Traumatic Brain Injury

Topic Overview

What is a traumatic brain injury?

A traumatic brain injury (TBI) can range from a mild concussion to a severe head injury. It is caused by a blow to the head or body, a wound that breaks through the skull (such as from a gunshot), a fall, or another injury that jars or shakes the brain. This can cause bruising, swelling, or tearing of brain tissue.

With rest, most people fully recover from a mild brain injury. But some people who have had a severe or repeated brain injury may have long-lasting problems with movement, learning, or speaking.

What are the symptoms?

Symptoms of a traumatic brain injury range from mild to severe and can last for hours, days, weeks, or even months. These symptoms may include:

• Not thinking clearly, or having trouble remembering new information.
• Having headaches, vision problems, or dizziness.
• Feeling sad, nervous, or easily angered.
• Sleeping more or less than usual.

If you develop these kinds of symptoms at any time after a head injury-even much later-call your doctor.

You may need another person to watch you closely to make sure that your symptoms aren't getting worse. Follow your doctor's instructions about how long you need someone to stay with you.

How is a traumatic brain injury diagnosed?

The doctor will ask you questions about the injury. He or she may ask questions that test your ability to pay attention, learn, remember, and solve problems. The doctor will check for physical signs of a brain injury by checking your reflexes, strength, balance, coordination, and sensation. The doctor may order imaging tests such as a CT scan or an MRI to make sure that your brain isn't bruised or bleeding. You may need tests to see if your brain is working as it should.

How is it treated?

If your brain has been damaged, you may need treatment and rehabilitation, perhaps on a long-term basis. This might include:

• Physical and occupational therapy to help you regain the ability to do daily activities and to live as independently as possible.
• Speech and language therapy to help you with understanding and producing language, as well as organizing daily tasks and developing problem-solving methods.
• Counseling to help you understand your thoughts and learn ways to cope with your feelings. This can help you feel more in control and help get you back to your life's activities.
• Social support and support groups so that you get the chance to talk with people who are going through the same things you are. Your family or friends may be able to help you get treatment and deal with your symptoms.
• Medicines to help relieve symptoms like sleep problems, chronic pain, and headaches. Medicine can also help if you have anxiety, depression, or memory problems. Talk with your doctor about what medicines might be best for you.

You may need to try different types of treatment before finding the one that helps you. Your doctor can help you with this. Treatment can help you feel more in control of your emotions, have fewer symptoms, and enjoy life again.

What is it like to live with a traumatic brain injury?

Your brain will need time to heal. Rest is the best way to recover. Here are some tips to help you get better:

• Get plenty of sleep, and take it easy during the day.
• Don't drink alcohol or use illegal drugs.
• Return to your normal activities gradually.
• Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
• Avoid activities that make you feel worse. These may be physically or mentally demanding activities like housework, exercise, schoolwork, or video games.
• Ask your doctor which medicines you should and shouldn't take.
• If you feel grumpy or irritable, get away from whatever is bothering you.

Long after the brain injury, you may still feel mental and physical effects (postconcussive syndrome), or new symptoms may develop.

• Headaches: They are especially common after a brain injury, even months later. You may find that your headaches evolve into chronic pain, which can make even the lightest activities difficult.
• Thinking skills: Brain injuries can affect how well you can concentrate. It may be hard for you to learn a lot of new information all at once. You may not be able to remember things that just happened.
• Communication: You may have trouble expressing yourself clearly or understanding what other people are saying. When you talk in a group of people, you might find it hard to keep up.
• Emotions: You may feel anxious or depressed, have rapid mood changes, or lose interest in things you used to enjoy. Your emotional ups and downs may be tied to struggles with speaking, thinking, and memory.
• Sleep: You may have changes in your sleep patterns, such as not being able to fall asleep or stay asleep, or sleeping much more of the time. Not getting good sleep can affect how well you recover and how severely other symptoms affect you.
• Drug or alcohol abuse: You may use drugs or alcohol to get rid of feelings of anxiety, depression, and stress or to feel normal or accepted. If you are having problems with drugs or alcohol, treatment can help. The first step is often detoxification, along with medical care.
• Post-traumatic stress disorder: Along with the physical damage from a brain injury, you might have long-lasting effects from the trauma of the injury. You may have fears about a loss of safety and control in your life. You may pull away from other people, work all the time, or use drugs or alcohol. It's important to get treatment for post-traumatic stress disorder (PTSD). Talk to your family doctor. Or, if you're a veteran, contact your local VA hospital or Vet Center.
• Developmental problems: In children, a brain injury, even a mild one, can interrupt the brain's development. This can have a permanent effect on a child's ability to keep up with his or her peers. If your child has had a head injury, call your doctor for advice on what to do.

If you find that you are feeling sad or blue or aren't enjoying the activities or hobbies that you enjoyed in the past, talk to your doctor about these feelings. You may have depression, which is common with chronic pain and other symptoms of a brain injury. If you have thoughts about hurting yourself or someone else, call 911 or 1-800-273-TALK (suicide hotline), or go to a hospital emergency room.

What can you do for a loved one who's had a brain injury?

If someone you care about has had a traumatic brain injury, you may feel helpless. It's hard to watch someone who used to be active or happy become inactive, struggle with speech and memory, or suffer from chronic pain. But there are some things you can do to help.

• Help the person get treatment or stay in treatment.
• Encourage and support the person.
• Learn about brain injuries and the long-lasting symptoms that can interrupt a life.
• Help the person have good health habits, such as being active, eating healthy foods, getting enough sleep, and limiting alcohol.
• Help the person take it one day at a time, setting small goals on the way to getting better.
• If the person isn't getting better, help him or her get treatment with a doctor who specializes in brain injury.

It's possible for long-lasting effects of a brain injury to lead to depression. And depression can lead to suicide. Call 911 or the national suicide hotline at 1-800-273-TALK (1-800-273-8255) or other emergency services if the person plans to harm himself or herself or others.