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!
Resources for further information:
Traumatic Brain Injury (TBI) | National Institute of Neurological Disorders and Stroke (nih.gov)
Brain Injury Awareness Month - Brain Injury Association of America (biausa.org)
Traumatic Brain Injury / Concussion | Concussion | Traumatic Brain Injury | CDC Injury Center
Traumatic Brain Injury (TBI): What Is It, Causes, Types (clevelandclinic.org)
For People with Brain Injury: Community & Support | BrainLine