Mild Traumatic Brain Injury
Traumatic brain injury, or a TBI, occurs when a sudden injury damages the brain. Leading causes of TBI include: motor vehicle crashes, falls, assaults, gunshot wounds and sports-related injuries. The severity of the injury can vary.
What happens in a TBI?
A jolt to the head can disrupt the normal function of the brain. In most cases, there are no lasting effects from an injury to the head because of the built-in cushion around the brain. Sometimes the force of the injury is severe enough to cause bruising and swelling, nerve damage or tears in the blood vessels that provide oxygen and nutrients to the brain. When this happens, you are more likely to notice some of the symptoms listed below.
How serious was the head injury?
Symptoms of a TBI can be mild, moderate, or severe. About 80 percent of all head injuries are classified as mild. Although medical professionals may describe a head injury as mild, the effects may still be serious.
The severity of the injury is measured by the amount of time a person was unconscious, or knocked out, after the injury or if the person loses memory of the events before or after the event. In a mild TBI, there may be no loss of consciousness or a brief loss of consciousness, lasting less than 30 minutes.
If imaging of the brain is done after a loss of consciousness, it may or may not show bleeding or bruising. When there is no bleeding or bruising in the brain, the injury may be called an uncomplicated brain injury. People with uncomplicated brain injuries are less likely to have symptoms than people who had bleeding or bruising in their brains after the injury.
What are the symptoms?
Symptoms that are common after a mild TBI include poor concentration, irritability, increased fatigue, depressed mood, memory problems, headaches, anxiety and trouble thinking. Some patients also report blurry or double vision and being sensitive to bright light or noise.
Some symptoms may appear right away, others may not show up for days or weeks after the injury. Early treatment of these symptoms may speed recovery.
How long will the symptoms last?
Recovery after a traumatic brain injury can vary among patients. Most people have complete recovery within three to four weeks following the injury. About 70 percent of patients have complete recovery within three to six months.
A small group of people may have symptoms that last a year or longer. Other factors, such as stress, substance abuse, depression, anxiety, injuries to other parts of the body or prior history of brain injury may contribute to longer-lasting difficulties.
What can I do about these symptoms?
Keep in mind that symptoms are a normal part of recovery and will often go away without further treatment. The following suggestions could help reduce the symptoms and the effects they have on your daily life.
- Poor concentration: If you are having trouble staying focused on a task, take a short break or shorten your task. Being tired can make paying attention harder. Getting rid of distractions may help. Try to do one thing at a time.
- Irritability: Everyone gets irritable, frustrated or angry from time to time. Irritability becomes a problem when these emotions make it hard to get along with people from day to day.
People tend to lose their tempers more often when they are tired. Changing your schedule to allow for more rest may reduce this problem. Think about the cause of your irritability, and try to come up with ideas to solve the problem. This can often make the problem less irritating.
- Fatigue: It is common to feel tired after a head injury. Avoid wearing yourself out. Slowly increase your activity level, and take frequent rest breaks.
- Depression: People may feel depressed or discouraged when unpleasant things happen to them. Plan enjoyable things to do on a regular basis and stick to your plan. Thinking about doing something you enjoy can improve your mood. It may help to lower your expectations of yourself during your recovery time.
- Memory problems: The part of the brain most often involved in head injury plays a big role in storing memories. Difficulty concentrating, pain, unpleasant emotions and fatigue can also affect our memory. If you are having trouble remembering things, it may help to write them down. Ask your doctor to have your memory tested.
- Headaches: Headaches are very common after a TBI and commonly go away with time. When headaches start several weeks after a head injury, they are frequently caused by fatigue, overstimulation, stress or tension. This may mean that you are trying to do too much. Changing your schedule may help. You can also try relaxation techniques, such as deep breathing or listening to calming music, to reduce muscle tension.
- Anxiety: Worry about symptoms and problems at work are the main causes of anxiety in patients with head injury. Realizing these symptoms are a normal part of getting better will likely reduce your anxiety.
- Trouble thinking: Problems with thinking are often due to other symptoms, such as fatigue, headache and decreased concentration. This may mean that you are doing too much, too soon.
- Dizziness: Your doctor should address loss of balance, feelings of light-headed or dizziness. Dizziness may be treated by medication and typically goes away with time. If dizziness persists, your doctor may refer you to a physical therapist for further assessment and treatment.
- Visual changes: Blurred or double vision and eyes that tire easily are common after a head injury. Talk to your provider. Vision changes may be treated by medication and often improve with time.
- Sensitivity to light or noise: You may be more sensitive to light or sound, and this may be more common if you have headaches. Paying attention to these symptoms often makes them seem worse. Often, the less you think about these symptoms, the faster they will go away.
If symptoms persist, there are rehabilitation professionals who can help with therapy or ideas to help you address these symptoms.
A rehabilitation psychologist or mental health professional can help with depression, anxiety and irritability. A speech language pathologist can help with strategies for memory, difficulty thinking, and difficulty concentrating. A physical therapist can help with headaches and dizziness. Your primary care provider can help you decide whether referrals would be helpful.
Contact your primary care provider, and share this information with him or her. The physician can then refer you to the appropriate rehabilitation professional based on your needs.
If you do not have a primary care provider or if your provider has questions about the information in this handout, you can contact Thomas Lukehart at Harborview Medical Center at 206.744.2096.
Tips for recovery:
- Rest is important because it helps the brain to heal, and healing takes time
- Return to your normal activities slowly, not all at once
- Avoid doing things, such as contact sports, that could lead to a second brain injury
- Discuss return to driving, work, or school with your provider
- Take only the medicines approved by your provider
- Do not consume alcohol