Traumatic Brain Injury (TBI)

A traumatic brain injury (TBI) is an injury to the brain caused by outside trauma to the head that results in loss or alteration of consciousness, as well as other physical, cognitive, and emotional symptoms that occur immediately following the injury. Common causes of TBI include a blow to the head, a fall, a motor vehicle accident, or the blast of an explosion. (Adapted from the Defense and Veterans Brain Injury Center Clinical Practice Guidelines, 2006).

TBI can be mild, moderate, or severe. The level of injury is determined by the length of time that a person is unconsciousness, confused, and unable to form new memories following the injury. Current estimates are that 85% of all TBIs sustained by military personnel fall in the mild range. A mild TBI is also referred to as a concussion.

Diagnosing a mild TBI can be challenging, particularly in a combat situation given the noise and confusion occurring during a blast or a firefight (e.g. “the fog of war”). The combat environment itself can provide confusion, uncertainty about what is going on, or cause difficulty in thinking clearly. However, in order to have a concussion or mild TBI, these symptoms should be a direct result of an injury to the head.

What are the symptoms?

Symptoms tend to be general and nonspecific. They also overlap a great deal with other health or psychological problems, which is why it is important to coordinate treatment across different health disciplines.

Physical symptoms can include headache, dizziness, sensitivity to light or sounds, and/or blurry vision.

Cognitive symptoms can include difficulty concentrating, difficulty with memory, and slowed speed of thinking.

Emotional symptoms can include irritability and/or moodiness.

How long do symptoms last?

Symptoms of a mild TBI can be quite disturbing, but do tend to improve over time, often resolving entirely within a few weeks of the time of injury.  However some patients can experience symptoms for longer periods of time, referred to as “prolonged postconcussion syndrome.”  In such cases, there are often other conditions that contribute to perpetuating the symptoms. These include posttraumatic stress disorder (PTSD), depression, chronic pain, poor sleep, or adverse cognitive effects of medications.