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Domestic violence victims likely suffer a higher rate of brain trauma than football players and soldiers, but the exact number is unknown because many of these injuries, which overwhelmingly occur in women, are never diagnosed, according to the New York Times.
“People might think, someone smacked her in the head or pushed her, no big deal,” says Dr. Eve M. Valera, associate professor of psychiatry at Harvard University and a leading expert on traumatic brain injuries among domestic violence survivors.
In 1990, Dr. Gareth Roberts evaluated the brain of a 76-year-old woman who died after years of abuse from her husband who was reported to have become ‘demented’ in her final years, according to the news outlet.
But he discovered on autopsy that her brain was similar to those patients with Alzheimer’s and compatible “to a degree” with boxers who suffered from chronic traumatic encephalopathy, and the case became the first connection in the literature between neurogenerative disease and abused women, according to the Times.
Intimate partner violence (IPV) includes physical, sexual or psychological abuse in a romantic relationship that approximately one in four women or one in 10 men have experienced as sexual or physical violence and/or stalking during their lifetime, according to the Centers for Disease Control and Prevention.
Strangulation is defined as the external obstruction of blood vessels and/or airflow in the neck resulting in loss of oxygen, according to The Training Institute on Strangulation Prevention.
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Approximately 68% of IPV victims experience near-strangulation, but only half have visible signs of trauma with only 15% of those who do show evidence of injuries subsequently photographed to document the abuse, per the Institute.
But loss of consciousness can occur within seconds and death can follow within minutes during strangulation, with the Institute noting the odds increase by 750% for an IPV survivor of one strangulation to be killed compared to someone who has not been strangulated.
Common signs of strangulation include petechiae (small red spots caused by bleeding under the skin) on the face, eyeballs and eyelids, swelling, scratch marks and abrasions around the neck, according to a Strangulation in Intimate Partner Violence Fact Sheet.
The fact sheet also notes victims may complain of memory loss, dizziness, headaches, a hoarse voice, difficulty swallowing or breathing.
Because of these symptoms, victims may have difficulty processing the event and often don’t report it to the police, so many domestic assaults largely go unnoticed, per the Times.
The frequency and severity of the symptoms makes it ” … difficult to think through or cope with the complex, often formidable organizational tasks required for battered women to stop the violence, disengage from violent partners and/or establish independent lives,” said the authors of a domestic abuse 2002 study, where almost all participants had suffered head trauma with 40% losing consciousness.
Even though most of the research regarding concussions and neurogenerative disease comes from studying male brains, some of the research suggests women are more susceptible to concussions in part because males have more muscular necks to cushion a blow to the head and women have leaner nerve fibers, known as axons, that shear more easily during trauma, according to the Times.
But women also may be more vulnerable to post-concussive symptoms because of sex hormones differences with research pointing to a progesterone disruption that occurs possibly because of impact on the pituitary gland in the brain. Several studies suggest if a victim happens to be in her menstrual cycle during the traumatic event, she can suffer more anxiety and depression afterward compared to men, per the Times.
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“So much money goes into investigating concussions in sports that those protocols and papers go on to shape the way concussions in general are thought about,” said Stephen Casper, professor of history of Clarkson University.
“There’s no money to be made from studying intimate-partner abuse.”
The Government Accountability Office released a report in 2020 concluding that IPV affects over 30% of men and women in the United States, but acknowledged because the overall prevalence data on these injuries is unknown, this has caused a lack of understanding of the issue.
The Times compares severe brain injuries to powerful earthquakes, but instead of bridges and buildings crumbling, our bones fracture as hemorrhages later erupt with raw painful facial wounds.
“But mild brain injuries are smaller quakes: Books fall off shelves; vases are broken. It’s harder to survey the damage and easy to miss what’s broken, but something is clearly wrong,” the paper said.
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