Understanding Traumatic Brain Injury
Understanding Traumatic Brain Injury
By Joelle Y. Jean, FNP
A traumatic brain injury or TBI can happen to anyone at any time. According to the Center for
Disease Control and Prevention (CDC), each year in the United States,1.5 million children and
adults experience a TBI.
When a TBI occurs, it can be mild- lasting for a few days- or severe, leaving you with serious
injury or death. About 5.3 million lives with a permanent injury to the brain.
The best way to avoid a TBI is prevention.
In this article, we will discuss the most common causes of TBIs, common types of TBIs, those at
higher risk, signs, and symptoms. We will also discuss when to seek help, treatment, and
prevention. Lastly, advice to caregivers.
Common causes of TBIs
According to the CDC, the most common causes of TBIs are:
● Falls
● Car accidents
● Suicide by firearm
● Assault
It was originally thought TBIs are more common in men. Men tend to participate in high-risk
behavior and work in male-dominated professions. Men do experience more TBIs but at a
younger age.
Women catch up to men with TBIs when they get older because of falls. Women are also
participating in more contact sports and enlisting in the military. It is worth noting this because
TBIs can be missed in women causing treatment to be delayed.
Falls are more common over the age of 65. This age group tends to:
● Lose their balance
● Fall due to medication side effects
● Fall due to poor eyesight
Common types of TBIs
An acquired TBI is when someone sustains an injury to the head. There are two types:
1. Non-traumatic
2. Traumatic
A non-traumatic brain injury happens when the injury happens inside the head or internally:
● A stroke
● Infectious diseases
● Lack of oxygen to the brain i.e. a heart attack
A traumatic brain injury happens from outside or an external injury like:
● A gunshot wound
● Hit with a blunt object i.e. a bat
● Hitting your head in a car or motorcycle accident
There are several common types of TBIs. It is based on how mild or severe the injury is. The
three most common TBIs are:
1. Mild TBI or concussion
2. Moderate TBI
3. Severe TBI
A Mild TBI or concussion is the most common injury. You may feel dazed or confused after a
mild concussion for a day or two. A person passes out no more than 30 minutes and will not
have memory loss or difficulty with attention.
A moderate TBI is when you lose consciousness or pass out for more than 30 minutes but not
longer than a day. You can be confused for up to a week.
A severe TBI is when you lose consciousness for over a day. Doctors and/or health care
providers will see changes in your brain when they are taking pictures of your brain by an MRI
or CAT scan.
These common TBIs are based on many factors. It should be explained to you by your provider
in detail.
Groups at higher risk for TBIs
There are groups who are at higher risk for TBIs because of health disparities. Health disparities
are differences in health outcomes. These groups have a higher chance of living with severe
injury, or death. These groups include:
● Racial and ethnic minority groups
● People with lower income
● People living in rural areas
● Military and Veterans
● People who experience homelessness
● People in correctional facilities
● People who experience intimate partner violence
Brain Injury Symptoms
If you hit your head, you may experience a TBI and not know it. You may not seek care right
away. You may experience mild to severe symptoms. If you experience symptoms, you should
seek care immediately. The symptoms include:
● Headache
● Dizziness and or confusion
● Seizures
● Behavior or mood changes
● Blurred vision
● Your pupils increase in size
● Nausea and/or vomiting
● Agitation
● Can’t sleep or sleeping too much
● Light bothers your eyes or you are bothered by certain smells
● Difficulty speaking
When to seek help
If you hit your head because of a fall, a car accident, a motorcycle accident, or you hit your head
with a hard object, the best place to seek help is the emergency room. Even if you think you are
okay, it is appropriate to be seen by a doctor or health care provider.
Seeking help can save your life. If you can’t make it to the emergency room, telemedicinespeaking
to a provider over a video visit- is also appropriate.
Treatment for TBIs
One important treatment for TBIs is seeking help quickly. This can save your life and also help
you on the road to recovery. Other treatments your doctor or healthcare provider may order are:
● Rest
● Surgery
● Rehabilitation
You may need rehabilitation after a TBI. Your doctor or primary care provider may order:
● Physical therapy - helps builds strength and coordination.
● Speech therapy- helps improves your speech and communication. It also can help with
swallowing.
● Occupational therapy- helps you relearn how to bathe, dress, and eat.
● Counseling- helps with your well-being and helps you return back to work and focus on
challenges you may face.
● Cognitive therapy - helps with improving memory, learning, and judgment.
The goal is to build strength, coordination, and confidence back into your life.
Advice to Caregivers
Caring for a loved one with a TBI can be stressful. If you are caring for someone with a TBI, it is
important to also care for yourself. Know when to ask for help and advocate for your loved one,
as well as yourself.
It is important to recognize your limitations and set realistic goals. Goals include:
● Setting time for yourself
● Perform small tasks at a time so they aren’t overwhelming
● If you don’t complete something, give yourself time to complete it later or the next day
● Listening before reacting
Remember you aren’t alone in the journey. Know when to lean into your support network for
encouragement, guidance, and advice.
Prevention
No one expects a TBI, so the best thing is to prevent them. Here are some strategies to prevent
TBIs:
1. Wear a helmet.
2. Wear your seatbelt, and put children in car seats, and booster seats.
3. Do not drink alcohol or take drugs while driving.
4. Speak to your doctor or health care provider about certain medications you are taking
and their side effects.
How to prevent falls in the home:
1. Haverails on the staircase.
2. Install grip bars in the shower, and/or tub.
3. Exercise to increase your strength.
4. Get your eyes checked regularly.
5. Remove rugs or other tripping hazards.
6. Use walkers and canes.
7. Window guards for children.
You want to feel safe when you’re on the move! The most important advice is to prevent TBIs. If
you do hit your head in an accident, even if you feel well, see a health care provider.
Resources:
Fall Prevention Checklist: https://www.cdc.gov/steadi/pdf/check_for_safety_brochure-a.pdf
Brain Injury Association of America: https://www.biausa.org
Center for Disease Control and Prevention: https://www.cdc.gov/traumaticbraininjury/index.html
BIO
Joelle Y. Jean, RN, FNP-BC has been a nurse for over 10 years and Family Nurse Practitioner
for over 3 years. She has a background in pediatric emergency room, labor and delivery and
primary care. Today, she is a senior nurse writer for nursejoural.org. She lives in New York with
her husband, two adorable children, and cat, Zuzu.