What is TBI?
Traumatic brain injury (TBI) encompasses a wide variety head injuries that disrupt normal brain function and is considered a significant global health concern.
Globally, it is estimated that over 69 million people are affected by TBI annually. In the United States in 2021, there were approximately 190 TBI-related deaths every day.
Common causes of traumatic brain injury include falls, being struck by an object, motor vehicle accidents, assaults, or sports-related injuries*. However, TBIs may also result from injuries sustained from childhood, active-duty injuries, shockwaves from explosions, chemical inhalation, or hypoxia, just to name a few.
TBIs can be classified into three different categories: mild, moderate, or severe, depending on whether the injury caused unconsciousness, duration of the loss of consciousness, and the severity of the symptoms experienced. While the majority of TBIs are classified as mild because they are not life-threatening, there can be serious and long-lasting effects.
TBI can have a significant effect on individuals, their families, and society as a whole. TBI usually results in physical, cognitive and functional impairments, impaired activities of daily life, and poor quality of life. These impairments may require ongoing medical care and support.
There is a link between a history of TBI and the later development of neurodegenerative conditions like dementia, Alzheimer’s disease (AD), Parkinson’s disease (PD), and chronic traumatic encephalopathy (CTE). CTE is a degenerative brain disease associated with repeated head traumas. It has been primarily seen in athletes, particularly in football players, who frequently experience concussions or repetitive blows to the head. The exact mechanism behind CTE is not well understood but may be due to an accumulation of protein which can disrupt normal brain function and lead to symptoms like confusion, memory loss, mood changes, and difficulties with thinking and reasoning.
It is important to note that there are several features that have important implications for subsequent risk for neurodegeneration, including TBI severity, age of injury, multiple TBI injuries, loss of consciousness, etc. It is worthwhile to obtain a diagnosis of TBI to better understand your injury.
*For parents of children who want to participate in sports, it is highly recommended that you speak to your child’s physician to obtain an order for a brain MRI or DTI exam prior to the start of the sports season. This can be very useful for your child and care team if any sports-related injuries occur in the future to compare against baseline.
TBI Symptoms
TBI results in a wide variety of symptoms that may occur immediately after the injury or appear several weeks or months later. When a combination of symptoms lasts for an extended period of time, this is generally referred to as persistent post-concussive symptoms.
In general, TBI symptoms may include physical, sensory, cognitive, behavioral, and mental symptoms.
Physical symptoms include pain, persistent headaches or headaches that worsens, fatigue, nausea, vomiting, dizziness, vertigo or loss of balance, seizures, tremors, weakness or numbness in fingers and toes, and loss of coordination.
Sensory symptoms may include blurred vision, ringing in the ears, changes in the ability to smell, a bad taste in the mouth, and increased sensitivity to light or sound. Problems perceiving senses can also include difficulty recognizing objects, impaired hand-eye coordination, blind spots, difficulty smelling, skin tingling, pain, or itching.
Cognitive, behavioral, or mental symptoms may include loss of consciousness, being in a dazed, confused, disoriented state, memory difficulties, concentration problems, attention span problems, mood changes or mood swings, increased feelings of depression and anxiety, increased anger and irritability, problems with sleep, difficulties sleeping, staying asleep, or sleeping more than usual, and changes in speech patterns (stuttering, slurred speech, using the wrong words, saying nonsense words).
Cognitive symptoms can also include having more difficulty focusing on tasks at hand, taking a longer time to process thoughts, having a difficult time with memory, learning, reasoning, judgement, and impairment in attention and concentration. Problems with executive functioning include having difficulty with problem-solving, multi-tasking, switching tasks, organization, planning, decision-making, and beginning and completing tasks.
Changes in communication may also be a symptom, which can include difficulty understanding speech or writing, changes in your signature, difficulty speaking or writing, inability to organize thoughts or ideas, trouble following and participating in conversations.
Behavioral changes may also be a symptom, including a lack of self-control, more prone to verbal or physical outbursts, lack of awareness of surroundings, may engage in risky behavior, and may have challenges in social situations. Changes in emotion and personality may include increased depression, anxiety, anger and irritability, mood swings, or lack of empathy for others.
Traumatic brain injuries to the back of the head, or base of the skull, may result in nerve damage to the nerves that emerge directly from the brain (called cranial nerves). Cranial nerve damage symptoms may include double vision, loss of vision, loss or change in sense of smell or taste, paralysis of facial muscles or a loss of sensation in the face, swallowing problems, vertigo, loss of balance, dizziness, ringing in the ears (tinnitus), or hearing loss.