Frequently Asked Questions About Brain Injuries

Traumatic brain injuries (TBIs, or often simply referred to as “brain injuries”) are usually occurs as a result of a violent blow, or a sudden and forceful bump to the head, a sudden and forceful jolt to the body, or a penetrating injury (such as a gunshot wound) to the head.

If you or someone you love has been affected by a brain injury, there is no doubt that the injury has had an impact on your life in some way. Furthermore, there is no doubt that you have several questions about the injury. It’s important for survivors of traumatic brain injuries, as well as their families and friends, to learn as much as possible about these injuries so that they are better equipped to cope with the aftermath. To that end, we have assembled a list of frequently asked questions and answers that TBI patients and their loved ones often have about brain injuries.

Q: Are there different levels of brain injury?

A: Yes, traumatic brain injuries are usually classified into four main types, including: • Mild TBI or concussion • Moderate TBI • Severe TBI • Persistent vegetative state

Q: How is the severity of a TBI determined?

A: The severity of a traumatic brain injury is determined using the Glasgow Coma Scale (GCS), a tool that functions as a scoring system that measures a patient’s level of consciousness following a brain injury. The GCS is comprised of 15 points, and each point measures different functions, such as a patient’s verbal response or the function of his or her eyes. The more points a patient scores on the GCS, the higher his or her level of brain function will be; in other words, a higher score translates to higher functioning. The following scores are assigned to the different severity levels of TBI: • GCS score of 13 to 15 points = concussion of mild TBI • GCS score of 9 to 12 points = moderate TBI • GCS score of 4 to 8 points = severe TBI • GCS score of 3 points = persistent vegetative state

Q: What are the different types of TBI?

A: Typically, health care professionals group brain injuries into two primary categories: • Closed injury. A closed injury occurs when a patient develops a brain injury, but there skull was not fractured. Rather, the injury was sustained as a result of a violent blow or a forceful bump to the head, or a sudden and forceful jolt to the body. These injuries cause the brain to move back and forth or twist in the skull, and the movement of the brain damages the brain tissue. • Open injuries. Open injuries occur when the patient’s skull is broken, or when it is penetrated by a foreign object. For example, a piece of the individual’s skull bone breaks off and penetrates the brain, or a foreign object, such as a bullet or shrapnel, breaks through the skull and passes through the brain, damaging the brain tissue.

Q: What are the symptoms of traumatic brain injury?

A: The symptoms of TBI vary and depend on several factors, including the severity of the injury, the part of the brain that was injured, the cause of the injury, the age of the patient, and his or her health status prior to the injury. With that said, the following are some of the symptoms that can accompany a brain injury: • Headache • Fatigue and drowsiness • Nausea and vomiting • Speech issues • Dizziness or loss of coordination • Sensory problems, such as blurred vision, seeing double, ringing in the ears (tinnitus), changes in the ability to smell, a foul taste in the mouth • Light or sound sensitivity • Loss of consciousness • No loss of consciousness; however, a state of confusion or disorientation • Changes in the mood, or mood swings • Feelings of depression and/or anxiety • Sleep changes, such as difficulty falling asleep, staying asleep, or sleeping more than usual • Convulsions or seizures • Dilation of one or both pupils • Weakness or numbness in the digits (the fingers and toes) • Coma

Q: Are the symptoms of TBI the same in babies and children?

A: While babies and children can exhibit one or more of the symptoms listed above, because of their inability to communicate what they are experiencing, the symptoms may present in different ways. Some of the symptoms of TBI among babies and children include the following: • Changes in eating or nursing habits • Persistent crying or inability to be consoled • Increased and/or unusual irritability • Changes in the ability to pay attention • Seizures • Changes in sleep habits • Drowsiness • Sadness or depression • Loss of interested in things they usually enjoy, such as activities or toys

Q: Does TBI affect children and babies differently than adults?

A: Yes. Not only can the symptoms of TBI manifest different in babies and children, but the impact of TBI-related injuries can affect babies and children differently than it affects adults. This is due to the fact that babies and children’s brains are still developing, and an injury to the brain, no matter the severity, before it is fully developed can disrupt a baby or child’s development, and can limit his or her ability to take part in “normal” activities, such as school, sports, and other extracurricular activities. Babies and children may develop changes in their overall health, their thinking, and/or their behavior as a result of TBI-related injuries. These effects can impact a child’s ability to learn, self-regulate, and participate socially.

Q: How common is TBI in the United States?

A: According to the US Centers for Disease Control and Prevention (CDC), TBI is a major cause of disability and death. In the year 2020, an estimated 64,000 Americans died as a result of TBI-related injuries, which equates to around 176 deaths every day in 2020.

Q: Are certain groups more prone to developing more severe outcomes as a result of TBI-related injuries?

A: While TBI affects people of all demographics, data suggests that certain groups of people are at an increased risk of developing a TBI-related injury. These groups include the following: • Active service members and veterans • Survivors of domestic abuse • Individuals who experience homelessness • Those who live in rural areas • People who are incarcerated in correctional or detention facilities • Certain racial and ethnic minorities

Q: What are the common causes of TBI?

A: Traumatic brain injury can occur as a result of a violent bump or blow to the head, or a sudden and forceful jolt of the body. It can also occur as a result of a penetrating injury, such as a gunshot wound or shrapnel. The following are some of the most common causes of brain injuries among people of all ages and demographics in the United States: • Slips and falls, which account for nearly half of all TBI-related hospitalizations • Motor vehicle crashes and domestic assaults • Firearm-related suicides • Sporting or recreational activity accidents

Q: What happens following a TBI?

A: Immediately after an injury to the head, it is essential that the patient receives prompt medical care. This is true even in cases that seem mild, or when an individual does not appear to be showing signs or symptoms of TBI. This is due to the fact that often, the effects of a traumatic brain injury may be delayed; in other words, though a patient may not appear to have been impacted immediately following the injury, symptoms may develop several hours, days, or even weeks after the injury. Medical professionals will conduct a thorough assessment of the patient. They will assess things like the patient’s consciousness, speech, and his or her ability to make controlled eye movements. They will also perform a thorough assessment of a patient’s overall health and well-being; his or blood pressure and heart rate will be checked, for example. For patients who are exhibiting signs and symptoms of TBI, diagnostic testing will likely be ordered. This typically included CT (or CAT) scans, and in some cases, may also include an MRI. The images produced from these diagnostic tests will allow medical professionals to further assess the individual’s brain for swelling, bleeding, and other issues that can be associated with a TBI. In the most severe cases of TBI, immediate surgical intervention may be necessary; surgery to reduce swelling on the brain, or to address bleeding, for example.

Q: What does recovery entail?

A: Recovery varies and again, depends on several factors, such as the severity of the injury, as well as the part of the brain that was injured, the type of injury, the cause of the injury, and the individual’s age and health prior to the TBI. For individuals who have suffered a concussion or a mild TBI, other than a comprehensive assessment, additional medical intervention is not needed; rather, he or she can recovery at home, and recovery will include resting and limiting cognitive activity. For patients who have suffered a mild or severe TBI, medical intervention and stabilization to monitor his or her health and basic functions will be necessary. After the patient has stabilized and any potentially life-threatening complications have subsided, rehabilitation in the hospital setting usually commences. After a TBI, there is a window of time, usually referred to as the “spontaneous recovery period” then the brain starts to recover and repair on its own, and the process can take several weeks, months, or even years. Typically, during this period, the victim has to re-learn several physical and functional skills, such as walking, talking, feeding, etc. Medical recovery programs for TBI usually include restorative therapies, such as speech and language therapy, occupational therapy, and physical therapy; additionally, medical supervision is required.

Q: What happens when the patient is discharged from the hospital?

A: When a patient’s doctors have determined that he or she has recovered to a point that going home is a possibility, there are several steps that his or her family and friends can and should take in order to assist with the recovery process. The patient may need to attend group-based recovery programs, as well as outpatient therapy services; however, if the TBI has caused severe and persisting complications, more intensive care and assistance will likely be necessary. In these cases, it may be best for the patient to continue recover in a long-term care facility; transitional or supportive living programs, for example.

Q: How long does it take to recover from a TBI?

A: The amount of time it will take to recover from a traumatic brain injury varies and depends on numerous factors, including the severity of the injury and the extent of the damage. For individuals who have been diagnosed with a concussion or a mild TBI, a full recovery can be realized within a few days or a few weeks; however, the patient should be monitored during this time, and if symptoms persist or worsen, or if new symptoms appear, medical care should be provided. For patients who suffer moderate or severe TBI, the recovery process will take longer. It can take several months or years for a patient to recover; however, in some cases, the complications, while they may lessen, can be life-long or permanent.

Q: What causes a TBI patients inability to become angry or aggressive?

A: Research indicates that there is a correlation between the location of the injury and the development of anger and aggression. Often, when the frontal lobe of the brain is injured, anger or aggression can occur, and it appears to be the result of reduced impulse control because of damage to the parts of the brain that filter anger and aggression.

Q: How likely is it that a TBI patient will regain independence?

A: There is no way to tell. A patient’s ability to regain independence varies and depends on numerous factors, such as the location of the injury, the severity of the injury, and the type of treatment the patient received. While there aren’t any guarantees, a lot of patients who suffer brain injuries do make exceptional improvements after their injuries. It isn’t uncommon for survivors to show improvement years after the injury occurred; additionally, in a lot of cases, TBI survivors can return living a lives of purpose, intention, and meaning. Speak with a brain injury law firm to learn about ways to regain your financial independence if you have been involved in an accident.