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Traumatic Brain Injury

It is well recognized and accepted in the medical community that a so-called mild head injury can be a significant and serious traumatic brain injury, with a major impact on family, personal relationships and employment, even though the person was not "knocked out" at the scene, did not suffer a skull fracture or any cuts or broken bones, and even though they may have been talking and exchanging their driver's license information and insurance information at the scene of the accident. In crashes involving traumatic brain injury, it is quite typical that the injured person is at first unaware of the-significance of the event, and by the time that the consequences of the traumatic brain injury begin to interfere significantly with the person's life, neither they nor their family members relate the problems to the automobile accident, slip and fall, or whatever physical trauma occurred.

While there are many signs and symptoms of Traumatic Brain Injury, some of the leading ones that can be present, without any other medical problems are:

  • Headaches
  • Memory problems
  • Concentration and attention problems
  • Personality changes
  • Difficulty with organization tasks, planning, the day, preparing meals, planning a work day or planning and organizing activities
  • Fatigue or inability to get going
  • Inability to fall asleep or remain asleep
  • Balance and dizziness problems
  • Irritability, anger and/or frustration and emotional problems
  • Difficulty with reading or watching television
  • Double vision
  • Speech and communication problems with inability to express thoughts and misunderstanding of others
  • Depression, which can be related to the traumatic brain injury itself, and to the changes caused by the traumatic brain injury

It may take more effort to do the things you used to do automatically. You may experience memory problems.

Emotionally, you may find yourself more irritable and quicker to get angry. You may get depressed more easily, or laugh or cry when you don't expect to. You may feel more argumentative. All these emotional reactions are a direct result of damage to nerve cells suffered as a result of your accident, and do not mean you are crazy or abnormal.

Finally, you may find it more difficult to make plans, get organized, and set and carry out realistic goals. You may say and do things that others take offense at, which you wouldn't have done before. Your judgment may be off. Often you will hear these observations from others that are concerned about you, rather than noticing them yourself. Your friends and family may comment that "you are not the same person" since your injury.


What is traumatic brain injury? Traumatic brain injury is the temporary disruption of brain functioning due to an insult to the head. Usually the patient is sent directly home from the hospital.

Is the head always struck in a traumatic brain injury? No. Usually the head is struck, as in a car accident, fall, or blow to the head. But traumatic brain injury may occur as a result of sudden violent motion - such as a whiplash injury - without the head actually hitting anything.

Is There Always Loss Of Consciousness? Usually, but not always. Brief loss of consciousness is common, but traumatic brain injury can occur even without loss of consciousness.

What happens during traumatic brain injury? The damage occurs when the soft, movable brain twists and collides with the rough interior surface of the skull during violent motion to the head. Nerve fibers may be stretched and torn, and bruising may occur on the surface of the brain. (In more serious injuries, bleeding and swelling may occur within the brain.)

Why is Traumatic Brain Injury called "THE UNSEEN INJURY." Because even though physical recovery may be complete, and the person may look fine, nonphysical problems in the areas of thinking, behavior, and emotions may remain as a result of damage to nerve cells.

Does Traumatic Brain Injury Always Result in Permanent Problems? No. Most people who suffer mild bumps will be OK. Temporary symptoms will disappear with time. Only when enough nerve cells have been damaged--or if there are repeated minor injuries--will persons experience permanent changes in the way they think, feel, and act.

What is The Normal Course Of Recovery For Traumatic Brain Injury? Some people may experience headaches, dizziness, nausea, vomiting, confusion, disorientation, fatigue, and slowness immediately after. For some time after the injury, persons may have problems with learning and memory, attention and concentration, a slower thinking process, irritability, and physical and mental fatigue. These symptoms are common and mean that a person has suffered a "concussion." Usually these symptoms will gradually disappear over a period of weeks or months.

When Do More Permanent Problems Occur? When a sufficient number of nerve cells have been damaged, certain symptoms may remain and interfere with a person's life at home, in school, or on the job. Often this is not encountered until a person returns to the demands of work, school, or home.

How will I Recognize these problems? You will notice that "something is off;" things just "aren't the same." Memory problems are common, not for things already known, but for new learning. You may more forgetful of names, where you put things, appointments, etc. Your attention span may be shorter, you may be easily distracted, or forget things or lose your place when you have to shift back and forth between two things. You may find it harder to find the right word or express exactly what you are thinking. You may find yourself irritable or emotional.

What Do These Changes Mean? When these changes persist for many months, it means that enough nerve cells were damaged to affect your thinking, emotions, and behavior. You should seek help to learn to adapt or overcome the changes.

Will Medical Doctors Find Neurological Damage If I Have These Problems? Not necessarily. The nerve cell damage that occurs may be widespread and microscopic, so that it does not appear on x-rays, CT scans, MRI's or on neurological exams. Your problems may be real and caused by nerve cell damage even if not medically obvious. Do not fall victim to being told you are malingering or imagine your symptoms.

Does this mean none of my problems are psychological? No. When you cannot function the same as you used to, and do not understand why, it is natural to become frustrated and depressed. If you are told you have no real problems and are just imagining things, it is easy to feel guilty, angry, frightened, or like you are going crazy. These feelings complicate the problem. It means you should seek help.

What should I do if I encounter these problems? Contact the medical professional you trust most. Explain your problems and ask for a referral for a neuropsychological evaluation. A neuropsychologist is a psychologist who is specially trained to understand and treat the problems that occur following damage to the brain.

I have had a traumatic brain injury. Should I be worried? No. Most people recover, after minor accidents, with time. Don't be so anxious that you start avoiding situations. Return slowly to your normal routine. But if your problems persist, seek help.

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