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My Turn: The concussion too many women ignore

Neurologist: Brain injuries caused by domestic violence disproportionately affect women, and the consequences are devastating.

Javier Cárdenas
AZ I See It
Traumatic brain injuries can affect victims of domestic violence as much as soldiers and sports figures.

The Gulf War thrust traumatic brain injuries into the spotlight as the "signature wound" of the Iraq conflict. Public awareness grew as the media shifted focus to sport-related concussions.

Now we have turned the page to the third chapter in the concussion story: domestic violence.

The population affected in this chapter - largely female, often poor - has suffered in silence. Unlike professional athletes, domestic violence victims live in the shadows.  And unlike professional athletes, these patients rarely have the support, money and other resources needed to get help for their traumatic brain injuries.

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But a pioneering domestic violence program at Barrow Neurological Institute in Phoenix is changing that narrative and we wanted to highlight it during this, Domestic Violence Awareness Month.

The Barrow program, which provides medical care for homeless victims who have sustained a brain injury as result of domestic violence, was created after social worker Ashley Bridwell identified a three-way link between homelessness, domestic violence and traumatic brain injuries.

Focus was on Rice's concussion, not hers

The Barrow medical team has found that many of these victims may lose their jobs and income and eventually become homeless. Although there is no clear or established data, some reports speculate that up to 90 percent of domestic-violence victims may suffer brain injuries.

Many people associate black eyes or broken bones with domestic abuse. Those injuries, while painful, usually heal in time. Traumatic brain injuries are more sinister and may have  devastating long-term effects.

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There are times when sports and domestic violence intersect. This was the case when former Baltimore Ravens running back Ray Rice attacked his then-fiancee in 2014 in an assault caught on camera. But when Janay Rice was knocked out cold in the elevator, the media attention was on how Ray Rice had previous concussions. Almost no one mentioned that the woman in the elevator suffered a brain injury right in front of everybody's eyes.

For the vast majority of domestic abuse victims, the injuries occur in private, and many are never reported.

At Barrow, we are working to bring domestic violence-related brain injuries out of the shadows. Dr. Glynnis Zieman and social worker Bridwell collaborated with me on a study of 115 patients (109 females) with an age range of 4-68 years old. Each had a history of head trauma as a result of domestic violence.

Study: Only 21 percent of women sought help

Dr. Javier Cardenas, a neurologist at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center in Phoenix.  Credit: Brad Armstrong.

Overall, 88 percent reported more than one head injury, Eighty-one percent reported a history of loss of consciousness associated with their injuries and 81 percent reported they had concussion that were "too many to count." Only 21 percent sought medical help at the time of injury.

Headache was the most common chief complaint, but behavioral symptoms were the most severe. Brain injuries sustained over many years may lead to lasting physical, behavioral and cognitive consequences.

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These findings should set off alarms in domestic violence shelters across the country.

The public’s grasp of traumatic brain injuries has evolved significantly in a relatively short time. By better understanding the link between domestic violence and traumatic brain injuries, and treating the victims with dignity and compassion, we can write a positive ending to the latest chapter of traumatic brain injury.

Dr. Javier Cárdenas is a neurologist and director of the Barrow Concussion and Brain Injury Center at Barrow Neurological Institute in Phoenix.