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Traumatic Brain Injury: Types, Symptoms, and Recovery

Learn about the two types of traumatic brain injury, the immediate effects, severity, recovery stages, long-term impacts, and differences in children. Discover the common treatment methods and resources available for those affected.

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Traumatic Brain Injury: Types, Symptoms, and Recovery

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  1. Traumatic Brain Injury

  2. What is Traumatic Brain Injury (TBI)?

  3. Two types of brain injury occur • Closed brain injury • Open brain injury

  4. Closed Head Injury • Resulting from falls, motor vehicle crashes, etc. • Focal damage and diffuse damage to axons • Effects tend to be broad (diffuse) • No penetration to the skull

  5. Open Head Injury • Results from bullet wounds, etc. • Largely focal damage • Penetration of the skull • Effects can be just as serious

  6. What Happens Immediately After TBI?

  7. TBI: A biological event within the brain • Tissue damage • Bleeding • Swelling

  8. TBI: Changes in functioning • Loss of consciousness/coma • Other changes due to the TBI • Post-traumatic amnesia (PTA)

  9. Injured Brain • Does not mend fully • Leads to problems in functioning

  10. What Do We Mean by Severity of Injury • Amount of brain tissue damage

  11. How to measure “severity”? • Duration of loss of consciousness • Initial score on Glasgow Coma Scale (GSC) • Length of post-traumatic amnesia • Rancho Los Amigos Scale (1 to 10)

  12. Mild injury 0-20 minute loss of consciousness GCS = 13-15 PTA < 24 hours Moderate injury 20 minutes to 6 hours LOC GCS = 9-12 Severe injury > 6 hours LOC GCS = 3-8

  13. What Happens as the Person with Moderate or Severe Injury Begins to Recover After Injury?

  14. Recovery • A multi-stage process • Continues for years • Differs for each person

  15. What is the Long-term Impact of a Moderate or Severe TBI in the Person’s Functioning?

  16. Impact depends on • Severity of initial injury • Rate/completeness of physiological recovery • Functions affected • Meaning of dysfunction to the individual • Resources available to aid recovery • Areas of function not affected by TBI

  17. Areas of function affected • Cognition

  18. Cognitive functions • Attention • Concentration • Memory • Speed of Processing • Confusion • Perseveration • Impulsiveness • Language Processing • “Executive functions”

  19. Areas of function affected • Cognitive • Sensory/Perceptual

  20. Sensory/perceptual functions • Vision • Hearing • Smell • Vestibular • Taste • Touch • Balance

  21. Areas of function • Cognitive • Sensory/perceptual • Seizures

  22. Areas of function affected • Cognitive • Sensory/perceptual • Seizures • Other physical changes

  23. Other physical changes • Physical paralysis/spasticity • Chronic pain • Control of bowel and bladder • Sleep disorders • Loss of stamina • Appetite changes • Regulation of body temperature • Menstrual difficulties

  24. Areas of function affected • Cognitive • Sensory/perceptual • Seizures • Other physical changes • Social-emotional

  25. Social-emotional • Dependent behaviors • Emotional lability • Lack of motivation • Irritability • Aggression • Depression • Disinhibition • Denial/lack of awareness

  26. Recovery vs. “improvement”

  27. Permanence of change? • Physical recovery • Reeducation of the individual • Environmental modifications

  28. What Happens With Mild (or Minor) TBI?

  29. Mild TBI • Lesser levels of brain damage • Brief or no loss of consciousness • Often referred to as ‘concussion’

  30. Mild injury is important to discuss • Long-term impact for 15% • Don’t see that TBI is cause of deficits • Repeated injury leads to problem emergence-”second impact syndrome” • 300,000 sports and recreational injuries • CT, MRI and EEG are usually normal

  31. Effects of mild TBI: outcomes • Problems disappear on their own in about 85% of cases • Compensatory skills acquired • Education prevents emotional upset (“shattered sense of self”)

  32. Effects of mild TBI: outcomes • Problems are not attributed to TBI • Compensatory skills are not learned • Best approach is early education and information • Best rehab assessment is neuropsychology

  33. How is TBI Different (or the Same) for Those Injured as Children.

  34. Children • Brain still developing • Brain more flexible than adult’s • Fewer educational “building blocks” • Effects may not emerge immediately • Follow the child over time

  35. How Common is TBI, and Who is the Typical Person with TBI?

  36. Who is the typical person with TBI? • 4:1 ratio, males to females • 15 to 25 years of age • 1.5 million brain injuries per year in US • Alcohol is the leading risk factor

  37. Adolescents and young adults: highest rate Aged: second highest

  38. What is the Course of Treatment for Those with TBI?

  39. Integrated System of Care • Inpatient Rehabilitation Programs • Coma Recovery Programs (rarely used) • Extended Care Programs ( typically inappropriate) • Outpatient Programs • Community Support Services

  40. Community/Post Acute Services • Outpatient In clinic At home/work/community

  41. Community/Post Acute Services • Residential • neurorehabilitation/transitional living • neurobehavioral intensive • long-term supported living

  42. Brain Injury Association of PA • Biapa.org • Brain Injury Resource Line 1-866-635-7097 • biausa.org

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