Traumatic brain injury (TBI) is a general term for any injury to the brain that occurs in a sudden manner, usually through an impact injury.
Causes of TBI
TBIs can be caused by multiple injuries ranging from car or motorcycle accidents, falls, sports injuries, or any injury that involves hitting the head or moving the neck in a sudden and abnormal manner.
Symptoms of TBI
The symptoms of a TBI can include headaches, visual changes, weakness, numbness or tingling, difficulty with speaking, difficulty walking or coordinating movements, balance problems, dizziness, falls, emotional changes, memory loss, confusion, decreased consciousness, seizures, and, most severely, coma or death. Anyone who is experiencing these symptoms after a head or neck injury or any injury, even if it is not clear that the head was directly injured, should seek medical help. Unless the symptoms are very mild and stable, most patients need urgent evaluation as the symptoms can worsen quickly if there is bleeding, or hemorrhage, in the brain.
Effects of TBI
TBI can impair cognitive function and cause memory loss because the brain is damaged by an injury. The injury itself and associated bleeding cause direct injury to the brain tissue. There are also other effects on the brain that happen when the tissue is injured and, in the process of repairing, can cause further injury days or even up to a week after the original injury. All of this may lead to long-term effects, especially if there is a severe initial injury or repeated injuries to the brain, but more research is being conducted in this area to give better insight into how or why this occurs.
How to Treat It
TBIs are usually determined to be mild, moderate or severe based on a combination of the examination and findings on imaging such as CT or MRI of the head. The Glasgow Coma Scale is an examination that uses eye opening, movement and response to pain, and speech to determine a score that assesses a patient’s level of consciousness. A patient is considered to have a mild TBI if the score is high and a severe TBI if the score is low.
The imaging is an important part of the medical work-up for a TBI, but not everyone with a TBI needs imaging. Usually, a patient’s first evaluation is a CT scan because it shows blood or hemorrhages well and can be done quickly. However, in more mild injuries or with persistent symptoms, an MRI may be an appropriate first imaging study as this imaging study shows more details of the brain and can pick up other injuries that are not hemorrhage.
Individuals who experience a TBI or TBI-like symptoms should contact their primary care physician or contact 911 in more immediate, severe cases.
Reviewed on August 27, 2018.
Dr. Erin Manning is a neurologist at Hospital for Special Surgery. She specializes in the treatment of neuromuscular disorders, including neuropathy, myopathy, spine disorders, autoimmune diseases and sports neurology, including head injuries and concussions. Dr. Manning currently practices at Hospital for Special Surgery’s Manhattan campus and Stamford Outpatient Center.