Things to Know About Traumatic Brain Injury 

By Emilee Kucheruk, COTA/L  

 March is Traumatic Brain Injury (TBI) Awareness Month.  This blog provides simple but essential information on TBIs to help people understand and better recognize them.   

 

Head injuries are no joke and should always be taken seriously.  A TBI is an injury to the brain that impacts how it functions due to increased swelling and expansion of the brain within the skull. TBIs can be caused by a hit or blow, forceful bump, or jolt to the head and/or body, or from an object that can pierce through the skull and enter the brain causing a traumatic injury. Most TBIs are closed, meaning that the outside force that strikes the head does not penetrate through the skull, but some can result from an object that pierces through the skull and enters the brain causing a traumatic injury. It is important to note, however, that not all bumps, hits, or injuries to the head result in a TBI. 

TBIs come in all shapes and sizes, and can affect memory, communication, movement/coordination, processing, actions, and comprehension of information. 

Types and Grades of TBI 

Mild TBI/Concussion (mTBI) 

  • Concussions are the most common type of TBI with ¾ of all TBIs yearly being this type of injury 

  • Brief alterations of consciousness or loss of consciousness for less than 30 minutes 

  • Confusion typically lasts for about 1 day 

Moderate TBI 

  • Associated with loss of consciousness for more than 30 minutes but less than 1 day 

  • For up to 1 week, confusion can occur 

Severe TBI 

Consciousness lost for over 1 day 

  • Typically associated with changes on a head CT scan or brain MRI 

Uncomplicated TBI 

  • Head CT scan or brain MRI are normal, regardless of grade (mild, moderate, or severe) 

Closed 

  • Outside force that strikes the head, such as a hit or jolt, does not penetrate through the skull 

  • Brain swelling occurs 

Open 

  • May also be called a penetrating TBI that occurs when an outside force penetrates the skull 

Nontraumatic 

  • May also be called a hypoxic/anoxic brain injury, in which a seizure, stroke, near-fatal drowning, or choking can cause a brain injury due to oxygen deprivation to the brain 

  

What does a TBI look like and how may it present? There are physical, cognitive/behavioral, and perceptual/sensational ways to detect a possible TBI. 

Physical 

  • Blurred/double vision 

  • Convulsions/seizures 

  • Headache 

  • Unequal eye pupil size/dilation 

  • Nausea/vomiting 

  • Clear fluids draining from nose or ears 

  • New neurological deficits (slurred speech, weakness in extremities or face, loss of balance) 

Cognitive/Behavioral 

  • Difficulties with memory, concentration, or decision-making 

  • Loss of/change in consciousness (few seconds to hours) 

  • Difficulty waking/decreased level of consciousness 

  • Mild to profound confusion/disorientation 

  • Increased frustration or irritability 

  • Changes in sleep patterns, such as increased sleep, difficulty rousing, restlessness, or difficulty falling/staying asleep 

Perception/Sensation 

  • Increased fatigue/drowsiness 

  • Decreased energy or motivation 

  • Sensitivity to light or sound 

  • Bad taste in mouth 

  • Blurred vision 

  • Difficulty hearing/ringing in ears 

  • Light-headedness, dizziness, vertigo, and loss of balance/coordination 

  • Feeling anxious/depressed 

  • Changes in mood (mood swings, combativeness, agitation, or other unusual behavior) 

Children can also experience TBIs, but may be harder to detect due to their difficulty alerting others that they’re feeling differently following a head injury. For children, the signs and symptoms are similar to adolescents and adults, including: 

  • Seizures 

  • Sadness/depression 

  • Changes in sleep patterns 

  • Changes in eating/nursing habits 

  • Persistent crying, crankiness, irritability with difficulty to be consoled 

  • Difficulty with attention 

  • Lack of interest in favorite activity/toy 

  • Loss of a skill (toileting) 

  • Vomiting 

  • Loss of balance/unsteady walking 

The leading causes of TBIs include falls, blunt trauma accidents, vehicle-related injuries, assaults/violence, and explosions/blasts. TBIs are diagnosed through a healthcare provider performing an examination and asking about symptoms experienced. A neurological evaluation (memory, motor function, hearing, vision, thinking), imaging tests (CT scan or MRI), or blood tests (Banyan Brain Trauma Indicator- BTI) can be performed based on the severity of the injury and symptoms present. 

Treatment for a TBI depends on the severity of the brain injury and symptoms. Common treatment can involve counseling, surgery, physical therapy, occupational therapy, speech therapy, rest, and gradual return to typical activities, work, and hobbies. 

If you’ve been diagnosed with a TBI, physical, occupational, and speech therapy can help you get back to a sense of normalcy and return to a full life!