Mild Traumatic Brain Injury

Mild traumatic brain injury (TBI) is damage to brain tissue from a blow to the head or to the body. This blow causes the brain to rapidly move back and forth within the skull. The injury changes the way your brain normally works.

CAUSES

Falls are the most common cause of mild traumatic brain injury. Other causes include motor vehicle accidents and sports-related injuries.

SYMPTOMS

Symptoms depend on the type and extent of the injury. Symptoms can last minutes to hours and may include:

  • Scalp swelling. A large bump may develop under the skin.

  • Loss of consciousness.

  • Fatigue or drowsiness.

  • Sleep disturbances including sleeping more or less than usual or having trouble falling asleep.

  • Headache.

  • Being unable to remember events surrounding the injury (amnesia).

  • Confusion, disorientation, or feeling mentally foggy.

  • Concentration or memory problems.

  • Nausea or vomiting.

  • Dizziness.

  • Irritability or feeling more emotional.

  • Balance problems.

  • Visual problems including sensitivity to light.

  • Sensitivity to noise.

  • Difficulty speaking. You may have slurred speech or a delay when following directions or answering questions.

  • Twitching or shaking (seizures).

  • Numbness or tingling.

In a few cases, someone with a mild TBI will experience "post-concussion syndrome." Post-concussion syndrome is a group of symptoms that can occur after a head injury. It is characterized by headaches, dizziness, difficulty with concentration or thinking, and problems with mood. These symptoms occur for a few weeks to a few months and usually go away without treatment.

DIAGNOSIS

Your caregiver can usually make the diagnosis of mild TBI by asking you what happened and by your exam. If your caregiver is concerned about a more serious TBI, he or she may ask for testing. Testing may include getting a CT (computed tomography) scan of the brain.

TREATMENT 

  • Only take medicine for pain or other symptoms as directed by your caregiver.

  • Review your current medicines with your caregiver to make sure it is okay to keep taking them. Do not stop regular medicines unless told to do so.

  • If there was a direct blow to your head, you may apply an ice pack to the injured area to reduce pain and swelling.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 10 to 15 minutes every hour while you are awake for up to 48 hours after the injury. Ask your caregiver if you should use ice longer than 48 hours.

HOME CARE INSTRUCTIONS 

Almost everyone recovers completely from a mild TBI. You must give your brain and body enough time for recovery. As symptoms decrease, you may begin to gradually return to your daily activities. If symptoms worsen or return, lessen your activities, then try again to increase your activities slowly. 

Rest

  • Get plenty of sleep at night.

  • Avoid staying up late at night.

  • Keep the same bedtime hours on weekends and weekdays.

  • Rest during the day as needed. Take daytime naps or rest breaks when you feel tired or fatigued.

Brain (Cognitive) Rest

Rest your brain. Limit activities that require a lot of thought or concentration. Those activities can make symptoms worse. Avoid or minimize:

  • Computer work.

  • Homework or job-related work.

  • Watching TV.

  • Playing video games.

  • Talking on the phone.

  • Text messaging.

  • Listening to loud music.

  • Activities such as balancing a checkbook.

  • Making important decisions. If you need to make an important decision, get help from a trusted family member or friend.

Activity

Talk to your caregiver about activities you should avoid until you recover. You may need to avoid some or all of your common activities, such as:

  • School.

  • Work.

  • Driving.

  • Air travel.

  • Recreation, such as:

  • Contact sports.

  • Running.

  • Riding roller coasters and other high-speed amusement park rides.

  • Bicycling.

  • Skiing.

  • Ice or inline skating.

  • Horseback riding.

  • Skateboarding.

  • Swimming. If you do go swimming, do not swim by yourself.

  • Physical exercise, physical education class, working out, weight training, weightlifting, or heavy lifting.

Nutrition

  • Follow a normal diet and fluid intake.

  • Avoid or limit alcoholic beverages.

Follow-up Appointments

Keep all follow-up appointments. Repeated evaluation of your symptoms is recommended for your recovery. Ask your caregiver when it will be safe to return to your regular activities. Ask your caregiver for help with written recommendations for your employer. It may be helpful to return to your job gradually.

Return to School or Work

  • Inform your teachers, school nurse, school counselor, coach, athletic trainer, or work manager about your injury, symptoms, and restrictions. They should be instructed to report:

  • Increased problems with attention or concentration.

  • Increased problems remembering or learning new information.

  • Increased time needed to complete tasks or assignments.

  • Increased irritability or decreased ability to cope with stress.

  • Increased symptoms.

PREVENTION

Protect your head from future injury. It is very important to avoid another head or brain injury before you have recovered. In rare cases, another injury can lead to permanent brain damage, brain swelling, or death.

  • Get a helmet that is fitted correctly. Wear your helmet during activities such as bicycling or horseback riding.

  • Wear a seat belt when driving and when you are a passenger.

  • Prevent falls in the home by:

  • Removing clutter and tripping hazards from floors and stairways.

  • Using grab bars in bathrooms and handrails by stairs.

  • Placing non-slip mats on floors and in bathtubs.

  • Improving lighting in dim areas.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe or worsening headaches.

  • You have worsening drowsiness or confusion.

  • You cannot recognize people or places.

  • You have unusual behavior changes.

  • You have unusual restlessness or unsteadiness, or increasing irritability.

  • You have a seizure.

  • You have vision problems.

  • You develop a fever or repeated vomiting.

  • You have neck pain or a stiff neck.

  • You lose bowel or bladder control.

  • You have weakness or numbness in any part of the body.

  • You have slurred speech.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.