26%   Recreation - mainly sports injury: chiefly boxing but includes

                      football, soccer, basketball and activities like pole-vaulting

                      and diving.

          25%   Motor Vehicle Accident (MVA)

          17%   Assault - Post-concussive syndrome.

          14%   Falls - among the most common are falling sideways by the

                      elderly, slipping, tripping, postural HTN and obesity.

            6%   Drug & Alcohol Poisoning The following agents are known

                      to cause neurological pathology:

                         Alcohol - cortical atrophy = loss of IQ.

                         Amphetamine - multiple brain chemistry abnormalities and

                            neuroimaging shows dopaminergic damage as well as

                            neurotransmitter transportation anomalies. Included

                            gliosis leads to plaque formation (“drying of the brain”)

                            and predisposition to early dementia. Neurotoxic

                            stimulants induce psychosis that rarely tapers to baseline

                            after cessation of use. Decrease of inhibitory control

                            leads users to risk-taking behavior.    

                         Cannabis/Hashish - mild psychosis, apathy, immuno-

                            suppression related brain tumors, loss of insight (while

                            believing the opposite), pseudo-philosophy, lowered

                            testosterone and breast development in males, brain

                            lesions, decreased ability to store new information,

                            decreased libido, amotivation, acquired pacifism,

                            impaired left and right hemispheric brain collaboration

                             (loss of insight and capacity to connect between cause

                            and effect).

                         CNS depressants (heroin, drugs of the morphine type,

                            benzodiazepines and barbiturates) - cloud judgment,

                            impede insight, cell density loss secondary to respiratory

                            depression (cerebral hypoxia) and deterioration of white

                            matter that undermines the ability to regulate behavior.

                            Narcotic overdose always results in permanent brain


                         Cocaine (any form)  -  dysrhythmia, chaotic distribution of

                            blood flow in the brain (hypoxic periods), hypertension,

                            stroke, permanent damage to cerebral vasculature.

                         Ecstasy (MDMA) - neurotoxicity includes destruction of

                            serotonin axon terminal–any regrowth is abnormal–cells

                            involved in memory retention and problem-solving.

                          Gamma Hydroxybutyrate (GHB). Similar negative impact

                            on the brain as other CNS depressants, which is

                            chemically induced nerve cell pruning.

                         Hallucinogens - N,N-Dimethyltryptamine (DMT),

                            dextromethorphan (DXM), LSD, Ayahuasca, Salvia.

                         Inhalents (glue, correction fluid, white board cleaner,

                            refrigerant, permanent markers,hair spray, paint thinner,

                            toluene and other solvents) - brain hypoxia and

                            demyelination of nerve fibers leads to motor dysfunction

                            (slowed movement and clumsiness that mimics MS) and

                            short-term memory impairment (inability to properly

                            register and store new information = chemically induced

                            learning disorder), diminished intelligence, damage to

                            brain’s audio processing. (Kidney damage.is common.)

                         Ketamine - MRI scans now evidence brain lesions and

                            atrophy in the frontal parietal and occipital cortices,

                            caused by abuse of this hypnotic.

                         Methamphetamine (more potent form of amphetamine:


                         Peyote (Mescaline), psilocybin (“magic mushrooms”) -

                             long term users score higher for cluster A scales

                            (psychoses), especially the increasingly common

                            schizotypal personality trait with enduring mild psychosis

                            and seemingly random episodes of disorganized thinking,

                            paranoia and visual disturbances.

                          Rohypnol (flunitrazepam) - this potent benzodiazepine

                            impairs memory.

                         Steroids - brain tumors, shortened life-span, irreversible

                            male pattern baldness. MALES: testicular atrophy,

                            gynecomastia (breast development). FEMALES: coarse

                            skin, clitorus enlargement, excessive body hair, voice

                            pitch lowered.

                         Tobacco - while stimulating the brain, the toxic effects of

                            the 7,000 chemicals in tobacco cause free radical

                            damage in brain tissue. Studies now link macular

                            degeneration with tobacco product use. Snuff and

                            chewing tobacco are less toxic but still associated with

                            disfiguring cancers.

                         Stimulants (Rx) - same as amphetamines if not prescribed

                            in lower therapeutic doses.

            4%   Motorcycle Accident (MCA)

            3%   Cycling - helmets reduce the severity of brain damage but do

                      not prevent TBI.

             3%   Shaken Infant - following a subdural hematoma and brain

                      swelling, delayed development, visual impairment, motor

                      dysfunction and a variety of cognitive difficulties typically

                      ensue shaken impact syndrome. While the brain

                      compensates for loss of brain cells due to destruction best

                      before the age of three–providing the abuse ceases–scar

                      tissue cells from inflammation predisposes the individual to

                      early dementia in later life.

            2%   Toxic Fumes - working with solvents, paint, and poorly

                      ventilated garages, where carbon monoxide fumes

                      concentrate. See “Inhalents” for a brief list of consequences.
             ?%   The following are not well reported: general anesthesia                        (depressed metabolic rate of oxygen in the brain and

                      neuronal apoptosis; estimated 21 million/yr in a pop of 319

                      million = 6.58%); epilepsy also a sequela of TBI; brain

                      tumors; stroke (CVA); brain aneurysm; encephalopathy,

                      including hepatic encephalopathy; non-fatal myocardial

                      infarction (MI); neurological disease (Alzheimer’s);

                      attempted suicide; radiation from CT scans and X-rays

                      (more than one every 2-3 years); survivors of choking,

                      drowning, suffocation and strangulation; hyperthermia (heat

                      stroke) & hypothermia; neuroleptic medication (high doses

                      in chronic use cause brain shrinkage); obstructive sleep

                      apnea (SA) has been shown to cause progressive loss of

                      “gray matter” (cerebral cortex) that results in poor memory,

                      emotional disturbances and increased cardiovascular

                      disturbances. Use of a CPAP device can reverse most of

                      the damage; severe asthma attack, electric shock with loss

                      of consciousness; prolonged exposure to high altitude; blood

                      loss, including internal hemorrhage.


                       Other unknown causes are animal related; hypoxia/anoxia

                      at birth; cardiac arrest (est. 735,000/yr = 0.3%); parental

                      abuse, such as striking a child's head.

                                                 Year: 2014
                                                 Deaths: 52,000
                                                 Hospitalizations: 275,000
                                                 ER Visits: 1.4 million
                                                 Concussion: > 75%
                                                 Cost: 76.5 billion


 Sources: Data averaged and compiled from meta-analysis of published literature by

 U.S. National Library of Medicine, CDC and reporting US governments agencies. The

 figures are averaged, since non-traumatic brain injuries herein, such as poisoning, are

 combined with the traumatic type (TBI). Males are approximately twice as likely to

 suffer brain injury after birth.