an insult to an isolated body system,” but a “chronic disease” that requires ongoing (and perhaps lifelong) treatment and consideration.

“TBI increases long-term mortality and reduces life expectancy,” Masel and DeWitt write in an abstract on the subject. “It is associated with increased incidences of seizures, sleep disorders, neurodegenerative diseases, neuroendocrine dysregulation, and psychiatric diseases, as well as non-neurological disorders such as sexual dysfunction, bladder and bowel incontinence, and systemic metabolic dysregulation that may arise and/or persist for months to years post-injury.” The purpose of these observations, the men say, is not to dishearten those who face such obstacles, but to encourage them to treat their injury as a chronic illness rather than a temporary ailment. In a similar fashion, the men’s purpose is to encourage insurance providers to consider traumatic brain injury a process. If the chronic nature of TBI can be recognized by insurance companies and government organizations alike, “research can be directed at discovering therapies that may interrupt the disease processes months or even years after the initiating event,” they say.

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