Brain, Spine, & Nerve

Traumatic brain injury (TBI)

Traumatic brain injury (TBI) is brain dysfunction caused by an external force like a blow to the head. Symptoms can be mild or severe. Early care and the right follow-up can support recovery and long-term outcomes.

Traumatic brain injury (TBI) occurs when an external force, such as a blow or jolt to the head, causes the brain to function abnormally. Severity ranges from mild injuries, like concussions, to severe injuries that may result in long-term complications or be life-threatening.

Common Symptoms
Physical:

  • Headache
  • Dizziness
  • Nausea or vomiting
  • Balance problems
  • Changes in vision
  • Sensitivity to light or noise
  • Seizures

Cognitive:

  • Confusion
  • Trouble concentrating or remembering
  • Slowed thinking
  • Feeling disoriented

Emotional and Behavioral:

  • Mood changes
  • Irritability
  • Anxiety or depression
  • Personality changes

Sleep:

  • Sleeping more or less than usual
  • Trouble falling asleep

Causes
Traumatic brain injuries most often result from falls, especially in young children and older adults. Other causes include:

  • Motor vehicle accidents
  • Sports injuries
  • Bicycle accidents
  • Assaults
  • Penetrating injuries, such as gunshot wounds

Risk Factors
The risk of TBI is higher in males, young adults ages 15–24, and adults age 65 and older. Additional risk factors include:

  • Participation in contact sports
  • Not wearing helmets or seat belts
  • Previous TBI
  • Alcohol or drug use
  • Certain occupations, such as construction or military service

How TBI Is Diagnosed
Diagnosis begins with a discussion of how the injury occurred and a careful neurologic exam. Our team often uses the Glasgow Coma Scale to assess consciousness and injury severity. Imaging tests such as CT scans are commonly used to detect bleeding, swelling or fractures. MRI may be used if more detail is needed. If symptoms persist, neuropsychological testing can evaluate ongoing issues with memory or thinking.

Prognosis and Follow-Up
Recovery varies widely. Many people with mild TBI recover within days to weeks, while others experience lingering symptoms. Moderate to severe TBIs can result in long-term challenges affecting thinking, movement or emotions. Rehabilitation, including physical, occupational and speech therapy, along with mental health support, plays an important role. Early care and individualized follow-up improve recovery outcomes.

When to Seek Care
Seek emergency care right away if a head injury is followed by:

  • Loss of consciousness
  • Repeated vomiting
  • Worsening headache
  • Seizures
  • Sudden weakness or numbness
  • Slurred speech
  • Confusion
  • Unequal pupil size
  • Difficulty staying awake

Even without urgent warning signs, see a provider if symptoms worsen or do not improve.

Prevention

  • Wear seat belts and use proper car seats for children
  • Use helmets for biking and contact sports
  • Reduce fall risks at home by clearing hazards and adding handrails
  • Never drive under the influence of alcohol or drugs
  • Follow safety guidelines at work and during recreational activities

What is the difference between a concussion and a traumatic brain injury?
A concussion is a mild form of traumatic brain injury caused by a blow or jolt to the head that briefly affects brain function. More severe TBIs may involve longer loss of consciousness, visible injury on imaging or more serious neurologic problems.

How will I know if a head injury is serious?
Seek emergency care for loss of consciousness, repeated vomiting, worsening headache, seizures, weakness, numbness, slurred speech, confusion, difficulty waking, or fluid leaking from the nose or ears.

What tests are done after a suspected TBI?
Evaluation includes a neurologic exam and Glasgow Coma Scale assessment. CT scans are commonly used to look for bleeding or fractures, with MRI used in some cases. Neuropsychological testing may be recommended if symptoms persist.

How long do concussion symptoms last?
Many people improve within one to two weeks, though symptoms may last longer depending on age, prior injuries and overall health.

Can TBIs cause long-term problems?
Yes. Moderate and severe TBIs can cause lasting issues with thinking, movement and mood. Repeated mild injuries may also lead to persistent symptoms. Early rehabilitation improves outcomes.

What treatments are available for TBI?
Immediate treatment focuses on stabilizing the patient and preventing further injury. Recovery may involve physical therapy, occupational therapy, speech-language therapy, cognitive rehabilitation and mental health care.

Is rest or activity better after a concussion?
Rest is important for the first 24 to 48 hours, followed by a gradual return to activity under medical guidance. Prolonged complete rest may slow recovery.

When can I return to sport or work?
Return should be gradual and individualized. Athletes must be symptom-free before progressing. Work adjustments may be needed depending on symptoms and job demands.

Can repeated TBIs cause dementia or other degenerative conditions?
Repeated head injuries may increase the risk of long-term brain conditions, such as chronic traumatic encephalopathy (CTE) or dementia. Risk depends on injury frequency, severity and individual factors.

How can I reduce my risk of TBI?

  • Use seat belts and proper child restraints
  • Wear helmets for sports and biking
  • Reduce fall risks, especially for older adults
  • Avoid driving while impaired
  • Follow safety rules at work and during recreation

If you have concerns about a recent head injury or ongoing symptoms, contact your healthcare practitioner or seek emergency care for guidance.