Most commonly, TBIs are mild, and this form is also known as a concussion. Most people fully recover from a mild TBI within several weeks of injury. Some people, however, may have longer lasting or more serious problems, or even severe and permanent deficits. More severe TBI can lead to a coma or prove fatal. Secondary brain injury involves changes that develop over several hours or days after the primary brain injury. It can involve a range of changes in cells, tissue, chemicals, and blood vessels in the brain that play a role in additional destruction of normal brain function. (1) RELATED: How Resilience Helped Me Transform My Life After a Brain Injury
Loss of consciousness for a few seconds or minutesNo loss of consciousness, but being dazed, confused, or disorientedHeadacheNausea or vomitingFatigue or drowsinessProblems with speechDifficulty sleepingSleeping more than usualDizziness or loss of balanceSensitivity to lightBlurred or double visionRinging in the earsChanges in the ability to taste or smellMemory or concentration problemsMood changes or mood swingsFeeling depressed or anxious
Moderate or severe TBIs can include any of the symptoms of mild injury listed above. Additional symptoms that may surface within several hours or days of the injury, include:
Loss of consciousness from several minutes to hoursPersistent headache or headache that worsensRepeated vomiting or nauseaConvulsions or seizuresDilation of one or both pupilsClear fluids draining from the nose or earsInability to wake up from sleepWeakness or numbness in fingers and toesLoss of coordinationProfound confusionAgitation, combativeness, or other unusual behaviorSlurred speechComa and other disorders of consciousness (2)
Symptoms of TBI in Children
Children, especially infants and toddlers, may not be able to articulate symptoms. While they can experience symptoms similar to those seen in adults, there are also some symptoms that parents should watch for that can be unique to younger patients, according to Boston Children’s Hospital. (3) Young kids, for example, may lose interest in nursing or eating or stop playing with their favorite toys. Older children might struggle with class work or refuse to go to school. Falls, for example, are the most common causes of closed head injuries among adults 65 and older, according to the NIH. (4) Motor vehicle crashes, meanwhile, are the most common cause of closed head injuries among young adults. Falls and collisions, often while playing sports, are the most common cause of these injuries among children (5 PDF). Among infants, toddlers, and preschoolers, falls and assault, including shaken baby syndrome, are the most common cause of this type of TBI. Penetrating brain injuries happen when something pierces the skull. Some common causes of this type of TBI include being hit by a bullet or shrapnel, getting struck by a weapon like a knife or baseball bat, or a serious accident like a car crash that causes a bone fragment to puncture the skull, according to the NIH. (4) For more serious TBIs, doctors first stabilize the patient by checking the pressure inside your skull, managing blood pressure, and making sure the brain gets enough oxygen, according to the NIH. (4) Surgeons might operate to remove hematomas, areas of clotted blood in the brain or between the brain and skull, or to relieve pressure in the skull. They might also perform surgery to repair skull fractures and allow excess fluid to drain. (4) There isn’t a drug specifically to treat a TBI, but doctors may prescribe medications to relieve symptoms, including (4):
Anti-anxiety medication to reduce nervousness and fearAnticoagulants to prevent blood clotsAnticonvulsants to prevent seizuresAntidepressants to treat symptoms of depression or mood instabilityMuscle relaxants to reduce muscle spasmsStimulants to increase alertness and attention
Treatment may also include rehabilitation (rehab) services such as physical, occupational, and speech therapy, as well as psychiatric care and social support, according to John Hopkins Medicine. (7) Rehab might help improve a patient’s ability to manage daily tasks, address mental and physical health problems caused by TBI, and help patients adapt to changes in how their brain and body work after injury. In addition, rehab can help prevent complications of TBI, such as blood clots, pain, pressure ulcers or bedsores, breathing problems or pneumonia, a drop in blood pressure from moving around, muscle weakness or spasms, bowel and bladder problems, and sexual dysfunction. (7) RELATED: Blue Light Therapy Might Help Improve Mood in People With TBI
Prevention of Traumatic Brain Injury
Accidents may be unavoidable, but there are steps people can take to minimize their risk of head injuries, according to the Cleveland Clinic. (8) Helmets are a good place to start. Riding a motorcycle without a helmet doubles the risk of TBI, for example. And up to 85 percent of bicycle-related head injuries could be prevented with helmets. Airbags and seatbelts can also reduce the risk of TBI from motor vehicle collisions. Placing infants in rear-facing car seats, and toddlers and younger children in car seats or booster seats, can also prevent head injuries. Other prevention strategies for kids include using window guards to prevent falls out of open windows, using safety gates on stairs, putting nonslip mats in showers and tubs, and using playgrounds with shock-absorbing materials on the ground, according to the Shepherd Center. (9) Older adults can also take steps to reduce their risk of TBI, according to the Shepherd Center. These include installing handrails in bathrooms and on both sides of stairways, removing tripping hazards like throw rugs and clutter, improving lighting in the home, getting regular vision and hearing checkups, and staying physically active. (9) If the skull is fractured, patients have an increased risk of infection because this can sometimes tear the membrane that surrounds the brain, allowing bacteria to enter the wound. With a severe TBI, some patients may also go into a coma, vegetative state, or minimally conscious state. With these disorders of consciousness, patients may struggle to stay awake or keep their eyes open. They may also have limited awareness, and a reduced ability to follow instructions or communicate. Brain injuries can also lead to a range of other temporary or permanent problems, according to the NHS. These can include: (10)
Difficulty with movement, balance, and coordinationDamage to the pituitary gland, resulting in reduced hormone production and thyroid problemsSensory deficits like loss of taste or smell, impaired vision, or inability to maintain body temperatureProblems with memory, speech, and communicationOngoing mood or mental health symptomsPost-traumatic stress disorder (PTSD)
Post-concussion syndrome — a cluster of symptoms like headaches and dizziness — can last for several weeks or months after a brain injury, according to the Mayo Clinic. (2) This happens more commonly with mild TBIs, but can also occur after more serious brain injuries. Headaches can often feel like migraines or tension headaches. Other symptoms can include:
DizzinessFatigueIrritabilityAnxietyInsomniaLoss of concentration and memoryRinging in the earsBlurry visionNoise and light sensitivity
That year, TBIs contributed to 56,800 fatalities, including 2,529 deaths among kids, according to the CDC. Approximately 812,000 youth 17 and younger were treated in U.S. emergency rooms for a concussion or TBI, either alone or in combination with other injuries. (11)
