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Traumatic Brain Injury (TBI)

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What is Traumatic Brain Injury (TBI)?

What is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) is brain damage caused by a severe blow, strike, or penetration of an object through the brain, resulting in permanent or temporary damage. Brain damage can range from mild to severe or even death. TBI can impair cognitive, physical, or psychological behavior.

Concussions are classified as mild traumatic brain injury since most people recover over time. More severe forms of TBI can result in a coma. Some mild brain injuries can cause temporary damage to brain cells.

Types of Traumatic Brain Injury

Types

Traumatic brain injury is considered the effect of sustained damage. Therefore, the seriousness of the TBI is determined by the severity of the injury. Unconsciousness, neurological impairments, memory loss, and any irregularities revealed by a CT scan (computerized tomography) or an MRI (magnetic resonance imaging) of the brain suggest a serious injury.

Injuries of the brain are categorized according to the types and grades of the TBI. Traumatic brain injuries are classified as mild, moderate, or severe:

  • Mild concussion (mTBI) - The majority of TBIs that happen each year are concussions. These concussions can include a brief loss of consciousness (less than 30 minutes). People with mTBIs may experience slight confusion for a day.
  • Moderate TBI - Head injuries of this type generally result in unconsciousness for over 30 minutes but no longer than 24 hours. Confusion may last up to one week.
  • Severe TBI - This level of injury would result in a person losing consciousness for over 24 hours, and abnormalities could be visible on a CT or MRI of the brain
  • Uncomplicated TBI - This type of brain injury does not produce irregular effects detectable on a CT or brain MRI despite the grade of severity
  • Complicated TBI - Produces abnormalities visible during a CT or MRI of the brain, such as bleeding or bruising on the brain
  • Closed TBI - A brain injury sustained by an outside force causing a blow or strike without an object penetrating the skull. These injuries commonly cause swelling of the brain.
  • Penetrating brain injuries - Sometimes this brain injury may be referred to as an open TBI, meaning a bullet, knife, or other object goes through the skull, possibly damaging the brain tissue
  • Hypoxic/anoxic brain injury - Nontraumatic TBIs are caused by a stroke or seizure, choking, or lack of oxygen (cerebral hypoxia) due to near-fatal drowning

Signs & Symptoms of a Traumatic Brain Injury

Symptoms

Signs and symptoms of traumatic brain injuries vary according to the severity of the initial head injury. Some symptoms become apparent immediately, while other symptoms could take days or weeks to manifest. These signs are further broken down into physical, sensory, and cognitive symptoms.

Children experience symptoms similar to adults, but because their brains are still developing, some of the cognitive problems they experience may not appear until they are older. TBI in children can alter their eating habits or affect their ability to pay attention. It is also associated with depression or sadness and losing interest in their favorite games or toys.

Common symptoms associated with mild traumatic brain injury

Physical symptoms:

  • Headache
  • Nausea or vomiting
  • Feeling tired or drowsy
  • Difficulty sleeping or sleeping more than usual
  • Dizzy or loss of coordination

Sensory symptoms:

  • Blurred vision, ringing in the ears, changes in smell or taste
  • Sensitivity to light
  • Problems speaking

Cognitive symptoms:

  • Brief loss of consciousness (under 30 minutes)
  • Feeling confused (without losing consciousness)
  • Mood changes, including depression

Common symptoms associated with moderate to severe traumatic brain injuries

In addition to the symptoms mentioned for mild TBI, moderate to severe TBI might also include:

Physical symptoms:

  • Persistent headache
  • Recurring nausea and vomiting
  • Seizures or convulsions
  • Dilated pupils
  • Liquid draining from ears or nose
  • Lack of coordination
  • Extreme tiredness with the inability to wake up

Sensory symptoms:

  • Difficulty speaking or slurred speech
  • Numb or weak fingers and toes

Cognitive symptoms:

  • Unconscious from several minutes to hours
  • Extreme confusion
  • Anger or agitation

The outcome for people diagnosed with moderate to severe TBI can be uncertain. People who incur traumatic brain injuries often cannot return to work or provide for themselves. Some require long-term care to help carry out normal daily activities; this puts them under tremendous physical, emotional, and financial strain, along with their families or caregivers. Although strides are being made to improve brain cell regeneration, much of the brain damage sustained may be difficult to repair.

More to explore

    What Causes a Traumatic Brain Injury?

    Causes

    A traumatic brain injury occurs because of a blow to the head or body. This includes falls, vehicle crashes, sports injuries, or assault by another person or weapon. Gunshot wounds or other objects piercing the brain can cause traumatic brain injuries. The most common causes of traumatic brain injuries result from:

    • Falls - Nearly half of all TBI-related hospitalizations occur because of a fall
    • Gun-related suicides - Death by suicide is the most common cause of TBI-related deaths in the United States
    • Car accidents - One of the most common reasons for TBI
    • Assault - A common factor in people with TBI due to repeated blows to the head or being hit with an object

    Traumatic Brain Injury Risk Factors

    Risk Factors

    No one is exempt from experiencing a TBI. However, research has suggested that certain groups are at a higher risk of dying from a TBI or facing extended health problems because of their brain injuries. Groups most affected by traumatic brain injury include:

    • Children - Especially those from newborn to 4 years old
    • Young adults - Especially people between the ages of 15 to 24
    • Older adults - Especially adults 60 years and older
    • Males - In any age group, males have a higher chance of experiencing a TBI than females
    • Racial and ethnic minorities - Native American children and adults have a higher rate of TBI hospitalizations and deaths than any other racial or ethnic group. Factors include higher rates of car accidents, substance use, suicide, and lack of proper healthcare services. Non-Hispanic Black and Hispanic patients are less likely to receive follow-up care or rehabilitation for brain injuries sustained than non-Hispanic white patients
    • Military service members and veterans – This group may experience ongoing symptoms of TBI in addition to post-traumatic stress disorder (PTSD) and depression. This is attributed to the lack of healthcare services available to them, especially mental healthcare. People in this group also report contemplating suicide stemming from their depression.
    • Unhoused people - Those experiencing homelessness are 2 to 4 times more likely to have any type of TBI and up to 10 times more apt to have a record of moderate to severe traumatic brain injuries. This group often has both poor physical and mental health issues, many relating to violence or trauma experienced during their childhood, drug or alcohol problems, and contemplation and attempts of suicide.
    • Incarcerated individuals in correctional or detention centers - It is estimated that almost half of the people in correctional or detention centers have a history of TBI due to mental health problems, severe depression, anxiety, substance abuse, anger management problems, and suicidal thoughts or attempts.
    • Survivors of domestic violence – People who have sustained TBI because of a physical assault are also more likely to be diagnosed with PTSD, depression, and all-around poor health
    • Those living in rural areas – People in this groupare more likely to die from a TBI compared to people living in more populated areas because of the time it takes to receive proper emergency medical care. In addition, specialized TBI care units are unavailable in many rural areas.
    • People who lack health insurance or with lower incomes – People in this group face problems receiving appropriate TBI care such as rehabilitation, and they are more likely to die in the hospital before receiving the necessary treatment and tests

    How to Prevent a Traumatic Brain Injury

    Prevention

    There is no clear-cut way to prevent a traumatic brain injury from occurring. However, certain precautions can be taken to lessen the chance of experiencing a TBI. Some protections to help older adults from falling include:

    • Install handrails in the bathroom
    • Place a slip-proof mat in the tub or shower
    • Remove area rugs to prevent tripping over them
    • Install handrails on both sides of the staircases
    • Improve lighting, especially on the staircases
    • Keep floors and stairs clutter-free
    • Get your vision checked

     

    Some precautions that can help avoid injuries to children that could result in TBI are:

    • Install safety guards on staircases
    • Keep stairs clear of clutter
    • Install window guards to prevent children from accidentally falling out the window
    • Use nonslip mats in the bathtub and shower
    • Install shock-absorbing materials on the ground near play areas
    • Keep area rugs secured in place
    • Don't let children play on fire escapes or balconies

     

    Some commonsense precautions for people of any age include:

    • Always wear a seatbelt or use a child car seat when traveling in a vehicle
    • Don't drive if you're taking medication that makes you drowsy
    • Wear a helmet when playing sports, riding a motorcycle, scooter, ATV, or riding a horse
    • Stay fit and exercise to improve your balance and stamina, possibly avoiding a fall
    • Use a walking device to assist you in keeping your balance
    Get Care

    Trust NewYork-Presbyterian for Traumatic Brain Injury Care

    Brain injuries are serious and must be treated right away to prevent further damage. Our neurologists and neurosurgeons are world-renowned, offering their expert care and knowledge to treat even the most complex cases involving the brain.

    Our experts are leaders in clinical trials and the latest therapies to treat traumatic brain injuries. NewYork-Presbyterian treats patients of all ages—from children to older adults.