Traumatic brain injury is caused by falls, motor vehicle accidents, assaults and blows to the head. Traumatic brain injuries are classified as mild, moderate and severe. The severity rating of a traumatic brain injury is estimated by scores on the Glascow Coma Scale (GCS), either at the scene of the injury or hospital.
The severity rating is not consistently predictive of overall improvement after the injury. At all levels of brain injury, prediction of the person’s long term future is very complex and individualistic. After all, everyone is different before their brain injury, so no two people are going to recover exactly the same way.
Mild Traumatic Brain Injury
A concussion is a mild form of traumatic brain injury and can be caused by a bump, blow, or jolt to the head or body that makes the brain move rapidly inside the skull. This results in a loss of consciousness up to 30 minutes, but may not affect consciousness at all. Imaging studies often show no damage. Even if there is no loss of consciousness, a mild TBI is diagnosed when the person has any loss of memory for events immediately before or after the injury.
Symptoms of mild TBI include headache, dizziness, insomnia, decreased concentration and attention span, depression, anxiety, mood swings, impaired balance, decreased speed of information processing and decreased ability to learn new things and recall. Symptoms may go undetected until they interfere with activities of daily living (ADLs).
Persons who have mild TBI usually have a good recovery, but some individuals may take weeks or even months of treatment to reach their maximum potential. Approximately 75% of traumatic brain injuries are concussions or other forms of mild TBI.
Loss of consciousness lasts a few minutes to a few hours. With a moderate TBI, there are usually abnormal CT or MRI findings. Patients who have suffered a moderate TBI normally have confusion lasting a few days to weeks. However, physical, cognitive and/or behavioral impairments could last for months or be permanent. Patients with moderate TBIs generally make a good recovery with rehabilitation or, successfully learn to compensate for their deficits.
There is usually a prolonged unconscious state or coma that lasts days, weeks, or months. Patients with severe TBI can make significant improvements, including return to a life very similar to what they had before the injury. However, some are left with permanent physical, cognitive, or behavioral impairments.
Possible Deficits Following TBI
Most people who have a TBI experience some level of deficit in information processing speed, attention, memory, and executive functioning (a term that includes higher level cognition such as planning, problem solving, inhibition, multi-tasking, awareness of deficits, and more).
Health complications may include seizures, hydrocephalus, cerebrospinal fluid leaks, infections, cranial nerve injuries, pain, hypertension, hormonal changes, decreased immune system, sleep disorders, and risk of earlier life disease processes such as dementia.
Symptoms of traumatic brain injury can include loss of consciousness, headache, nausea, vomiting, lack of coordination, dizziness, trouble with balance, dilation of one or more pupils, slurred speech, behavioral or mood changes, loss of coordination, restlessness and agitation.