Betty Clooney Center: Serving Persons with Traumatic Brain Injury with TBISince 1983

About Brain Injury

From the perspective of a person with a brain injury:

In 1907, 70 percent of those who had a severe injury to the brain did not survive. By 1975, this fatality rate has declined to 50 percent. Today, the fatality rate is 30 percent.

Ten years after my traumatic brain injury (TBI) I became aware that many of my actions were the results of this insult to my brain. My actions were not totally bizarre given the situation, but many people, including neurologists, psychiatrists, and myself, did not know why the actions or inactions occurred. However, I knew that I was responsible for each of my actions no matter how strange and humiliating they were. I had to live with myself and become “friends” again.

There are symptoms of brain injury, which may occur and be obvious to the caretakers of the injured. However, some may be very subtle and irritating to those directly involved. The following are some normal deviations that may be experienced, in varying degrees, as a result of this insult to the brain – regardless of how one acted before. Some of the following may or may not occur at all.

In order to better understand ourselves and other others with brain injury, I have outlined three primary areas that may be involved.


  • Decreased job or school performance due to the inability to correctly and quickly process information and for numerous other reasons.
  • Memory loss or impairment – short and/or long term.
  • Inability or reduced efficiency to track – impaired ability to maintain a steady train of thought simultaneously and/or reduced efficiency to switch smoothly between different lines of thought.
  • Mental inflexibility.
  • Feeling of vulnerability and loss of control.
  • Excessive daydreaming.
  • Getting lost easily – disoriented to surroundings.
  • Difficulty reading simple directions and difficulty following and completing directions.
  • Difficulty with simple math calculations.
  • Inability to generalize.
  • Persistence – refusing to give up, or finding it difficult to give up.
  • Indecisiveness – impaired decision-making ability; for example, in response to the question, “What do you want to do?” The response: “I dunno, whatever you want to do.”
  • Wandering – leaving a designated area due to being distracted.
  • Inability or reduced efficiency to sequence – impaired ability to plan one’s actions and do them in the correct order.
  • Inability or reduced efficiency to see the whole picture; for example, in a work setting, the ability to see how your work affects the entire organization or other co-workers.


  • Extreme mental and/or physical fatigue; for example, more effort is required to do anything, even staying awake and doing sedentary work. In addition, reading, comprehension and locomotion may be decreased.
  • Muscular incoordination, possible lack of coordination, balance and visual problems, speech impediments and inability to coordinate speech and salivary glands.
  • Seizure activity.
  • Insomnia
  • Physical deficits, which may include some or all of the following:
    • Impaired small motor control
    • Hemiparesis
    • Alteration in “side” domination (right, left-handedness)
    • Decreased bowel and /or bladder control
    • Altered awareness in smell or taste
    • Increased sensitivity to sound
    • Pervasive efficiency to regular food intake
    • Inability to detect illness
  • Photo sensitivity: an increase fatigue level with decreased amount of light.
  • Decreased sensitivity to pain.

Behavioral / Psychological

  • Lowered stress tolerance: frequent severe and periodic mood changes that result in mood swings and/or melancholy attitudes, irritability.
  • Lack of initiative: failure to direct new activities or prompt self-action.
  • Reduced maturity and responsibility: not willing to conform to societal mores – failure to assume responsibility for one’s action.
  • Lack of inhibition: diversion from accepted sexual practices, use and expressions of language.
  • Marital /family conflict
  • Reduced self-esteem.
  • Emotional liability: excessive anger and/or uncontrollable laughter or crying.
  • Paranoid feelings.
  • Overly polite, solicitous.
  • Isolation
  • Over-sensitivity.
  • Heightened defense mechanism.
  • Escapism through food, drugs or alcohol.
  • Decreased awareness of deficits.
  • Denial of deficits.
  • Diminished or total loss of expectation (apathy).
  • Lack of motivation.