Traumatic Brain Injury
Traumatic Brain Injury (TBI) also known as an intracranial injury is a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. Everyone is at risk for a TBI, especially children, and older adults.
Effects of TBI can include impairments related to thinking or memory, movement, sensation (e.g., vision or hearing), or emotional functioning (e.g., personality changes, depression). These issues not only affect individuals but also can have lasting effects on families and communities.
TBI can result when the head suddenly and violently hits an object or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate or severe, depending on the extent of damage to the brain. Mild cases may result in a brief change in mental state or consciousness, while severe cases may result in extended periods of unconsciousness, coma or even death.
Traumatic Brain Injury Symptoms
Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.
Mild Traumatic Brain Injury
The signs and symptoms of mild Traumatic Brain Injury include:
Physical symptoms
- Loss of consciousness for a few seconds to a few minutes
- No loss of consciousness, but a state of being dazed, confused or disoriented.
- Headache
- Nausea or vomiting
- Fatigue or drowsiness
- Problems with speech
- Difficulty sleeping
- Sleeping more than usual
- Dizziness or loss of balance.
Sensory symptoms
- Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell
- Sensitivity to light or sound.
Cognitive or mental symptoms
- Memory or concentration problems
- Mood changes or mood swings
- Feeling depressed or anxious
Moderate to severe Traumatic Brain Injury
Moderate to severe traumatic brain injuries can include any of the signs and symptoms of mild injury, as well as these symptoms that may appear within the first hours to days after a head injury:
Physical symptoms
- Loss of consciousness from several minutes to hours
- Persistent headache or headache that worsens
- Repeated vomiting or nausea
- Convulsions or seizures
- Dilation of one or both pupils of the eyes
- Clear fluids draining from the nose or ears
- Inability to awaken from sleep
- Weakness or numbness in fingers and toes
- Loss of coordination
Mental Symptoms
- Profound confusion
- Agitation, combativeness or other unusual behavior
- Slurred speech
- Coma and other disorders of consciousness
Traumatic Brain Injury Symptoms In Children
Infants and young children with brain injuries might not be able to communicate headaches, sensory problems, confusion, and similar symptoms. In a child with traumatic brain injury, you may observe:
- Change in eating or nursing habits
- Unusual or easy irritability
- Persistent crying and inability to be consoled
- Change in the ability to pay attention
- Change in sleep habits
- Seizures
- Sad or depressed mood
- Drowsiness
- Loss of interest in favorite toys or activities.
Traumatic Brain Injury Causes
Traumatic brain injury is usually caused by a blow, jolt or other traumatic injuries to the head or body. The degree of damage can depend on several factors, including the nature of the injury and the force of impact.
The common events causing traumatic brain injury include:
- Falls. Falls from bed or a ladder, downstairs, in the bath and other falls are the most common cause of traumatic brain injury overall, particularly in older adults and young children.
- Vehicle-related collisions. Collisions involving cars, motorcycles or bicycles — and pedestrians involved in such accidents — are a common cause of traumatic brain injury.
- Violence. Gunshot wounds, domestic violence, child abuse, and other assaults are common causes. Shaken baby syndrome is a traumatic brain injury in infants caused by violent shaking.
- Sports injuries. Traumatic brain injuries may be caused by injuries from a number of sports, including soccer, boxing, football, baseball, lacrosse, skateboarding, hockey, and other high-impact or extreme sports. These are particularly common in youth.
- Explosive blasts and other combat injuries. Explosive blasts are a common cause of traumatic brain injury in active-duty military personnel. Although how the damage occurs isn’t yet well-understood, many researchers believe that the pressure wave passing through the brain significantly disrupts brain function.
Traumatic Brain Injury Risk factors
The people most at risk of traumatic brain injury include:
- Children, especially newborns to 4-year-olds
- Young adults, especially those between ages 15 and 24
- Adults age 60 and older
- Males in any age group.
Traumatic Brain Injury Complication
Several complications can occur immediately or soon after a traumatic brain injury. Severe injuries enhance the risk of a greater number and more-severe complications.
Altered consciousness
Moderate to severe traumatic brain injury can result in prolonged or permanent changes in a person’s state of consciousness, awareness or responsiveness. Different states of consciousness include:
- Coma. A person in a coma is unconscious, unaware of anything and unable to respond to any stimulus. This results from widespread damage to all parts of the brain. After a few days to a few weeks, a person may emerge from a coma or enter a vegetative state.
- Vegetative state. Widespread damage to the brain can result in a vegetative state. Although the person is unaware of surroundings, he or she may open his or her eyes, make sounds, respond to reflexes, or move. It’s possible that a vegetative state can become permanent, but often individuals progress to a minimally conscious state.
- Minimally conscious state. A minimally conscious state is a condition of severely altered consciousness but with some signs of self-awareness or awareness of one’s environment. It is sometimes a transitional state from a coma or vegetative condition to greater recovery.
- Brain death. When there is no measurable activity in the brain and the brainstem, this is called brain death. In a person who has been declared brain dead, the removal of breathing devices will result in cessation of breathing and eventual heart failure. Brain death is considered irreversible.
Physical Complications
- Seizures. Some people with traumatic brain injury will develop seizures. The seizures may occur only in the early stages, or years after the injury. Recurrent seizures are called post-traumatic epilepsy.
- Fluid buildup in the brain (hydrocephalus). Cerebrospinal fluid may build up in the spaces in the brain (cerebral ventricles) of some people who have had traumatic brain injuries, causing increased pressure and swelling in the brain.
- Infections. Skull fractures or penetrating wounds can tear the layers of protective tissues (meninges) that surround the brain. This can enable bacteria to enter the brain and cause infections. An infection of the meninges (meningitis) could spread to the rest of the nervous system if not treated.
- Blood vessel damage. Several small or large blood vessels in the brain may be damaged in a traumatic brain injury. This damage could lead to a stroke, blood clots or other problems.
- Headaches. Frequent headaches are very common after a traumatic brain injury. They may begin within a week after the injury and could persist as long as several months.
- Vertigo. Many people experience vertigo, a condition characterized by dizziness, after a traumatic brain injury.
At times, any or several of the above symptoms might linger for a few weeks to a few months after a traumatic brain injury. This is currently referred to as persistent post-concussive symptoms. When a combination of these symptoms lasts for an extended period of time, this is generally referred to as post-concussion syndrome.
Traumatic brain injuries at the base of the skull can cause nerve damage to the nerves that emerge directly from the brain (cranial nerves). Cranial nerve damage may lead to:
- Paralysis of facial muscles or losing sensation in the face
- Loss of or altered sense of smell
- Loss of or altered sense of taste
- Loss of vision or double vision
- Swallowing problems
- Dizziness
- Ringing in the ear
- Hearing loss.
Intellectual Complications
Many people who have had a significant brain injury will experience changes in their thinking (cognitive) skills. It may be more difficult to focus and take longer to process your thoughts. Traumatic brain injury can result in problems with many skills, including:
Cognitive problems
- Memory
- Learning
- Reasoning
- Judgment
- Attention or concentration
Executive functioning problems
- Problem-solving
- Multitasking
- Organization
- Planning
- Decision-making
- Beginning or completing tasks.
Communication Complications
Language and communications problems are common following traumatic brain injuries. These problems can cause frustration, conflict, and misunderstanding for people with traumatic brain injury, as well as family members, friends, and care providers.
Some of the communication problems may include:
Cognitive problems
- Difficulty understanding speech or writing
- Difficulty speaking or writing
- Inability to organize thoughts and ideas
- Trouble following and participating in conversations
Social problems
- Trouble with turn-taking or topic selection in conversations
- Problems with changes in tone, pitch or emphasis to express emotions, attitudes or subtle differences in meaning
- Difficulty understanding nonverbal signals
- Trouble reading cues from listeners
- Trouble starting or stopping conversations
- Inability to use the muscles needed to form words (dysarthria)
Behavioral changes
People who’ve experienced brain injury often experience changes in behaviors. These may include:
- Difficulty with self-control
- Lack of awareness of abilities
- Risky behavior
- Difficulty in social situations
- Verbal or physical outbursts
Emotional changes
Emotional changes may include:
- Depression
- Anxiety
- Mood swings
- Irritability
- Lack of empathy for others
- Anger
- Insomnia
Sensory problems
Problems involving senses may include:
- Persistent ringing in the ears
- Difficulty recognizing objects
- Impaired hand-eye coordination
- Blind spots or double vision
- A bitter taste, a bad smell or difficulty smelling
- Skin tingling, pain or itching
- Trouble with balance or dizziness
Traumatic Brain Injury Prevention
There are many ways to reduce the chances of sustaining a traumatic brain injury. See the prevention tips listed below:
Seat belts and airbags. Always wear a seat belt in a motor vehicle. A small child should always sit in the back seat of a car secured in a child safety seat or booster seat that is appropriate for his or her size and weight.
Alcohol and drug use. Don’t drive under the influence of alcohol or drugs, including prescription medications that can impair the ability to drive.
Helmets. Wear a helmet while riding a bicycle, skateboard, motorcycle, snowmobile or all-terrain vehicle. Also, wear appropriate head protection when playing baseball or contact sports, skiing, skating, snowboarding or riding a horse.
Preventing falls
The following tips can help older adults avoid falls around the house:
- Install handrails in bathrooms
- Put a non-slip mat in the bathtub or shower
- Remove area rugs
- Install handrails on both sides of the staircase
- Improve lighting in the home
- Keep stairs and floors clear of clutter
- Get regular vision checkups
- Get regular exercise
Preventing head injuries in children
The following tips can help children avoid head injuries:
- Install safety gates at the top of a stairway
- Keep stairs clear of clutter
- Install window guards to prevent falls
- Put a non-slip mat in the bathtub or shower
- Use playgrounds that have shock-absorbing materials on the ground
- Make sure area rugs are secure
- Don’t let children play on fire escapes or balconies.
Traumatic Brain Injury FAQs
What defines a traumatic brain injury?
A traumatic brain injury (TBI) is defined as a blow to the head or a penetrating head injury that disrupts the normal function of the brain. TBI can result when the head suddenly and violently hits an object or when an object pierces the skull and enters brain tissue.
What causes traumatic brain injury?
Causes include falls, sports injuries, gunshot wounds, physical aggression, and road traffic accidents. The Centers for Disease Control and Prevention (CDC) define a TBI as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.”
Is Traumatic Brain Injury permanent?
Traumatic brain injuries are serious. They cause damage that can be permanent. In some cases, a traumatic brain injury can lead to coma or death. Always seek medical care if you have hit your head.
How do they test for TBI?
To diagnose TBI, health care providers may use one or more tests that assess a person’s physical injuries, brain and nerve functioning, and level of consciousness.
Imaging Tests
- Computerized tomography (CT). …
- Magnetic resonance imaging (MRI). …
- Intracranial pressure (ICP) monitoring.
What is considered a brain injury?
Brain injury refers to the occurrence of an insult to the brain which causes damage.
What happens if TBI is not treated?
Sustaining a concussion or any brain injury can lead to changes in cognitive abilities and control of emotions, mobility, speech, and senses. Left undiagnosed and untreated, a TBI can have a huge impact on how a person thinks and acts, and on his or her mental health.
Can you fully recover from a brain injury?
Recovering from a severe TBI can take a long time. Some people regain consciousness within a few days or weeks and recover quickly. Others progress more slowly and may remain in a state of impaired consciousness for months or years.
What is the difference between ABI and TBI?
TBI is short-form for a Traumatic Brain Injury and ABI is an acronym for an Acquired Brain Injury. An acquired brain injury is a brain injury after birth that is not caused by a congenital defect, degenerative disease nor is hereditary in nature.
It can be a traumatic brain injury, however, it also includes injuries not caused by an external force. Injuries such as tumors, stroke or loss of oxygen to the brain and infections of the brain are examples of an acquired brain injury