Advanced Care for Brain Trauma

A traumatic brain injury (TBI) is an injury that causes sudden brain damage. A TBI can result from a car accident, fall, sports injury, gun shot wound, or another sudden blow to the head or body. Concussions are one of the most common forms of TBI, and do not cause an injury that can be seen with a CT or MRI scan.

TBI Symptoms

If you or a loved one has experienced a TBI, you may notice some symptoms right after the injury, while other symptoms may not appear until days or even weeks afterward. Some of the symptoms to watch for include:

• Changes in senses, including blurred vision or ringing ears
• Clear fluid draining from the nose or ears
• Confusion
• Dizziness or trouble with balance
• Drowsiness or fatigue
• Headaches
• Loss of consciousness
• Mood changes
• Nausea or vomiting
• Seizures
• Slurred speech
• Trouble sleeping and/or trouble waking from sleep
• Trouble speaking
• Trouble with memory or concentration

These symptoms may appear a bit different in children. If your child has experienced a blow to the head or body that could result in a TBI, watch for these warning signs:

• Changes in eating habits
• Changes in mood, such as increased irritability or feeling especially sad or depressed
• Changes in sleep patterns
• Lack of interest in toys, usual activities, etc.
• Trouble paying attention

Concussion Symptoms

It’s possible to have a concussion and not realize it. Typical symptoms include:

• Balance problems
• Blurred or double vision
• Clumsiness that wasn’t present before an injury
• Confusion, memory problems or trouble concentrating
• Sensitivity to light or noise
• Headaches or a feeling of pressure in the head
• Nausea or vomiting
• New or increased feelings of sadness, anxiety or irritability
• Feeling sluggish, hazy, foggy or groggy
• Trouble following instructions after an injury

Your primary care doctor or sports team trainer can manage most concussions successfully. However, if you or a loved one has a concussion and symptoms don't go away within a week, you may need a referral to our specialists.

TBI Evaluation and Diagnosis

It’s important for a medical professional to evaluate you right away if you’ve been injured in a way that means you’re at risk for a TBI. When you come to us for help, depending on where you go and what type of injury you have, you may see one of our:

• Neurologists
• Neurosurgeons
• Physiatrists (doctors of physical medicine)
• Trauma surgeons

We’ll ask questions about your injury and how it happened. If there is concern that the injury is more severe than a concussion, you may need imaging tests, such as a CT (computed tomography) scan or an MRI (magnetic resonance imaging) scan so we can see the extent of your TBI. You may also need neuropsychological testing so we can find out whether your TBI has affected your memory or cognitive (thinking) ability.

Baseline Testing Before Concussions in Sports

Baseline tests measure your normal cognitive abilities before a concussion. Because athletes, especially those in contact or collision sports such as football, are at higher risk for concussions, we recommend baseline tests for any athletes 10 and older who are in a contact or collision sport. You or your child should have a baseline test before contact drills, as concussions can happen during practices.

We use the ImPACT™ test, which is the same test many college and professional sports leagues use. The test takes about 30 minutes. The results can let team trainers and us better understand the extent of the injury if you or your child ever experiences a concussion.

TBI Treatment

Many mild TBIs improve on their own with observation and rest. If you have a moderate or severe TBI (seen on MRI or CT scan), you may need to stay with us in the hospital. We’ll work with you on a customized treatment plan based on your symptoms and needs.

Your treatment plan may include medications or consultation with neurosurgery. One of our Physical Medicine & Rehabilitation providers can help plan your rehabilitation and guide your care during recovery from a significant traumatic brain injury.

You may need rehabilitation therapy as part of your recovery. Rehabilitation therapy can help you improve your ability to perform your regular activities after a serious TBI. Based on your symptoms and needs, your doctor may recommend one or more of the following types of rehabilitation:

• Occupational therapy: This can help you be better able to manage everyday tasks, such as getting dressed or bathing
• Physical therapy: This can help you improve your coordination and balance after a TBI
• Speech therapy: This can help address any issues you may have with speaking after a TBI

Concussion Treatment

You should not return to your sport or other physical activities for 24 to 72 hours after the injury to make sure your symptoms don’t get worse. Try to rest during this time, and limit activities like watching TV, reading or using your smartphone. Once your symptoms are improving you should gradually resume normal activity as tolerated. In the case of competitive sports, your team trainer or one of our Sports Medicine physicians should guide your return to your sport. If you have concerns or you symptoms aren’t improving quickly, you should see your Primary Care Provider (PCP).

Patients with mental health conditions or sleep disturbances often improve more slowly. Speak with your PCP or other specialist about optimizing treatment of such issues.

TBI Prevention

• Always wear your seatbelt when riding in a car.
• Always wear appropriate head protection such as helmets for cycling, skiing or working in construction.
• Always store firearms securely and separate from ammunition.
• If you have balance problems, consider physical therapy.