Concussion and Mild TBI

A blow or jolt to the head can disrupt the normal function of the brain. Doctors often call this type of brain injury a “concussion” or a “closed head injury.” Doctors may describe these injuries as a “mild” because concussions are usually not life threatening. Even so, the effects of a concussion can be serious.

After a concussion or mild brain injury some people lose consciousness or are “knocked out” for a short time, but not always -- you can have a brain injury without losing consciousness. Some people are simply dazed or confused. Sometimes whiplash can cause a concussion.

Because the brain is very complex, every brain injury is different. Some symptoms may appear right away, while others may not show up for days or weeks after the concussion. Sometimes the injury makes it hard for people to recognize or to admit that they are having problems.

The signs of mild brain injury and concussion can be subtle. Early on, problems may be missed by patients, family members, and doctors. People may look fine even thought they’re acting or feeling differently.

Because all brain injuries are different, so is recovery. Most people with mild injuries recover fully, but it can take time. Some symptoms can last for days, weeks, or longer.

In general, recovery is slower in older persons. Also, persons who have had a concussion in the past may find that it takes longer to recover from their current injury.

Medical Help

People with a mild brain injury or concussion need to be seen by a doctor. Most people with concussions are treated in an emergency room or a doctor’s office. Some people must stay in the hospital overnight for further treatment.

Sometimes the doctors may do a CT scan of the brain or do other tests to help diagnose your injuries. Even if the brain injury doesn’t show up on these tests, you may still have a concussion.

Your doctor will send you home with important instructions to follow. For example, your doctor may ask someone to wake you up every few hours during the first night and day after your injury. Be sure to carefully follow all your doctor’s instructions.

Danger Signs

In rare cases, along with a brain injury, a dangerous blood clot may form on the brain and crowd the brain against the skull. Contact your doctor or emergency department right away if, after a blow or jolt to the head, you have any of these danger signs:

• Headaches that get worse
• Weakness, numbness, or decreased coordination
• Repeated vomiting

• Cannot be awakened
• Have one pupil -- the black part in the middle of the eye -- larger than the other
• Have convulsions or seizures
• Have slurred speech
• Are getting more and more confused, restless, or agitated

Symptoms of Brain Injury

Brain Injury has many symptoms. These symptoms are usually temporary, but may last for days, weeks, or even longer. Generally, if you feel that “something is not quite right,” or if you’re “feeling foggy,” you should talk with your doctor.

Here are some of the symptoms:

• Low-grade headaches that won’t go away
• Having more trouble than usual:
• Remembering things
• Paying attention or concentrating
• Organizing daily tasks
• Making decisions and solving problems
• Slowness in thinking, acting, speaking, or reading
• Getting lost or easily confused
• Neck pain
• Feeling tired all the time, lack of energy
• Change in sleeping pattern:
• Sleeping for much longer periods of time than before
• Trouble sleeping or insomnia
• Loss of balance, feeling light-headed or dizzy
• Increased sensitivity to sounds, lights, distraction
• Blurred vision or eyes that tire easily
• Loss of sense of taste or smell
• Ringing in the ears
• Change in sexual drive
• Mood changes:
• Feeling sad, anxious or listless
• Becoming easily irritated or angry for little or no reason
• Lack of motivation

Older Adults

Older adults with a brain injury may have a higher risk of serious complications such as a blood clot on the brain. Headaches that get worse or an increase in confusion are sign of this complication. If these signs occur, see a doctor right away.

Getting Better

How fast people recover from brain injury varies from person to person. Although most people have a good recovery, how quickly they improve depends on many factors. These factors include how severe their injury was, what part of the brain was injured, their age, and how healthy they were before the injury.

Rest is very important after a brain injury because it helps the brain to heal. You’ll need to be patient because healing takes time. Return to your daily activities, such as work or school, at your own pace. As the days go by, you can expect to gradually feel better.

If you already had a medical problem at the time of your injury, it may take longer for you to recover from your brain injury. Anxiety and depression may also make it harder to adjust to the symptoms of brain injury.

While you are healing, you should be very careful to avoid anything that could cause blow or jolt to your head. On rare occasions, receiving another injury before a brain injury has healed can be fatal.

Even after your brain injury has healed, you should protect yourself from having another injury. People who have had repeated brain injuries, such as boxers or football players, may have serious problems later in life. These problems include difficulty with concentration and memory and sometimes with physical coordination.

Tips for Healing

• Get plenty of sleep at night, and rest during the day.
• Return to your normal activities gradually, not all at once.
• Avoid activities that could lead to a second brain injury, such as contact or recreational sports, until your doctor says you are well enough to take part in these activities.
• Ask your doctor when you can drive a car, ride a bike, or operate heavy equipment because your ability to react may be slower after a brain injury.
• Talk with your doctor about when you can return to work or school.
• Ask your doctor about ways to help your employer or teacher understand what has happened to you.
• Consider talking with your employer about returning to work gradually and changing your work activities until you recover.
• Take only those drugs that your doctor has approved.
• Don’t drink alcoholic beverages until your doctor says you are well enough to do so. Alcohol and certain other drugs may slow your recovery and can put you at risk of further injury.
• If it’s than usual to remember things, write them down.
• If you’re easily distracted, try to do one thing at a time. For example, don’t try to watch TV while fixing dinner.
• Consult with family members or close friends when making important decisions.
• Don’t neglect your basic needs such as eating well and getting enough rest.

Help for Families and Caregivers

If you notice that your family member or friend has symptoms of brain injury that are getting worse or are not getting better, talk to them and their doctor about getting help. They may also need help if you can answer YES to any of the following questions:

• Has their personality changed?
• Do they get angry for no reason?
• Do they get lost or easily confused?
• Do they have more trouble than usual making decisions?

You might also want to talk with people who have experienced what you are going through. The California Caregivers Resource Centers can give you advice and resources and the Brain Injury Association www.biausa.org can put you in contact with people who can help.

For more information on Traumatic Brain Injuries, visit the National Institute of Neurological Disorders and Strokes.