Traumatic Brain Injury

Traumatic brain injury (TBI) is a sudden, forceful injury to the brain caused by:

• The head being severely jolted
• The head hitting a solid object, like a wall or steering wheel, very hard
• An object penetrating the skull and brain^1,2

The major causes of TBIs are:

• Motor vehicle accidents
• Blasts, such as improvised explosive devices (IEDs)
• Falls
• Sports Injuries
• Violent crimes
• Child Abuse^3,4

Concussion is another term for a mild TBI. People who have a concussion may lose consciousness for a short period of time. They usually recover completely, but it can take anywhere from days to months. In a few people, some symptoms can continue for a longer time.

Symptoms can depend on the area of the brain that was injured and may include any of the following:

• Low-grade headaches that won't go away
• Having more trouble than usual:
  • Remembering things
  • Paying attention or concentrating
  • Organizing daily tasks
  • Making decisions and solving problems
  
• Slowness in thinking, acting, speaking, or reading
• Getting lost or easily confused
• Neck pain
• Feeling tired all the time, lack of energy
• Change in sleeping pattern:
  • Sleeping for much longer periods of time than before
  • Trouble sleeping or insomnia
• Loss of balance, feeling light-headed or dizzy
• Increased sensitivity to:
  • Sounds
  • Lights
  • Distractions
• Blurred vision or eyes that tire easily
• Loss of sense of taste or smell
• Ringing in the ears
• Change in sexual drive
• Mood changes:
  • Feeling sad, anxious, or listless
  • Becoming easily irritated or angry for little or no reason
  • Lack of motivation⁵

A moderate traumatic brain injury occurs when:

• A loss of consciousness lasts from a few minutes to a few hours
• Confusion lasts from days to weeks
• Physical, cognitive, and/or behavioral impairments last for months or are permanent.

Persons with moderate traumatic brain injury generally can make a good recovery with treatment or successfully learn to compensate for their deficits.⁶

A severe TBI may cause unconsciousness, or coma, that lasts for weeks or months. A person who receives a severe traumatic brain injury may never fully recover their prior mental or physical abilities.

There are several classifications of severe brain injury:

• Coma
• Vegetative State
• Persistent Vegetative State
• Minimally Responsive State
• Akinetic Mutism
• Locked-in Syndrome

For more information on these, please visit the Brain Injury Association of America web site at http://www.biausa.org/Pages/types_of_brain_injury.html#severe.

Recovering from TBI requires patience and the support of loved ones and health care providers. To help the brain heal and manage symptoms following a mild or moderate TBI

• Get plenty of rest & sleep
• Increase activity slowly
• Carry a notebook - write things down if you have trouble remembering
• Establish a regular daily routine to structure activities
• Do only one thing at a time if you are easily distracted - turn off the TV or radio while you work
• Check with someone you trust when making decisions⁷

It is also important to avoid things that can slow recovery or increase the chances of another brain injury:

• Avoid activities that could lead to another brain injury - examples include contact sports, motorcycles, skiing
• Avoid alcohol as it may slow healing of the injury
• Avoid caffeine or "energy-enhancing" products as they may increase symptoms
• Avoid pseudoephedrine-containing products as they may increase symptoms - check the labels on cough, cold, and allergy medicines
• Avoid excessive use of over-the-counter sleeping aids - they can slow thinking and memory⁷

Additional Resources:

1. National Institute of Neurological Disorders and Stroke, http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm.
2. Deployment Health Clinical Center (DHCC), http://www.pdhealth.mil/TBI.asp.

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Sources:

1. Centers for Disease Control and Prevention (CDC), "Facts About Traumatic Brain Injury," http://www.cdc.gov/ncipc/tbi/FactSheets/Facts_About_TBI.pdf.
2. National Institute on Deafness and Other Communication Disorders (NIDCD), "Traumatic Brain Injury: Cognitive and Communication Disorders," http://www.nidcd.nih.gov/health/voice/tbrain.htm.
3. NIDCD, http://www.nidcd.nih.gov/health/voice/tbrain.htm.
4. CDC, http://www.cdc.gov/ncipc/tbi/FactSheets/Facts_About_TBI.pdf.
5. CDC, "Facts About Concussion and Brain Injury," http://www.cdc.gov/ncipc/tbi/Section02.htm.
6. Brain Injury Association of America (BIAA), "Types of Brain Injury," http://www.biausa.org/Pages/types_of_brain_injury.html#moderate.
7. Department of Veterans Affairs Mental Illness Research, Education and Clinical Center (MIRECC), http://www1.va.gov/environagents/docs/TBI-handout-patients.pdf.