What Can You Expect After a Traumatic Brain Injury?

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There are a variety of situations that can lead to a traumatic brain injury. Among the most common reasons, and also contributors to the most severe, are car accidents. In children, traumatic brain injuries also often occur from playing sports and falls. 

TBIs can cause detrimental injury to the brain in the short- and long-term. 

A traumatic brain injury is a sudden one that can happen not only with a blow to the head but also with a jolt. TBIs are closed head injuries, and when they occur because something penetrates the skull, it’s known as a penetrating injury. 

If a loved one is dealing with a TBI, it can be scary and hard to know what to expect. Everyone’s recovery and process are different, but in general, the following maps out some of the expectations when recovering from TBI.

Diagnosis

It’s important to get a diagnosis of a TBI as soon after the injury as possible so that treatment can begin if needed. Even if you aren’t sure whether or not a head injury warrants medical attention, get it anyway. 

When someone goes to the hospital or a medical professional following a head injury, they’ll do an assessment of the condition. 

Some people are then released, and they can recover at home. Others may be admitted to the hospital, where they’ll be assessed. Doctors want to make sure someone’s brain is getting enough oxygen and blood flow. They’ll work to prevent blood clots, reduce seizure risk, and in severe instances, a doctor may need to do surgery to remove damaged brain tissue, remove clotted blood or alleviate pressure. 

A Lot Depends on Severity

Much of what someone’s recovery will look like is going to depend on the initial severity of the injury. 

TBI can be characterized as mild, moderate, or severe, with concussions representing a mild type of injury. 

While effects can be serious, most people recover from symptoms of TBI, which can be physical and psychological. 

Symptoms of a mild injury can include:

  • Brief period of lost consciousness
  • Confusion
  • Feeling lightheaded
  • Headache
  • Dizziness
  • Blurry vision
  • Tired eyes
  • Ringing in the ears
  • Fatigue
  • Lethargy
  • Changes in sleep patterns
  • Mood or behavioral changes
  • Problems with memory, attention, or thinking

With moderate or severe injuries, additional symptoms can include:

  • A persistent headache
  • Repeated nausea or vomiting
  • Seizures
  • Convulsions
  • Not being able to wake up
  • Dilated pupil in one or both eyes
  • Weakness or numbness in the limbs
  • Coordination loss
  • Slurred speech
  • Increasing agitation or confusion

In people with severe head injuries who are in a coma, something called neurostorming can occur. 

Neurostorming is when there’s a sudden, extreme stress response because of brain damage, leading to surges in heart rate, blood pressure, and body temperature. The situation refers to the hyperactive response of the sympathetic nervous system, which is in charge of activating the fight-or-flight response. 

Estimated Recovery Timelines 

For people with mild TBI, a.k.a. a concussion, most will recover the majority or all of their brain function within three months. Many people will recover sooner. 

With moderate TBI, most people will recover some or all of their brain function, but they might need treatment like speech or language therapy, physical or occupational therapy, or social services. 

It’s very challenging to predict recovery timelines for severe TBI. Factors that play a role include trauma location, the severity of the damage, and how long someone spends in a coma. 

In the initial weeks after a moderate to severe brain injury, there may be swelling, bleeding, and changes in brain chemistry. If someone is injured severely, they may not show signs of awareness, and their eyes might stay closed. 

As the swelling goes down and the blood flow and chemistry of the brain improve, for many people, the brain function will as well. 

Once someone’s eyes open, their sleep-wake cycles might start. The person who’s injured might follow commands and begin to respond to people. 

You might hear a few terms early in recovery, particularly for a very severe brain injury. 

  • One of these is a coma. When someone is in a coma, they’re conscious with their eyes continuously closed. They’re not responding to sounds or visual stimulation, and they can’t communicate or show any emotional response. 
  • A vegetative state is another term, also known as Unresponsive Wakefulness Syndrome. In this state, a person can usually breathe on their own, and they might have sleep-wake cycles along with functional reflexes. 
  • In a minimally conscious state, someone might know where visual stimulation and sounds come from and recognize objects. In a minimally conscious state, a person could show emotions or answer basic questions. 

Following a moderate-severe traumatic brain injury is something called a confusional state. A confusional state is also referred to as post-traumatic amnesia. Someone may have a hard time remembering and paying attention during this stage of their recovery. 

They may have alterations in sleep patterns and get restless, agitated, or nervous easily. 

There are often inconsistencies in behavior, and some days during the recovery period can be better than others. 

With later recovery stages, a person’s ability to respond will get better, and they can have improvements in physical and mental function. 

Two Years After An Injury

Finally, while mild injuries can take just days to recover from, more severe injuries can take much longer. 

For a moderate to severe brain injury, around 30% of people will still need some help from another person two years later. This might mean during the day, the night, or both. They can take care of themselves for the most part, though, and over time many people are able to move and get around without assistance. 

Problems with thinking and forming new memories are relatively common at two years, as is major depression. 

Around 25% of people who suffered a moderate to severe TBI will have major depression two years after the injury. Sometimes this is a direct effect of the injury, but in other cases, it’s because of the effects of the injury on their lives. 

More than 90% of people live in a private home, and around 30% have a job, but it may be different from the one they had previously. 

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