Traumatic Brain Injury

What is a traumatic brain injury?

A traumatic brain injury (TBI) is a type of brain injury caused by a blow or penetration to the head. A TBI can occur during a fall, a car accident, from being hit on the head, tackled during a football game, or from a combat-related wound.

After a TBI, nerve cells in the brain may be damaged. The neurons may have trouble doing their job of carrying signals to different parts of the brain. If you have a brain injury, you could have trouble thinking or moving normally. Your brain may also have trouble keeping your body working properly.

Most cases of brain injury that occur each year are mild. A concussion is a minor form of brain injury. But many TBIs can be severe. Severe brain injuries are life-threatening and need emergency care. People who survive severe brain injuries may need a lengthy recovery period. Their symptoms may last for a long time or even for life.

What causes a traumatic brain injury?

A TBI may occur after your head strikes an object or when an object goes through your skull and damages your brain. Many TBIs occur during motor vehicle accidents. Falls, firearms, explosions, and assaults are other major causes.

What are the symptoms of a traumatic brain injury?

TBIs can cause many symptoms, depending on their severity and which part of the brain they affect. These are possible symptoms:

• Loss of consciousness

• Trouble concentrating

• Headache

• Confusion

• Dizziness

• Severe tiredness (fatigue)

• Memory problems

• Trouble thinking

• Mood changes

• Personality changes

• Nausea or vomiting

• Agitation

• Seizures

• Change in sleep patterns

• Trouble waking up

• Problems with coordination

• Weakness or numbness in the arms or legs

How is a traumatic brain injury diagnosed?

Your healthcare provider will ask you questions about how the injury occurred and if you are having any symptoms. They will also likely want to know if you were unconscious after your injury and will ask you questions to evaluate your thought process.

You may need X-rays, a CT scan, or an MRI of your head and neck to assess the extent of the injury.

You may also need a neuropsychological assessment. It may help the provider find specific problems with memory and thinking skills.

How is a traumatic brain injury treated?

A mild brain injury may not need medical care. More severe cases need medical care.

If your injury is severe, you may need surgery to treat bleeding or bruising. After treatment, you may also need rehabilitation. During rehab, therapists may help you regain abilities and skills that were lost due to the injury. For instance, you may need help learning to speak, move, and take care of yourself again. Social support is also an important part of rehab for you and your family.

What can I do to prevent a traumatic brain injury?

You can take many steps to protect yourself from a TBI:

• Don’t drive when you are under the influence of alcohol or drugs, or when you're too tired.

• Always wear a seat belt while in a vehicle. Make sure airbags are in working order in your car.

• Wear a helmet while on a bicycle, motorcycle, or horse. Also wear a helmet during contact sports, such as football, and when riding skates or a skateboard, or while batting during baseball or softball.

• Take precautions to prevent falls around your home.

• Keep guns unloaded and locked away.

• Never work on a ladder if you feel dizzy or lightheaded. Alcohol can make you dizzy. Some medicines also can make you dizzy or affect your balance.

• Have your vision checked at least once a year. Poor vision can increase your risk for falls and other types of accidents.

• If you have diabetes and have numbness in your feet, don't walk in poorly lit areas.

For children:

• Buckle your child into the appropriate child safety seat every time the child rides in a car.

• Never shake a baby.

• Use safety gates and window guards to keep children safe from falling out of windows or down stairs.

Living with a traumatic brain injury

This type of injury may cause long-term changes. It may affect your thinking, your mood, or your ability to think, see, or hear normally. If these changes are bad enough, you may need help with your daily activities.

Protect your head. Take extra care not to do anything that could put you at risk for another head injury.

Take it slow. Get plenty of rest and take time needed for your brain to heal. The brain is slow to recover. Also don't drive a car or ride a bike until your healthcare provider approves. You may have a delayed reaction time after suffering a brain injury. Don't take part in sports or other physical activities after a concussion or other TBI until your provider says it's safe. Often people start with very mild exercise before going on to normal activity.

Use memory aids. Use notes, a white board, alarm clocks, calendars, and your mobile phone to help you remember important events or activities. Search the web for helpful memory apps you can download to your phone or computer.

Evaluate and adapt job or school tasks. Depending on your disability, your employer or school may be able to make some accommodations for you to continue work. Consider options with a flexible schedule or part-time work Reduce distractions and clutter in your work area and make daily "To Do” lists. Take notes or ask to use a tape recorder to help you remember things. Ask for less stressful assignments that have a flexible deadline.

Get support. Consider joining a local support group or find one online. Sharing your story and learning how others manage their condition can help.

When should I call my healthcare provider?

Call 911 or go to the emergency room if you have any type of severe head injury or if you lose consciousness after a blow to the head. You should also get help right away even after a mild head injury if you have any of these symptoms:

• Headache that gets worse and does not go away

• Weakness, numbness, or decreased coordination

• Nausea or vomiting

• Slurred speech

• Confusion

• Drowsiness

• Convulsions or seizures

• Fluid dripping from the nose or ear

These could be signs of a serious condition that needs treatment right away.

Key points about a traumatic brain injury

• Traumatic brain injuries are caused by a blow or a jolt to the head. They can range from mild to severe.

• Symptoms can range from headache, dizziness, or trouble thinking to nausea, vomiting, seizures, or loss of consciousness.

• Severe injuries need emergency medical treatment right away, which might include surgery. People with severe injuries may have a long recovery period.

• Even mild head injuries may affect your thinking, your mood, or your ability to remember things. It's important to adjust your daily activities so you have time to recover.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.