From Impact to Healing: What You Need to Know
According to the Centers for Disease Control and Prevention, approximately 75% of all traumatic brain injuries (TBIs) are classified as mild. These are commonly known as concussions. However, some TBIs – often interchangeably called brain injuries or head injuries – can have profound effects. Understanding their causes is important to help with prevention and care. They can include:
- An outside force such as a bump, blow or jolt to the head
- An object entering the brain
- A forceful hit to the body that causes the brain to move back and forth quickly
This force to the head or body can cause the brain to bounce or twist in the skull or create chemical changes in the brain. It can also cause the brain cells to stretch and become damaged.
Unfortunately, moderate or severe TBIs can lead to disability and even death. Some of the causes of more-serious TBIs can include:
- A fall, especially among older adults (ages 75 and older)
- A firearm-related injury
- Motor vehicle accidents
- Assaults
TBIs are considered either primary, meaning the damage is immediate, or they are considered secondary, meaning they can happen gradually over the course of hours, days and even weeks after injury. Secondary TBIs arise from the body’s responses following the initial head injury.
There are two main types of TBIs:
- Penetrating TBI (also known as an open TBI) happens when an object punctures the skull (such as a bullet, shrapnel or bone fragment) and enters the brain tissue. Penetrating TBIs usually damage only part of the brain.
- Non-penetrating TBI (also known as closed-head injury or blunt TBI) is caused when external force is strong enough to move the brain within the skull. Causes include falls, motor vehicle crashes, sports injuries, blast injuries (an injury resulting from direct or indirect exposure to an explosion) or being hit by an object.
What are the signs and symptoms of a TBI?
The symptoms of a TBI are different for everyone and may impact the way you feel, think, act or sleep. Headache, dizziness, confusion and fatigue tend to start immediately after an injury but may resolve over time. Emotional symptoms such as frustration and irritability can develop during recovery. Seek immediate medical attention if the person affected experiences any of the following symptoms within the first 24 hours after a head injury:
Physical
- Sensitivity to light or noise
- Headaches
- Convulsions or seizures
- One pupil larger than the other or dilation
- Dizziness or having trouble balancing
- Feeling tired or having a lack of energy
- Clear fluids draining from nose or ears
- Slurred speech
- Weakness in arms, legs or face
- Loss of balance
- Early nausea and/or vomiting
- Vision issues
Cognitive
- Loss of or change in consciousness for anywhere from a few seconds to a few hours
- Unable to be woken up easily
- Confusion or disorientation
- Trouble concentrating or paying attention
- Brain fog/not being able to think clearly
- Short- or long-term memory issues
- Grogginess
Social or Emotional
- Anxiety
- Irritability
- Getting angry easily
- Feeling overly emotional
- Sadness
Sleep Problems
- Being unable to fall asleep
- Sleeping more than normal
- Sleeping less than normal
Symptoms can also change as you recover. For example, at first, you might have headaches and feel sick to your stomach. A week or two later you may notice you feel more emotional than usual or have trouble sleeping.
What are the symptoms of a moderate to severe TBI?
As with a minor TBI or concussion, the symptoms of a moderate to severe TBI are different for each person and can change as recovery progresses. Most people who experience a moderate to severe TBI usually have one or more of the following symptoms:
Cognitive
- Problems thinking clearly or concentrating
- Difficulty learning new skills
- Trouble communicating
- Memory problems
Motor Skills, Hearing and Vision
- Weakness in arms and legs
- Coordination and balance issues
- Problems hearing or seeing
- Changes to sensory perception (touch)
Emotional Changes
- Anxiety and nervousness
- Feeling more emotional, frustrated or angry than usual
- Feeling sad or depressed
Behavioral Changes
- Changes in personality
- Difficulty controlling oneself
- Feelings of impulsivity
Traumatic Brain Injuries in Children
After an injury to the head, most children may not be able to communicate how they’re feeling to an adult, so it’s important to be able to notice and understand concerning symptoms of a TBI in children. Some of these can include:
- Changes in eating or nursing
- Increased and persistent crying, irritability or unusual crankiness (and unable to be consoled)
- Difficulty paying attention
- Lack of interest in normal activities or toys
- Issues with balance and walking
- Seizures
- Loss of a normal skill (such as toilet training)
- Vomiting
Helping to Prevent TBIs
Here are some ways you can help prevent a TBI:
- Wear a seatbelt
- Never drive under the influence of drugs or alcohol
- Improve balance and strength with a regular fitness routine
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Wear a properly fitting, sport/activity-appropriate helmet when doing the following activities:
- Riding a bike, scooter, motorcycle or all-terrain vehicle
- Skateboarding
- Roller skating/rollerblading
- Playing hockey or football
- Horseback riding
- Skiing/snowboarding
- Boxing
Help prevent falls and keep children and older adults safe in your home by:
- Installing safety gates and window guards for children
- Improving lighting and removing tripping hazards in hallways (rugs, clutter)
- Using nonslip mats and grab bars next to toilets and in the shower for older adults
- Installing handrails along stairways
Treating TBIs
Each TBI is different: the size, location and severity of the head trauma determines how it will be treated. It’s important to know that much of the damage from a TBI often happens following the initial injury.
In cases of a mild TBI (concussion), extensive treatment may not be needed, other than making sure you’re getting enough rest (or “brain rest”) and treating pain with over-the-counter pain relievers such as ibuprofen. “Brain rest” means avoiding anything that requires concentrating or paying attention. You should also be monitored closely for new or worsening symptoms.
After a mild TBI (concussion), your doctor may recommend the following:
- Return to daily activities gradually and only once you have permission from your doctor
- Make a follow-up appointment to discuss your healing progress, new or ongoing symptoms and medications you can safely take to help with any pain
- Pay attention to anything unusual or new symptoms that come up, even if they seem unrelated to the injury
- Avoid activities that could put you at risk for another head injury
- Stay connected to family and friends and discuss how you’re feeling
- Limit screen time, loud music and bright lights, especially before bed and while sleeping
After a severe TBI, treatment often focuses on:
- Preventing death
- Stabilizing vital organs such as the heart, lungs and spinal cord
- Controlling blood pressure
- Supporting effective breathing and oxygen delivery
- Preventing further brain injury
Emergency care staff will typically monitor brain blood flow, temperature, pressure and oxygen levels. During hospitalization for severe TBI, monitoring for infection and deep vein thrombosis is also important. In addition, if you have a severe TBI, you may need surgery to:
- Relieve pressure on the skull
- Remove dead brain tissue, debris or hematomas
- Repair skull fractures
Traumatic brain injuries can have long-lasting effects that reach beyond the initial injury, affecting individuals, families and communities. By focusing on prevention and proper care, we can help reduce these injuries, while recognizing the critical importance of timely treatment.
In an emergency, call 911 or go to the nearest emergency room.
Source: Centers for Disease Control and Prevention