Traumatic Brain Injury (TBI)

Overview

A traumatic brain typically is caused by a violent blow or jolt to the head or body. It may also be caused by an object entering the brain, such as a bullet. A mild traumatic brain injury may result in some short-term problems, such as issues with moving or thinking as one normally would. However, a more severe traumatic brain injury can cause lifelong complications or death.[1]

Symptoms

There are several symptoms of a traumatic brain injury that include physical, cognitive/behavioral, and sensory problems. An individual who experiences any of the following may be experiencing a TBI. These symptoms may appear immediately after an injury to the head, but they can also appear days or even weeks after the injury.[2]

Physical Symptoms

Headache
Nausea
Fatigue
Problems with speech
Unequal eye pupil size
Cognitive/behavioral symptoms
Loss of or change in consciousness
Mild to extreme confusion or disorientation
Problems remembering, concentrating, or making decisions
Changes in sleep patterns – including inability to be wakened from sleep
Frustration, irritability

Perception/Sensation

Light-headedness, dizziness, vertigo, or loss of balance
Blurred vision
Hearing problems – including ringing in the ears
Sensitivity to light / sound
Bad taste in mouth
Mood changes or swings
Feeling anxious or depressed
A lack of energy or motivation

Causes

The most common causes of a traumatic brain injury are motor vehicle accidents, falls, violence, gunshot wounds and military attacks.[3] In addition to this, sports-related traumatic brain injuries are extremely common. Roughly 1.6 to 3.8 million TBI’s each year are caused by sports related traumas, with football and bicycling accounting for the highest number of these injuries.[4]

Diagnosis

To diagnose an individual with a traumatic brain injury, a healthcare professional may conduct several different tests. First, imaging tests such as a CT and MRI, are used to take images of an individual’s brain to evaluate physical damage. Next, a healthcare provider may use the Glasgow Coma Scale (GCS), which measures a person’s functioning in three areas: ability to speak, ability to open eyes, and ability to move.

A score of 13 or higher indicates a mild TBI
A score of 9 -12 indicates a moderate TBI
A score of anything below 8 points to a severe TBI.

The Glasgow Coma Scale is also used to monitor an individual’s recovery, as it can be used to see how these functions either improve or worsen. As of 2018, blood tests have also been used to detect the release of two proteins, UCH-L1 and GFAP, which are typically released when a concussion occurs. Although this test can not be used alone to diagnose TBI, it can be used in tandem with the other tests to affirm that an injury to the brain has occurred.[5]

Complications

There are several complications that can arise due to a traumatic brain injury. Individuals can experience life-long brain damage. In addition, those who experience a TBI have an increased risk of developing anxiety, depression, and PTSD due to their injury.[6]

Treatment

The treatment of a traumatic brain injury depends on both how the injury was caused, as well as the severity of the injury. Recovery time for a TBI ranges from a week to several months, based on its severity.[7] For a mild TBI, specific treatment may not be required. However, it is essential that an individual rests and does not take part in physically demanding activities until cleared by a medical professional.

For more severe cases of TBI, surgery may be needed to help reduce the damage to the brain. This surgery could include removing blood clots and/or repairing skull fractures. Following surgery, a healthcare provider may prescribe medications such as anticoagulants to prevent blood clots or stimulants to help increase alertness and attention. Once an individual is physically healthy and strong enough, a healthcare provider will often recommend rehabilitation therapies. These therapies may include a combination of the following, dependent on the type and severity of a patient’s symptoms:[8]

Physical Therapy
Occupational Therapy
Speech Therapy
Psychological Counseling
Cognitive Therapy

If you feel you may be suffering from a traumatic brain injury or suspect that someone close to you is demonstrating signs of a TBI, please reach out to a licensed health professional (e.g., a primary care physician or a neurologist) or go to Urgent Care for medical assistance as soon as possible.

If you have been diagnosed with TBI and are suffering from anxiety and/or depression as a result of your symptoms, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.

Contributed by: Daphne Lasher

Editor: Jennifer (Ghahari) Smith, Ph.D.

References

1 Mayo Clinic. (2021, February 4). Traumatic brain injury. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

2 National Institute of Neurological Disorders and Stroke. (2023, February 7). Traumatic brain injury (TBI). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi

3 Shepherd Center. (n.d.). Brain damage: Traumatic brain injury causes. Common Causes of Brain Injury . https://www.shepherd.org/patient-programs/brain-injury/about/causes

4 University of Connecticut. (2015, March 4). Traumatic brain injury. UConn | University of Connecticut . https://ksi.uconn.edu/emergency-conditions/traumatic-brain-injury/#:~:text=It%20is%20estimated%20that%20approximately,school%20sport%2Drelated%20trauma%20reported.

5 National Institute of Health. (2020, November 24). How do healthcare providers diagnose traumatic brain injury (TBI)?. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/tbi/conditioninfo/diagnose

6 Cleveland Clinic medical professional. (2021, January 1). Traumatic brain injury (TBI): What is it, causes, types. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8874-traumatic-brain-injury

7 Moody Neuro. (2022, May 31). Traumatic brain injury recovery time. Moody Neurorehabilitation. https://www.moodyneuro.org/how-long-does-it-take-to-recover-from-a-traumatic-brain-injury/#:~:text=In%20fact%2C%20depending%20on%20the,long%20a%20patient%20is%20unconscious.

8 National Institute of Health. (n.d.). What are the treatments for traumatic brain injury (TBI)?. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/tbi/conditioninfo/treatment