Signs and Symptoms of a Traumatic Brain Injury (TBI)
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Medically reviewed by Smita Patel, DO
A traumatic brain injury (TBI) is any injury to your head that changes the way your brain typically works. Brain injuries usually stem from a sudden impact or trauma to the head—such as falling down, being involved in a car crash, or getting struck by another person or object. Symptoms can vary from mild to severe, depending on the type of injury you have. A TBI may cause blood clots, bruising, and bleeding, all of which can affect your thinking, emotions, behaviors, and perception.
Brain injuries may be penetrating, meaning an object pierced through the skull to the brain. Or they may be nonpenetrating, meaning either an object hit the head or the head was suddenly jolted. An example of a penetrating injury is a gunshot wound, while an example of a nonpenetrating injury is a blow to the head after being tackled while playing football.
TBI is most common among men, young children, and people over age 75. But anyone can sustain a TBI, and there are countless ways to have one. Recognizing the symptoms of a traumatic brain injury is crucial for prompt diagnosis and treatment. Severe or untreated TBI can lead to disability or death.
Common Symptoms
Healthcare providers classify the severity of a TBI as mild, moderate, or severe. Depending on the severity of the head injury, symptoms may last just a few days or a lifetime. TBI can affect many different brain functions and lead to a wide variety of symptoms. And different people may experience completely different TBI symptoms.
A TBI can affect your body physically and emotionally. But, you may also experience changes in your thinking, behavior, and perception.
Physical symptoms may include:
Nausea or vomiting
Seizures
Slurred speech
Dilated pupils
Cognitive symptoms may include:
Loss of consciousness ranging from a few seconds (passing out) to a few months (coma) to a lifetime (persistent vegetative state)
Confusion or disorientation
Trouble concentrating or remembering important information
Changes in sleep or difficulty waking up
Perception symptoms may include:
Lightheadedness or dizziness
Loss of coordination
Ringing in the ears
Emotional symptoms may include:
Mood swings
Irritability or agitation
Lack of motivation
Mild TBI Symptoms
The majority of TBIs (about 8 out of 10 cases) are mild. Healthcare providers usually call a mild TBI a concussion. Concussions usually are not life-threatening, and symptoms usually go away on their own within a few days to a few weeks.
Symptoms of concussion include a relatively brief change in the way your brain functions. Most commonly, a concussion causes confusion, memory loss, vomiting, or loss of consciousness for a short time.
However, some people will develop post-concussion syndrome. This means that the typical physical, cognitive, perception, or emotional symptoms of a TBI last longer than expected for a mild injury. People who have had multiple brain injuries in a short period are at higher risk for developing post-concussion syndrome.
It's also important to protect yourself from getting another TBI if you've recently experienced a concussion. Injuring the brain again before the first injury heals may lead to a very dangerous swelling of the brain. This effect is sometimes called the “second-hit” phenomenon, which can be life-threatening.
Moderate and Severe TBI Symptoms
Healthcare providers consider a TBI to be moderate if it causes loss of consciousness for up to 24 hours and signs of brain trauma that show up on standard imaging tests. A severe TBI causes loss of consciousness for more than 24 hours.
Symptoms of a moderate and severe TBI are more intense and longer-lasting than those of a mild TBI. They may progress to major changes in awareness and responsiveness, including:
Minimal consciousness: Showing serious impairment to consciousness but still able to react to their environment.
Coma: Complete inability to react to external stimuli. A coma can last for a few days to a few weeks.
Persistent vegetative state: Lack of consciousness over a period longer than a few weeks.
Brain death: Inability to measure any brain activity over a long period.
Moderate and severe TBIs are some of the most common injury-related conditions that lead to death and long-term disability. Unfortunately, thousands of people die from moderate and severe TBIs each year.
According to the Centers for Disease Control and Prevention (CDC), 22% of adults who receive treatment in a healthcare facility for a moderate to severe TBI lose their life within 5 years, and 30% get worse over time. Only 26% get better within 5 years. That said, if you hit your head or experience some other form of trauma to the brain, getting medical treatment promptly is essential.
Symptoms in Children
About 1 in 5 cases of TBI in children result from sports or recreational activities. Children may show unique signs of TBI. And they may be too young to communicate how they feel after an injury. Watch out for the following symptoms if your child has sustained an injury to the head:
Inability to be consoled or constant crying
Changes in eating or sleeping patterns
Difficulty with balance or coordination
Inability to focus or pay attention
Decreased interest in things they once enjoyed
Depressed or low mood
Loss of abilities or milestones they previously gained
Seizures
Symptoms in Older Adults
Hospitalizations and death from TBI are most common in adults over age 65. But TBIs in this age group often go undiagnosed, especially if the person has other health conditions that might cause similar symptoms, such as dementia.
Older adults who are taking blood thinners are also at increased risk of brain bleeding from a TBI. Bleeding in the brain raises the likelihood that a person will die from a TBI. If you know an older adult who has experienced a fall or car accident, make sure they visit their healthcare provider for an evaluation and receive proper treatment if necessary.
When to Contact a Healthcare Provider
If you have had an injury to your head and experience headaches, weakness, vomiting, or any of the common TBI symptoms, contact your healthcare provider soon. These could be signs of a TBI. This is especially important if you have a history of a concussion because having multiple TBIs can be very dangerous.
While you can treat most cases of mild TBI at home, your healthcare provider will give you special care instructions to follow. People with moderate or severe TBI will likely need ongoing care.
Questions to Ask Your Provider
Make sure to ask your healthcare provider the following questions after any kind of injury to your head:
What home care should I follow for a concussion?
Is it OK to continue taking my regular medications if I have had a head injury?
When can I go back to playing sports after a TBI?
Which treatments do you recommend to improve my symptoms?
A Quick Review
A traumatic brain injury results from a sudden blow or jolt to the head, disrupting the normal function of the brain. These injuries can range from mild to severe. TBI symptoms can vary, but may cause physical, cognitive, and emotional changes. If you notice any changes after hitting your head, make an appointment with a healthcare provider right away. Early diagnosis and treatment of a moderate to severe TBI could save your life.
Frequently Asked Questions
Can a TBI get worse over time?
Most TBIs are mild and resolve within a few days to a few weeks. However, almost one-third of serious TBIs in adults get worse over the five years following the initial injury. And people who have repeated TBIs, usually concussions, may have long-term impairment to concentration, memory, and balance, among other symptoms.
What is the life expectancy of a person with a traumatic brain injury?
Life expectancy depends on the severity of the injury. The majority of people who sustain a TBI will heal and go on to live full, healthy lives. However, 22% of adults who experience a severe TBI have a risk of dying within 5 years.
Is a TBI considered a disability?
A TBI is a common cause of disability in the United States. Most mild TBIs heal within weeks, but moderate to severe TBIs can lead to long-term disability. People with moderate to severe TBIs may experience permanent physical, cognitive, or emotional changes.
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