Many of the symptoms exhibited by someone who has sustained a moderate or severe traumatic brain injury, or TBI, are the same as those of a concussion but tend to be more intense and longer in duration. Examples of these symptoms include a prolonged headache, repeated vomiting, and inability to be roused from sleep and/or markedly increased disorientation, anxiety, and restlessness.
Below is a checklist encompassing signs and symptoms associated with moderate to severe TBI.
- Worsening headache that will not go away
- Weakness, numbness, or decreased coordination
- Feeling slowed down
- Repeated vomiting or nausea
- Slurred speech
- Appearance of drowsiness or inability to rouse the person
- Sensitivity to light and sounds
- Blurred vision
- Uneven size of pupils
- Convulsions or seizures
- Impaired ability to think, concentrate, or to remember, including inability to recognize familiar people and places
- Impaired balance and coordination
- Confusion, restlessness, and agitation
- Unusual or odd behavior that is out of character for the person
- Loss of consciousness, typically ranging from 20 minutes to six hours
If a person demonstrates any of these symptoms and/or has lost consciousness—no matter how briefly—it is important to seek medical attention immediately. TBI can result in permanent disability or death and prompt medical treatment can make a lifesaving difference.
TBI in young children, and particularly babies, can be very difficult to diagnose. They may demonstrate some of the symptoms above, but caregivers or parents should watch for other warning signs as well, including:
- Will not stop crying and cannot be calmed down
- Headache that persists
- Loss of interest in playing or favorite toys
- Loss of skills, such as talking, toilet training, crawling, etc.
- Loss of balance and trouble ambulating (walking, crawling, turning over)
- Will not nurse or eat
Causes of TBI
The majority of TBI cases result from falls (35%), followed by motor vehicle accidents (17%), pedestrian and bike accidents (17%), assaults (10%) and “other” factors, including warzone explosions and IED blasts (21%). Falls constitute the major cause of TBI for older adults. One in five patients diagnosed with TBI is a victim of violence, including firearms, as well as domestic and child abuse. Despite the increased publicity regarding the prevalence of concussions among football players, only 3% of all TBI are sports-related.
Cause of TBI also is strongly correlated with prognosis or patient outcome. Approximately 91% of all TBI resulting from firearms (including suicidal intent) result in death, while only 11% of TBI resulting from falls end in a fatality.