NOAA

According to new research on injuries sustained during twisters, brain damage and busted spines are common; impalements by flying wood less so.

We're only a week away from May, the tumultuous month with the highest historical frequency of tornadoes in America. If you have the misfortune this spring to be caught in one of these whirling horrors, what kind of bodily damage can you expect to suffer?

It's a macabre question, perhaps, but one of significant interest to the medical community. This week, physicians at the University of Alabama at Birmingham's Medical Center released a report detailing the injuries sustained by people caught up in the terrible Birmingham/Tuscaloosa tornado of April 27, 2011. Though twisters can cause an impressive range of awful and crippling injuries, the people who wrote the report are neurosurgeons, so the woundings they describe are particularly painful-sounding – mainly spine damage with a few cranial dents to boot.

The twister that struck Tuscaloosa and Birmingham was one of 62 to touch down in Alabama during the worst tornado outbreak in America's known history. This one wind funnel caused an estimated $2.2 billion in damages and killed 64 people (the death toll for the state was 248). It was an EF-4 spinning winds as fast as 190 m.p.h, blazing an 80-mile path through the land that measured 1.5 miles wide at one point. Here's the scar it left:

(National Weather Service)

And commentary from a rightfully freaked-out TV meteorologist:

Living as they do in one of the most deadly states for tornadoes, Alabamians are well acquainted with the maulings that emerge after a bad twister. A reporter at The Birmingham News wrote a fairly comprehensive description of possible injuries from tornadoes: "They employ bricks, 2-by-4s and chunks of trees to snap necks, crush ribs and bash skulls. They pelt and penetrate the flesh with shards of glass, sticks and stones. They fling human beings through the air like rag dolls."

Lots more can happen – you can be impaled by flying wood, which is what happened to two people in Alabama's Jefferson County during the outbreak. Or you might be trapped beneath falling walls or furniture and expire from suffocation, as did three Jefferson residents that chaotic April. As it so happens, most deaths from tornadoes are the result of head injuries, according to a review of the past 50 years of literature.

Of the roughly 340 people killed during the four-day outbreak, about 22 percent died from traumatic brain injuries. These unlucky souls probably died instantly or in the period immediately after the disaster, never making it to a hospital, say the Birmingham trauma center's physicians. In Birmingham, 27 patients received neurological consultations for a "wide variety of fractures as a result of being thrown or crushed during the tornado." Nearly two dozen incurred spine and spinal cord damage, four suffered intracranial injuries and two won the lottery with both kinds of abuse.

Images of a 29-year-old man in the Birmingham/Tuscaloosa tornado who "sustained an impressive L1–2 fracture dislocation (A and B) resulting in spondyloptosis and an AIS Grade A on the motor examination." Images C and D show the surgeons' repair job.

The physician's full report lists a number of bodily deformations that they encountered, none of which you should Google Image: traumatic spondylolisthesis, cerebral contusions with diffuse traumatic subarachnoid hemorrhaging, open depressed skull. They write:

The majority of injuries were the result of being thrown or crushed while taking cover. The mechanisms of injury were oftentimes incredible. Many patients suffered significant injuries while using their bodies to protect their children or loved ones. Many were found outside of their homes and some were found more than 100 yards from where they had taken cover. The CDC found that 40% of the dead were found outside their homes.

Oddly, children who were hurt in by this tornado showed a higher prevalence of brain injuries than adults. The physicians offer no guesses on why that was the case.

So when you hear about a tornado warning in your region, should you worry about an impending busted spine? Not if you take the right steps and get to a safe room, basement or, if you have the misfortune to be out in the open, a ditch. The risk of injury also has much to do with the strength of the tornado. It's usually the extremely rare EF-4 and EF-5 twisters that cause the worst damage, with almost 90 percent of the deaths during the 2011 outbreak linked to these meteorological behemoths.

If you want to be on the safe side, doctors in Birmingham have a low-tech safety precaution you might want to try: Wear a helmet. They're absolutely serious. ""Many types of helmets will work: motorcycle helmets, bicycle helmets, football and baseball helmets, even hard hats used by construction workers," according to a PSA from the University of Alabama, which adds the unfortunate pun: "Using a helmet to protect your head in a tornado is a NO BRAINER!"

Top photo courtesy of NOAA

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