Traumatic Brain Injury

Brain SilhouetteTraumatic brain injury (TBI) usually results from a violent blow or jolt to the head or body; or an object, such as a bullet or skull fragment, penetrating brain tissue. Common causes of TBI include falls, motor vehicle accidents, assaults, sports injuries and explosions or combat injuries. Those most at risk of sustaining a TBI include children age four and under, those between ages 15 and 24, adults age 60 and older, and males of any age.  

TBI may have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.

The severity of a TBI may range from “mild” (e.g. a brief change in mental status or consciousness) to “severe” (e.g. an extended period of unconsciousness or memory loss after the injury).  Most TBIs are mild; commonly called concussions.

Symptoms of a mild TBI may include:

  • Physical symptoms: short-term loss of consciousness, confusion or disorientation, headache, nausea and/or vomiting, fatigue or drowsiness, dizziness or loss of balance, problems with speech or change in sleep patterns.
  • Sensory symptoms: blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell, sensitivity to light or sound.
  • Cognitive or mental symptoms: memory or concentration problems, mood changes or mood swings, and/or feeling depressed or anxious.

It is important, even following a mild TBI, to continue to monitor for delayed onset of additional symptoms. Indications of a moderate to severe TBI may include any of the above symptoms as well as additional symptoms which may appear hours to days after the injury. These may include:

  • Physical symptoms: loss of consciousness lasting from minutes to hours, persistent or worsening headache, repeated nausea and/or vomiting, convulsions or seizures, dilation of one or both pupils of the eyes, clear fluids draining from the nose or ears, inability to awaken from sleep, weakness or numbness in fingers and toes, and/or loss of coordination.
  • Cognitive or mental symptoms: profound confusion, agitation, combativeness or other unusual behavior, slurred speech and coma or other disorders of consciousness.

It is imperative that medical attention is sought following any head trauma. Remember that the appearance of any symptoms of a moderate to severe TBI may emerge days after the original incident, and should be treated as a medical (911) emergency.

Due to the acute nature of TBI, no health promotion activity plan (HPAP) is part of this article. If someone you support has had a TBI, an individualized HPAP could be created addressing that person’s specific symptoms, treatments and supports.


National Institute of Neurological Disorders and Stroke, September 2015, Traumatic Brain Injury: Hope through Research, Bethesda, Maryland, National Institutes of Health