Inside the Brain: The Ends and Outs of TBIs

Traumatic Brain Injury
Bumping your head occasionally is usually not a cause for concern. However, intense blows to the head, through falling or accidents, can lead to traumatic brain injuries (TBIs). As serious as a TBI sounds, prompt treatment allows most people to survive these injuries and lead full lives.

If you suspect you or someone else has experienced a traumatic brain injury, visit the nearest emergency room or call 911.

What Is a Traumatic Brain Injury?

Every year, at least 2.8 million people in the U.S. experience a TBI. Each day, there are more than 586 hospitalizations and 190 deaths due to TBIs, and the highest number of TBIs are sustained by people who are 75 years and older.

TBIs are serious medical conditions that impact normal brain function. They can range from a mild concussion that goes away after a while to severe brain damage that leads to life-altering complications.

Your brain has billions of neurons, which are nerve cells that communicate with other parts of your body and allow you to talk, walk, breathe, and eat. A TBI can disrupt these brain cells and impact your cognitive and physical capabilities. 

Common Causes of TBIs

TBIs occur when external forces impact the brain and cause temporary or permanent damage. Common causes for TBIs include:

  • Sports injuries: Sports like boxing, ice hockey, soccer and football can cause head injuries and trauma that lead to TBIs.
  • Slips, trips and falls: Older adults are the most vulnerable to falls that cause TBIs.
  • Vehicle accidents: Car, bicycle and motorcycle accidents are other potential causes of TBIs and damage to the brain.

Different Types of Traumatic Brain Injuries

TBIs have different levels of severity. They include:

  • Mild TBIs: A concussion is an example of a mild TBI. While a concussion may cause confusion, headaches and dizziness, its symptoms are often temporary and not as severe as a moderate or severe TBI. Repeated concussions, however, could cause lasting and increasing damage.
  • Moderate TBI: Someone diagnosed with a moderate TBI may experience symptoms like loss of consciousness for up to 24 hours.
  • Severe TBI: People who have a severe TBI may experience extensive brain damage, prolonged unconsciousness lasting more than 24 hours and life-threatening problems.
  • Closed versus penetrating TBI: Closed TBIs result from a blunt strike to the head. With penetrating TBIs, an object penetrates the skull and harms brain tissue.

Symptoms of Traumatic Brain Injury

TBIs can impact your physical, cognitive and emotional functioning. These symptoms of TBI are also found in other conditions. A healthcare provider should always assess these symptoms to rule out or confirm a TBI.

Physical Symptoms:

  • Blurred vision
  • Dizziness and loss of balance
  • Fatigue or drowsiness
  • Headaches
  • Light and sound sensitivity
  • Nausea
  • Vomiting

Cognitive and Emotional Symptoms:

  • Confusion
  • Difficulty sleeping or excessive sleeping
  • Disorientation
  • Depression or anxiety
  • Memory loss or difficulty concentrating
  • Mood swings and irritability

Diagnosing Traumatic Brain Injuries

To diagnose a TBI, a health care provider must do a thorough assessment. They also order tests and scans to check your brain for any damage.

  • Cognitive and psychological tests: These tests measure your memory, concentration, problem-solving skills, response time and information processing.
  • Glasgow Coma Scale: This test measures the severity of the injury to the brain using eye, motor and verbal responses.
  • Imaging tests: CT and MRI scans can identify structural damage, swelling or bleeding in the brain, which are signs of severe traumatic brain injuries.
  • Neurological exam: This exam allows your doctor to gauge your reflexes, coordination and cognitive functions. They may ask you to push or pull on their hand, stand on one foot or walk in a straight line.

Treating TBIs

Treatment for a TBI depends on its severity. Mild TBIs usually involve rest and watching out for new symptoms or symptoms that get worse. Moderate to severe TBIs require emergency care and may involve surgery and oxygen therapy, followed by rehabilitation.

Emergency care for TBIs focuses on preventing further brain damage, ensuring vital signs are stable and your brain is getting sufficient oxygen. Rest, ongoing monitoring and pain relief are also part of emergency TBI treatment.

Tips to Prevent TBIs

There’s no single action you can take to avoid a TBI. However, you can follow certain precautions to reduce your risk, such as:

  • Always wear a helmet when riding motorcycles, bicycles or scooters, and remember to replace them after a single accident
  • Follow workplace safety rules, such as wearing a hard hat if required
  • Make your home safer by installing handrails, securing rugs and improving lighting to prevent falls
  • Using seat belts in a car to prevent head injuries if there’s a collision

Life After a TBI

After moderate or severe TBIs, some people may require additional therapies to help restore their cognitive and physical abilities. The goal of post-TBI rehabilitation is to help the brain relearn and rewire itself to make up for its injured areas.

This may include:

  • Counseling. Behavioral counseling can help with mood changes and depression from the injury itself and help you cope with life after a brain injury.
  • Occupational therapy. This type of therapy can help you live independently if a TBI affects your cognitive and physical abilities. Under the guidance of an occupational therapist, you may learn new skills to get dressed, make food and move around.
  • Speech and language therapy. You may engage in exercises that improve or restore your speech during speech and language therapy.
  • Physical therapy. This type of therapy involves exercises that help you regain and improve movement, balance and posture.

Family also plays an important role, as they are a vital source of support during the recovery process. Learn more about supporting a loved one after a TBI.

More to Read


Need care after a traumatic brain injury?

Neurologists and neurosurgeons at the University of Maryland Medical System offer treatment for and after TBIs to help patients return to good health.

Medically reviewed by Gary Schwartzbauer, MD, PhD, FAANS, FACS.

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