Remember the “old man that bumped his head, went to bed, and didn’t wake up in the morning”? Clearly the protagonist of the that slightly dark nursery rhyme suffered a traumatic brain injury.

Did you know that Montana has the second highest rate of Traumatic Brain Injuries (TBIs) in the US? John Bigart, of the Brain Injury Alliance says this startling fact is due to our “work hard play hard mentality”. Montanas ski and snowboard; we ranch and rodeo, paraglide, hike, ride motorcycles and drive arguably dangerous roads. Ice and snow doesn’t slow us down. We have a large population of veterans. Much of our population is blue collar workers and work jobs that come with a high level of risk. Our community runs off of “get her done”, shake off the dust, and look for the next adrenaline rush. And, unfortunately, our heads often suffer the consequences.

Traumatic Brain Injuries are defined by the CDC as any injury to the head that disrupts the normal function of the brain. It is estimated that every year over 2.8 million people suffer a TBI, with more than 50,000 of those resulting in death. That’s 153 deaths a day from “bumps to the head”.

TBIs are classified as mild or severe. Severe TBIs are defined by a head injury resulting in a loss of consciousness of over 30 minutes and symptoms such as dizziness or memory loss that prevail for over 24 hours. The results of severe TBIs can be obvious and devastating. They include loss of cognitive or physical function, long term memory loss or disorientation, comatose states, and/or death.

Mild TBIs are defined as a loss of consciousness from zero to thirty minutes. Symptoms can include dizziness, headaches, confusion, and loss of memory. Mild TBIs often do not appear on MRI’s or Cat Scans and can be missed in initial diagnostics, especially when they accompany other more obvious injuries. Though they are called “mild” the long term effects are often profound. Fifteen percent of people who suffer mild TBIs have symptoms that last longer than a year. Additionally, brains injuries are slow to heal and can become compounded over time. Many mild TBIs can present with the same symptoms and brain damage as one severe TBI. Small continual blows to the head can result in worse symptoms than one isolated severe blow.

Unfortunately there is no direct cure for a TBI. Both initial and long term treatment depends on the severity of the TBI. Initially life saving measures may have to be taken that include surgery, monitoring vitals, and repairing bleeding blood vessels within the brain. After a patient is stabilized the often long road to recovery beings. Treatment plans depend highly on the severity of the injury, the individual, and the long term symptoms. A combination of physical, speech, and occupational therapy is used to regain memory, body function, and cognitive ability. Additionally for many survivors, psychotherapy is often needed to address the emotionally challenging road to recovery. Many survivors find sollance in meeting with a counselor such as those found at the nCenter.

The nCenter also offers a unique and developing approach to treating TBIs. Neurofeedback has shown promising results as a treatment method. Psychologist Sarah Gray’s 2017 paper on the use of neurofeedback to treat TBIs states “[neurofeedback may aid in] reduction of symptoms related to attention, mood, and mindfulness.”

The take-away? TBIs, especially when mild, are often overlooked but can have dramatic and long term effects on an individual. The Montana way of life puts us at a high risk for suffering a TBI. Luckily TBIs can be easy to prevent– helmets, seatbelts, and other safety precautions dramatically decrease TBI rates. Additionally, there are resources to aid survivors on the road to recovery.  Some of these resources include the nCenter and Brain Injury of Montana. Research on preventing and treating TBIs is continual, and there is indication that neurofeedback is beneficial in treating a TBI. Throughout the state of Montana there are support groups for those suffering from brain injuries, to learn more check out the Brain Injury Alliance of Montana at And whether skiing, driving, or riding, make sure you protect your noggin’ this winter!


Blog by: Katlian Afton

Photo Courtesy of: Eric Stratton