Sandeep Vaishnavi M.D., Ph.D. and Vani Rao MBBS, M.D.

The Traumatized Brain

The Traumatized Brain

Surviving and thriving after brain injury

Posted Aug 31, 2015

Our society has become more aware of the consequences of traumatic brain injury (TBI).  For example, we are less likely to be dismissive of brain injuries in sports – while we may have thought such hits as harmless in the past (“having one’s bell rung,” a ding to the head, or even a symptom of manliness and growing up) – we are less likely to do so now.  We may be more likely now to understand intuitively that having the brain hit can’t be good.  Still, though, there are aspects of brain injury that are not well-known.  We hope to clarify these aspects of TBI and focus on potential long-term consequences of brain injury, such as mood changes, personality changes, and trouble with attention and memory, in this new blog.

We should start by defining TBI.  While it may seem obvious what a brain injury, it turns out that it’s actually not that clear, particularly with mild injuries.  There are a number of definitions of TBI, but one of the best definitions is also the simplest:  a traumatic brain injury is any injury where the person sustains a physical trauma to the brain and experiences a feeling of being  dazed or confused, even for a moment.  Of course, TBIs can lead to loss of consciousness or even coma, but at the mild end, you may only notice feeling momentarily disoriented and dazed. 

TBIs can be divided into mild, moderate, and severe categories.  Mild TBIs are actually the most common type, with around 70% of the total number of TBIs.  Mild TBIs (also known as concussions) are what we may be most familiar with and what we have referred to earlier, such as injuries while tackling in football, or heading the ball in soccer, or getting hit by a puck in hockey.  Car accidents resulting in rapid back and forth movement of the head with or even without the head striking against an object may also often lead to mild TBIs.

Moderate and severe TBIs are defined by the length of time before new memories can be made (technically called “posttraumatic amnesia”) and how long there is loss of consciousness.  The longer the loss of consciousness and posttraumatic amnesia, the more severe the brain injury is.    Major car accidents, falls, battlefield injuries, or any other incident where there is a major impact to the brain can lead to moderate to severe TBIs.

There are major issues to deal with immediately after a TBI, especially a moderate to severe injury.  These can include coming out of a coma, taking medications to treat or prevent seizures, and making sure there is no bleeding in the brain.  Over the longer term, though, the issues that need to be worked on are often things like mood changes (depression, irritability), behavior changes, and trouble with focus and distractibility and memory.  People may feel that they are slower in terms of thinking and making decisions.  These kinds of longer term issues are often not well-appreciated yet by the general public. 

We hope to use this blog to help explain these kinds of symptoms, to help you to understand why certain mood and behavioral consequences occur after TBI, and to offer some advice on what to do to help resolve these problems.  We want to help people understand the importance of being cognizant of TBIs and point out TBI-related issues in the public sphere and in current events.  We hope you take this journey with us!

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