Traumatic Brain Injury

Condition Basics

What is a traumatic brain injury (TBI)?

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 range from mild to severe and can last for hours, days, weeks, months, or years. Symptoms could include headaches, vision problems, dizziness, or having trouble remembering. They may also include changes in your mood or how you sleep. More severe symptoms could include speech problems, seizures, passing out, stroke symptoms, or a coma.

How is it diagnosed?

The doctor will ask you questions about the injury. You'll be checked for physical signs of a brain injury. The doctor may order imaging tests such as a CT scan or an MRI to check your brain for bruising or bleeding. You may need other tests.

How is a TBI treated?

Treatment depends on your injury and how bad it is. A mild brain injury may be treated with medicine and rest. Treatment for a severe injury may include medicine, fluids, help with breathing, or surgery. You may also need long-term treatment. This may include counseling, physical and occupational therapy, and speech and language therapy.

What Happens

After a TBI, you may still feel mental and physical effects (postconcussive syndrome) for a long time. And new symptoms may develop over time. How long the effects last depends on how severe the injury was.

• 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.
• Substance use disorder. 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 their 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.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Exams and Tests

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 check your brain for bruising or bleeding. You may need other tests. If you are awake and able to answer questions, the doctor will ask about the injury. They may ask questions that test your ability to pay attention, learn, remember, and solve problems.

Treatment Overview

If your brain has been injured, you may need treatment and rehabilitation. You may need emergency treatment right away that may include medicine, fluids, help with breathing, or surgery.

Rest can help you recover from a concussion (mild traumatic brain injury). You need to rest your body and your brain. For a concussion, your doctor may recommend treatments such as:

• Resting and getting plenty of sleep.
• Avoiding activities that are physically or mentally demanding.
• Taking an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• Avoiding alcohol and drugs.

If you have a more severe brain injury, you may need long-term treatment. This may include:

• Physical and occupational therapy. These kinds of therapy help you regain the ability to do daily activities and to live as independently as possible.
• Speech and language therapy. This kind of therapy helps you with understanding and producing language, as well as organizing daily tasks and developing problem-solving methods.
• Counseling. This helps you understand your thoughts and learn ways to cope with your feelings. Counseling can help you feel more in control and help get you back to your life's activities.
• Social support and support groups. These give you 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 help support you.
• Medicines. These can help relieve symptoms like sleep problems, chronic pain, and headaches. Medicines 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 ones that help you. Your doctor can help you with this.

Self-Care

A big part of recovering from a TBI is taking good care of yourself. This means building daily habits that can help you feel well and recover. Self-care can also help you manage your symptoms. Here are some ways to care for yourself at home.

• Build good sleep habits. And get plenty of rest during the day. Getting enough rest is an important part of recovery.
• Avoid drinking alcohol or using drugs.
• Return to your usual activities gradually. Or find other safe activities that you enjoy.
• Eat healthy foods. Healthy eating may help you feel well and have the energy you need for daily tasks.
• Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
• Ask your doctor when it is okay to return to sports or physical activities.
• Avoid activities that make you feel worse. These may be physically or mentally demanding activities like housework, exercise, schoolwork, or video games.
• If your doctor prescribed medicines for pain or other symptoms, take them as directed. Talk to your doctor about taking over-the-counter medicines if needed.
• If you feel irritable, get away from whatever is bothering you. Ask for support from friends or family if you need to. Or consider talking to a counselor.
• If you are getting long-term care, such as physical therapy, counseling, or other therapies, make sure to go to all of your appointments.

Managing daily tasks

If you have symptoms or limitations that make daily tasks around your home difficult, you might be able to make small changes or find easier ways to do those tasks. Your doctor or a therapist may be able to give you ideas. For example, a physical or occupational therapist can help if you have trouble with things like daily grooming or dressing.

Giving Support

Having a TBI can have a big impact on a person's daily life. And it can be hard for the people who care about them. It's hard to see someone you care about 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. Help them focus on things they enjoy and are still able to do.
• Learn about brain injuries and the long-term symptoms that can affect daily life.
• Help the person have healthy habits, such as being active, eating healthy foods, getting enough sleep, and limiting alcohol.
• Help the person take things one day at a time. Encourage them to set small goals that are focused on getting better.
• If the person isn't getting better, help them get treatment with a doctor who specializes in brain injury.

It's possible for long-term effects of a brain injury to lead to depression. Depression can be treated with medicines or counseling or both.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.