Traumatic Brain Injury (TBI): When to Seek Help After Hitting Your Head
Key takeaways:
Traumatic brain injury (TBI) is damage to the brain after head trauma. It can range in severity from mild injuries to severe brain damage.
TBI can be fatal when severe. Those who survive a head injury can develop severe impairments and disability.
You can prevent further brain damage by avoiding repeat injuries and receiving adequate medical care.
Traumatic brain injury (TBI) is a change in normal brain function after head trauma. Some people do not survive a TBI. In fact, over 60,000 people in the U.S. died of TBI-related causes in 2020. For survivors, symptoms can range from mild headaches and dizziness to severe impairments. It can have many short- and long-term health consequences and lead to permanent disability.
What causes a traumatic brain injury?
TBI can occur after any injury to the head. This can occur after a blow to the head directly or if your head hits an object suddenly or abruptly. It can also happen if an object penetrates the skull.
Common causes of TBI include:
Falls
Motor vehicle accidents
Suicide (a leading cause of death due to TBI)
Assaults
Gunshot wounds in the head
Sport injuries
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Who’s most at risk for a traumatic brain injury?
TBI is more common in infants, adolescents, and the elderly. Older people are more likely to be hospitalized and die after the injury. Some groups have higher chances of getting a TBI including:
Certain racial groups (American Indian/Alaskan native)
Military members and veterans
Prison inmates
Unhoused people
Domestic violence survivors
What are the types of traumatic brain injuries?
TBI can vary widely in severity. These injuries can be mild, moderate, or severe.
Mild TBI
Mild TBI, or concussion, can cause confusion or brief loss of consciousness. It usually occurs after a blow to the head — as seen in football injuries or at fist fights. After a concussion people may have symptoms like:
Headaches
Dizziness
Anxiety
Depression
Sleep problems
Changes in behavior
Moderate TBI
People with moderate TBI present with problems that are more serious than a mild TBI. Many can have medical complications and impairments. Most people with moderate TBI need some form of hospitalization and ongoing medical care. The mortality rate is 10% from moderate TBI.
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Severe TBI
Severe TBI may occur after a severe head trauma with loss of consciousness. In this case, you are likely to stay in a coma for more than 24 hours or need surgery after your injury. It’s also possible to be unresponsive in a vegetative state or need intensive care treatment.
This type of severe injury can have a death rate as high as 30%. So early intervention is important. Your healthcare team will work to lower pressure within the brain and improve circulation. This is to avoid further damage. Some people may stay in a coma or unconscious for long periods of time.
Quiz: Do I Have a Concussion?
What are the symptoms of a traumatic brain injury?
Symptoms of TBI will differ based on the severity of your injury. People with mild TBI may experience:
Vertigo
Dizziness
Loss of balance
Vision problems
Numbness or tingling
The following symptoms are more common after moderate or severe TBI:
Unconscious for an extended period of time
Weakness or uncoordinated movements in the arms, legs, or face
Quadriplegia in severe cases of TBI
Vision loss
Seizures
Confusion
Greater agitation
Pupil enlargement
Speech difficulties (slurred speech or inability to understand or articulate words)
Severe vomiting
Trouble with bladder control (urinary incontinence or retention)
Fecal incontinence or constipation
Dysphagia (difficulty swallowing) may also occur with more serious TBI. This can be due to weakness, poor control, or incoordination of the muscles involved in swallowing. It may also occur due to behavior changes. When swallowing is impaired, this raises the risk of complications like aspiration pneumonia.
How are traumatic brain injuries diagnosed?
There are many different ways to establish a diagnosis of TBI. Your provider will first do a neurological exam. This will check your level of consciousness, mental status, and assess any memory problems. These factors help determine the severity of injury. Knowing how severe the TBI is will be helpful in predicting what your recovery process will look like and how long it takes for you to heal.
The Glasgow Coma Scale is a tool used to test your level of consciousness. It measures your ability to:
Open your eyes
Give verbal responses
Follow prompts for movement
A lower score means less ability to perform those activities and a higher severity of TBI.
Your healthcare provider may also check your level of functioning. This can range from having purposeful and appropriate behavior to confusion, agitation, or showing no response at all.
Imaging studies can also provide your healthcare provider with useful information. A head CT scan helps detect skull fractures, swelling, or bleeding in the brain. An MRI is usually done once the person is stable, and it may show injuries that are missed on CT scan.
It’s important to know that sometimes these studies may show no abnormalities, especially most with mild TBI. In these cases, your healthcare provider will use your history, symptoms, and physical exam to decide the extent of your injury.
How can you prevent a traumatic brain injury?
Preventing TBI involves taking steps to prevent trauma to your head. You could prevent head trauma and injuries by:
Wearing a seatbelt when riding a vehicle
Not driving under the influence of alcohol or controlled substances
Wearing a helmet when riding a bike, a motorcycle, or a horse
Wearing a helmet while playing contact sports
Installing safety guards or gates for young children
You can also do your part to protect yourself by preventing falls at home. This can include removing rugs or objects that can cause you to trip or placing night lights in dark areas for greater visibility.
The bottom line
Traumatic brain injury (TBI) is an important consequence of head trauma. It can vary from mild injury to significant brain damage depending on the amount of trauma sustained. Moderate to severe TBI can have long-lasting impairment or disability. But, recovery is sometimes possible.
TBI is often unexpected, but there are steps you can take to try and prevent TBI. Taking safety measures to avoid head trauma can be helpful and may just save your life.
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References
Abouhashem, S., et al. (2021). Prediction of early mortality after primary decompressive craniectomy in patients with severe traumatic brain injury. Egyptian Journal of Neurosurgery.
Centers for Disease Control and Prevention. (2021). Facts about falls.
Centers for Disease Control and Prevention. (2021). Health disparities and TBI.
Centers for Disease Control and Prevention. (2021). Prevention.
Centers for Disease Control and Prevention. (2022). TBI Data.
Glasgow Coma Scale. (n.d.). Glasgow coma scale.
Haydel, M. J., et al. (2022). Evaluation of traumatic brain injury, acute. The BMJ.
National Institute of Child Health and Human Development. (2020). What are common symptoms of traumatic brain injury (TBI)?
Raciti, L., et al. (2022). Neurogenic dysphagia and nutrition in disorder of consciousness: An overview with practical advices on an “old” but still actual clinical problem. Medicines.
