What is Traumatic Brain Injury (TBI)

Traumatic brain injury is an injury to the brain that results from:

• A hard, direct blow to the head (closed injury).
• An object penetrating the skull and entering the brain (open injury).

Traumatic brain injury is also called a head injury or a concussion. TBI can be mild, moderate, or severe.

What are the causes?

Common causes of this condition include:

• Falls.
• Motor vehicle accidents.
• Sports injuries.
• Assaults.

What increases the risk?

You are more likely to develop this condition if you:

• Are 75 years old or older.
• Are a man.
• Play contact sports, especially football, hockey, or soccer.
• Are in the military.
• Are a victim of violence.
• Abuse drugs or alcohol.
• Have had a previous TBI.

What are the signs or symptoms?

Symptoms may vary from person to person, and may include:

• Loss of consciousness.
• Headache.
• Confusion.
• Fatigue.
• Changes in sleep.
• Dizziness.
• Mood or personality changes.
• Memory problems.
• Nausea or vomiting or both.
• Seizures.
• Clumsiness.
• Slurred speech.
• Depression and anxiety.
• Anger.
• Trouble concentrating, organizing, or making decisions.
• Inability to control emotions or actions (impulse control).
• Loss of or dulling of the senses, such as hearing, vision, and touch. This can include:
  • Blurred vision.
  • Ringing in your ears.

How is this diagnosed?

This condition may be diagnosed based on:

• Medical history and physical exam.
• Neurologic exam. This checks for brain and nervous system function, including your reflexes, memory, and coordination.
• CT scan.

Your TBI may be described as mild, moderate, or severe.

How is this treated?

Treatment depends on the severity of your brain injury and may include:

• Breathing support (mechanical ventilation).
• Blood pressure medicines.
• Pain medicines.
• Treatments to decrease the swelling in your brain.
• Brain surgery. This may be needed to:
  • Remove a blood clot.
  • Repair bleeding.
  • Remove an object that has penetrated the brain, such as a skull fragment or a bullet.

Treatment of TBI also includes:

• Physical and mental rest.
• Careful observation.
• Medicine. You may be prescribed medicines to help with symptoms such as headaches, nausea, or difficulty sleeping.
• Physical, occupational, and speech therapy.
• Referral to a concussion clinic or rehabilitation center.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take blood thinners (anticoagulants),aspirin, or other anti-inflammatory medicines such as ibuprofen or naproxen unless approved by your health care provider.

Activity

• Rest. Rest helps the brain to heal. Make sure you:
  • Get plenty of sleep. Most adults should get 7–9 hours of sleep each night.
  • Rest during the day. Take daytime naps or rest breaks when you feel tired.
• Do not do high-risk activities that could cause a second concussion, such as riding a bike or playing sports. Having another concussion before the first one has healed can be dangerous.
• Avoid a lot of visual stimulation. This includes work on the computer or phone, watching TV, and reading.
• Ask your health care provider what kind of activities are safe for you. Your ability to react may be slower after a brain injury. Never do these activities if you are dizzy. Your health care provider will likely give you a plan for gradually returning to activities.

General instructions

• Do not drink alcohol.
• Watch your symptoms and tell others to do the same. Complications sometimes occur after a brain injury. Older adults with a brain injury may have a higher risk of serious complications.
• Seek support from friends and family.
• Keep all follow-up visits as directed by your health care provider. This is important.

Contact a health care provider if:

• Your symptoms get worse or they do not improve.
• You have new symptoms.
• You have another injury.

Get help right away if:

• You have:
  • Severe, persistent headaches that are not relieved by medicine.
  • Weakness or numbness in any part of your body.
  • Confusion.
  • Slurred speech.
  • Difficulty waking up.
  • Nausea or persistent vomiting.
  • A feeling like you are moving when you are not (vertigo).
  • Seizures or you faint.
  • Changes in your vision.
  • Clear or bloody discharge from your nose or ears.
• You cannot use your arms or legs normally.

Summary

• Traumatic brain injury happens when there is a hard, direct blow to the head or when an object penetrates the skull and enters the brain.
• Traumatic brain injuries may be mild, moderate, or severe. Treatment depends on the severity of your injury.
• Get help right away if you have a head injury and you develop seizures, confusion, vomiting, weakness in the arms or legs, slurred speech, and other symptoms.
• Rest is one of the best treatments. Do not return to activity until your health care provider approves.