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Traumatic Brain Injury


Notice: Before you read this article, please note that it is provided exclusively for informational purposes. While this article discusses some of the common signs and symptoms of a traumatic brain injury, only a qualified health care professional can diagnose (or rule out) a brain injury. If you believe that you or a loved one has suffered a brain injury, please seek appropriate medical help. A person's medical needs must be assessed by a qualified medical professional.

The worst thing you can do if you have suffered a traumatic brain injury is mistakenly assume that you have not suffered injury, or that "it will get better by itself." If you suffer a brain injury in an accident, but do not report your symptoms or seek medical help, you may find yourself unable to convince your insurance company that your injury resulted from the accident. You may also find yourself unable to recover money damages from the person who caused your injury. A brain injury can be the longest lasting, most debilitating injury resulting from an accident, affecting your life long after your other injuries have healed.

Obtain Medical Care

If you believe you have a brain injury, seek treatment at the earliest possible date. Even if you don't think you have suffered a brain injury, you should report to your physician any symptoms that might suggest a brain trauma or blow to the head, such as pain or bruising, headaches, loss of memory of events before or after an accident, dizziness, tinnitus (ringing in the ears), bleeding or seepage of fluid in the ear canal, or any other suspicious symptoms. An emergency room physician should be prepared to respond to your questions about your symptoms, and can help determine if you show any immediate signs of brain injury, or if you should go through testing or further examination for possible injury.

It is a common mistake to assume that a brain injury cannot result from a low-speed traffic accident. There is now substantial medical literature, establishing that brain injury can occur even as the result of "minor" traffic accidents. Don't allow yourself or your physician to be fooled by the "minor" nature of the accident -- if you show any signs of a brain injury, you should explore the possibility that you have suffered one.

Causes of Injury

Traumatic brain injury (TBI) can arise from a variety of causes. The most common cause is a direct blow to the head of the injured person. However, a brain injury can occur even without a blow to the head - the brain can be injured by colliding with the inside of the skull. The brain can "ricochet" inside the skull as the result of an accident, resulting in injury even with little or no direct force to the outside of the head. Brain injuries can occur suddenly, as the trauma causes tissues in the brain to tear, or can occur as a result of swelling or bleeding of the brain following a traumatic incident. TBI can result from violent shaking (as with "shaken baby syndrome," sometimes seen in abused children), a loss of oxygen to the brain, poisoning or infection.

Signs and Symptoms of Injury

Serious brain injuries are usually apparent at the time of injury. However, mild traumatic brain injury (MTBI) is less likely to be diagnosed. Symptoms associated with MTBI include:

  • Brief loss of consciousness;
  • Loss of memory immediately before or after the injury;
  • Any alteration in mental state at the time of the accident;
  • Focal neurological deficits.

In many MTBI cases, the person seems fine on the surface, yet continues to endure chronic functional problems. Some people with MTBI suffer from post-concussion syndrome (PCS), and may experience significant changes in their personality and cognitive abilities.

Traumatic brain injury can significantly affect an injured person's mental, physical and psychological well-being.

Physical State

Symptoms can affect strength, endurance, balance and ability to walk (ambulation), coordination, and fine motor skills. Symptoms can also include tinnitus (ringing in the ears), visual blurring or double vision. An injured person may also suffer severe headaches or seizures as a result of TBI.

Psychological State

A broad variety of psychological effects can result from a brain injury, including change of personality, loss of impulse control, decreased judgment and depression. Depression may result from the brain injury itself, or as a reaction to the personality changes, loss of capacity, headaches, or other symptoms resulting from the injury.

Mental Functioning

Cognitive symptoms can include speech and communication difficulties, memory loss (short term and long-term), problems processing information, disorientation, frustration, anger, and loss of perceptual skills.

Adjustment And Rehabilitation

People who suffer brain injuries offen have adjustment difficulties during their recovery. It can be very difficult to deal with the change of personality, and the loss of cognitive skills that may result from a brain injury. It is difficult for people to accept that what used to come naturally to them is now a struggle. The recovery and therapy process, even where a brain injury is relatively mild, can be physically, mentally and emotionally exhausting. If the injured person is also suffering from headaches or depression, the exhaustion can be magnified.

If you have been diagnosed with a brain injury, you should consult with physicians and psychologists who specialize in brain injury cases, as they are in the best position to prescribe appropriate therapies and medications to help you make the fullest possible recovery. In appropriate cases, vocational therapy will be appropriate, perhaps including a "job coach" who will accompany you to work to help you readjust to your employment and to develop strategies to help you perform your work. Medications should be chosen with care, to avoid problems with dependence or "rebound headache."

Educating The Family

In the event of brain injury, family education is often appropriate, where family members will learn about the effect of TBI on the injured family member. Sometimes, an injured person will refuse to acknowledge, or be unable to recognize, that he has suffered a brain injury. A TBI will affect the injured person's relationships with other family members, and early education and family counseling can be very beneficial.

Injuries To Children

If your child has been in an accident, please remember that young children may have difficulty articulating the symptoms they are suffering as the result of a brain injury. It is up to you to watch for the signs of brain injury in your child, and to seek appropriate testing if you believe that your child has suffered a brain injury. Children are susceptible to brain injury from sources that their parents may not recognize, such as being poisoned by lead paint "dust" in older houses. (Don't make the mistake of assuming that lead paint poisoning comes only from "eating paint chips" - lead paint dust can be created by opening and closing windows that have been painted with a lead-based paint. That dust, if ingested, can poison your child, even if your child would never "eat paint chips." If you think your house may contain lead paint, have it tested to make sure that the lead levels are safe for your children.) The consequences of brain injury in a child can be extremely stressful on a family, and can affect the child for the rest of her life.

Diagnosing minor traumatic brain injuries in children can be difficult, as a child may not be actively using the cognitive skills associated with the injured region of the child's brain. At the age of six, an injured child may appear to have made a full recovery from a brain injury, but by the age of nine the same child may display great difficulty learning math as a result of the injury.

Past conventional wisdom was that infants and very young children made better recoveries from brain injuries than did older children and adults. Current research indicates that this is not the case - infants and very young children often have very difficult recoveries from their injuries.


If you believe that you or a member of your family has suffered a brain injury, seek appropriate medical treatment, and seek it early. If you believe that somebody may be legally responsible for the injury, whether through an intentional act or as the result of an accident or negligence, consult an attorney who is experienced with brain injuries to help you determine if you should file a lawsuit.