Traumatic Brain Injury
Traumatic brain injury (TBI) is a sudden injury from an external force that affects the functioning of the brain. It can be caused by a bump or blow to the head (closed head injury) or by an object penetrating the skull (called a penetrating injury).
TBI symptoms vary depending on the extent of the injury and the area of the brain affected. Some symptoms appear immediately; others may appear several days or even weeks later. A person with TBI may or may not lose consciousness—loss of consciousness is not always a sign of severe TBI.
Symptoms of mild TBI (concussion)
A person with a mild TBI may experience:
- Blurred vision
- Ringing in the ears
- Tiredness or sleepiness
- A bad taste in the mouth
- A change in sleep habits
- Behavior or mood changes
- Trouble with memory, concentration, attention, or thinking
- Loss of consciousness lasting a few seconds to minutes1
- Sensitivity to light or sound
- Nausea or vomiting
Symptoms of Moderate or Severe TBI
A person with moderate or severe TBI may have some of the symptoms listed above. In addition, the person may experience any of the following:
- Headache that gets worse or won’t go away
- Repeated vomiting or nausea
- Slurred speech
- Convulsions or seizures
- An inability to wake up from sleep
- Enlargement of the pupil (dark center) of one or both eyes
- Numbness or tingling of arms or legs
- Loss of coordination
- Increased confusion, restlessness, or agitation
- Loss of consciousness lasting a few minutes to hours
A person who suffers a blow to the head or another trauma that may have caused a TBI should seek medical attention.
A person who suffers a blow to the head or another trauma that may have caused a TBI should seek medical attention. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include insuring proper oxygen supply to the brain and the rest of the body, maintaining adequate blood flow, and controlling blood pressure.
Imaging tests help in determining the diagnosis and prognosis of a TBI patient. For moderate to severe cases, the imaging test is a computed tomography (CT) scan. In most cases of severe TBI, emergency care focuses on stabilizing the patient and promoting survival. This care may include ensuring adequate oxygen flow to the brain, controlling blood pressure, and preventing further injury to the head or neck. Surgery may be needed as part of emergency care to reduce additional damage to the brain tissues.
Once the patient is stable, other types of care for TBI and its effects can begin. Moderately to severely injured patients receive inpatient rehabilitation that involves individually tailored treatment programs prescribed by a pediatric physiatrist (physical medicine and rehabilitation physician), with a team of specialists that include physical therapy, occupational therapy, speech/language therapy, cognitive education, recreation therapy, music therapy, psychology/psychiatry, rehabilitation nursing, and social support. In the outpatient setting, pediatric rehabilitation medicine continues to monitor recovery, return to school, and prescribe medications, therapies, bracing, equipment, and other interventions to maximizes functional progress and recovery.
NIH: National Institute of Neurological Disorders and Stroke