Overview - Traumatic Brain Injury (TBI) Treatment

Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object that goes through brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.

Mild traumatic brain injury may affect your brain cells temporarily. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. These injuries can result in long-term complications or death.

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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 may include:

Physical symptoms

Headache
Nausea or vomiting
Fatigue or drowsiness
Problems with speech
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, behavioral or mental 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
Memory or concentration problems
Mood changes or mood swings
Feeling depressed or anxious
Difficulty sleeping
Sleeping more than usual

Moderate to severe traumatic brain injuries

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

Cognitive or mental symptoms

Profound confusion
Agitation, combativeness or other unusual behavior
Slurred speech
Coma and other disorders of consciousness

Children's symptoms

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 ability to pay attention
Change in sleep habits
Seizures
Sad or depressed mood
Drowsiness
Loss of interest in favorite toys or activities

When to see a doctor

Always see your doctor if you or your child has received a blow to the head or body that concerns you or causes behavioral changes. Seek emergency medical care if there are any signs or symptoms of traumatic brain injury following a recent blow or other traumatic injury to the head.

The terms "mild," "moderate," and "severe" are used to describe the effect of the injury on brain function. A mild injury to the brain is still a serious injury that requires prompt attention and an accurate diagnosis.

Causes

Traumatic brain injury is usually caused by a blow or other traumatic injury 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.

Common events causing traumatic brain injury include the following:

Falls
Vehicle-related collisions
Violence
Sports injuries
Explosive blasts and other combat injuries

Traumatic brain injury also results from penetrating wounds, severe blows to the head with shrapnel or debris, and falls or bodily collisions with objects following a blast.

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

Complications

Several complications can occur immediately or soon after a traumatic brain injury. Severe injuries increase the risk of a greater number of 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
Vegetative state
Minimally conscious state
Brain death

Physical complications

Seizures, fluid buildup in the brain (hydrocephalus), infections, blood vessel damage, headaches, vertigo, and sensory problems are some of the physical complications that may occur after a traumatic brain injury.

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 result in paralysis of facial muscles, loss of or altered sense of smell or taste, loss of vision or double vision, swallowing problems, dizziness, ringing in the ear, and hearing loss.

Intellectual problems

Many people who have had a significant brain injury will experience changes in their thinking (cognitive) skills. Traumatic brain injury can result in problems with memory, learning, reasoning, judgment, attention, concentration, executive functioning, problem-solving, multitasking, organization, planning, decision-making, and communication.

Behavioral changes

People who've experienced brain injury may experience changes in behaviors. These may include difficulty with self-control, lack of awareness of abilities, risky behavior, difficulty in social situations, and verbal or physical outbursts.

Emotional changes

Emotional changes may include depression, anxiety, mood swings, irritability, lack of empathy for others, anger, and 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, skin tingling, pain or itching, and trouble with balance or dizziness.

Degenerative brain diseases

The relationship between degenerative brain diseases and brain injuries is still unclear. But some research suggests that repeated or severe traumatic brain injuries might increase the risk of degenerative brain diseases. Degenerative brain diseases can cause gradual loss of brain functions, including Alzheimer's disease, Parkinson's disease, and dementia pugilistica.

Prevention

Follow these tips to reduce the risk of brain injury:

Seat belts and airbags: Always wear a seat belt in a motor vehicle.
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 sports.
Pay attention to your surroundings: Don't drive, walk or cross the street while using your phone, tablet, or any smart device. These distractions can lead to accidents or falls.

Preventing falls

The following tips can help older adults avoid falls around the house:

Install handrails in bathrooms
Put a nonslip mat in the bathtub or shower
Remove area rugs
Install handrails on both sides of staircases
Improve lighting in the home, especially around stairs
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 nonslip 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