Traumatic Brain Injury: Behavioral, Emotional & Sensory Changes Associated With Brain Injuries

A traumatic brain injury (TBI) occurs when the head is struck in such a manner as to cause damage to the brain inside the cranial cavity. Any object that penetrates the skull can also be the cause a trauma associated with TBI.

Mild brain injuries usually causes a temporary brain dysfunction. However, traumatic brain injuries which are more severe can cause long term or permanent complications, including coma and death.

Symptoms Commonly Associated With Brain Trauma

There are a wide variety of symptoms that are associated with traumatic brain injury. Symptoms can be both physical or psychological. While symptoms may appear immediately following the traumatic event, it is not unusual for symptoms to appear days or even weeks later.

Symptoms of mild injuries to the brain include:

• Unconsciousness for several seconds up to 30 minutes
• No unconsciousness, but confusion, disorientation or a dazed state
• Problems with memory or concentration
• Headaches
• Dizziness or vertigo
• Nausea or vomiting
• Blurred vision, ringing in the ears or a bad taste in the mouth
• Light or sound sensitivity
• Changes in mood or mood swings
• Unexplained depression or anxiety
• Unexplained fatigue or tiredness
• Insomnia
• Excessive sleep

Symptoms of moderate to severe damage to the brain include:

In addition to the already mentioned symptoms of mild TBI, a moderate or severe trauma can also present the following symptoms anytime from immediately to several days after the head injury occurs:

• Unconsciousness for several minutes to several hours
• Extreme confusion
• Aggressive or agitated behavior and any other unusual behavior.
• Slurred speech
• Inability to rouse from sleep
• Numbness or weakness in toes and fingers
• Clumsy or loss of coordination
• Headache that won’t go away or gets worse
• Continual nausea or repeated vomiting
• Seizures or convulsions
• Pupils dilated (either one or both eyes)
• Drainage of clear fluid from the ears or nose

Symptoms in Children

Young children and babies lack the necessary communication skills to let you know about many of the above mentioned symptoms. If your child has had a head injury look for the following signs and symptoms of traumatic brain injury:

• Eating or nursing habits changed
• Persistent crying and inability to be consoled
• Unusual irritability
• Lessened ability to pay attention
• Sleep habits change
• Sad mood
• Not interested in favorite toys

When to see a doctor: It is always a good idea to see the pediatrician after your child has had a severe blow to the head, or any blow to the head or body that results in changed behavior.

If necessary, go to the emergency room if there are symptoms of traumatic brain injury after a recent head injury.

Common Causes Resulting In Brain Injuries

A blow to the head or other traumatic injury to the body or head is the most common cause of TBI.

The amount of damage is dependent on several factors, and the injury may include any of the following factors:

• Brain cell damage may be confined to the area directly below the impact point on the skull.
• If the jolt or blow is very severe it can cause multiple damaged locations as the brain moves back and forth within the skull.
• If the jolt includes a severe rotational component, tearing of cellular structures within the brain can occur.
• An explosive blast can cause damage throughout the brain.
• Any object that penetrates the skull and enters the brain can cause severe and permanent damage to protective tissues, brain cells, and blood vessels within the brain.
• Untreated swelling, bleeding in and around the brain, and blood clots can impair the supply of oxygen and cause further damage.

Common events causing traumatic brain injury:

• Falls are the most common cause of brain injuries, especially amongst children and those over the age of 65.
• The second most common cause are collisions involving cars, trucks, motorcycles, and bicycles. These vehicle related injuries are the most common cause of death related to head trauma.
• Roughly 10 percent of all traumatic brain injuries are the result of violence.
  – This includes gunshot wounds, assaults, domestic violence, and child abuse.
  – Shaken baby syndrome is one of the leading types of violent traumatic brain injury.
• Any high impact sport such as football, lacrosse, boxing, skateboarding, hockey, and many others can cause brain damage.
• Explosive blasts are common among active military personnel. Researchers are not positive how the injury is caused, but it is theorized that the waves from the blast passing through the brain somehow disrupts the brains normal function.

Who is at Risk?

Those who are most at risk of sustaining a traumatic brain injury include:

– Children, especially from birth to 4 years old
– Young adults between the ages of 15 and 24
– Seniors over the age of 75

Complications Related To Brain Injuries

There are quite a few complications that can occur immediately following a TBI, or even for several weeks afterwards. The severity of the trauma increases the severity of the complications and the number of complications typically present.

Altered consciousness: Brain damage can cause changes in the awareness, responsiveness and state of consciousness of a person. These changes can be brief to permanent. Some of these changes include coma’s, vegetative states, minimally conscious states, and locked in syndrome.

Seizures: Seizures are not common immediately following the injury, but typically occur within the first week after the injury is sustained.

Fluid buildup: Some patients will have a buildup of fluid in the brain after a trauma. This buildup leads to increased pressure and swelling in the brain and can cause more damage.

Infections: In some instances the protective covering of the brain, or meninges, is torn during the trauma. This can allow bacteria to enter the brain and lead to the serious infection known as meningitis. If untreated, meningitis can spread throughout the nervous system leading to brain damage and even death.

Blood vessel damage: If blood vessels are damaged it can lead to further complications such as blood clots and strokes.

Nerve damage: When the head injury occurs at the base of the skull, the cranial nerves that emerge from the skull at that point can be damaged. Damaged cranial nerves could cause facial muscle paralysis, loss of vision, double vision, loss of smell, loss of sensation in the face, and difficulty swallowing.

Cognitive problems: The majority of people who have severe traumatic brain injuries will experience a change in their cognition. This can present itself in many ways and has been known to affect all of the following cognitive skills:

• Learning
• Memory
• Problem Solving
• Reasoning
• Judgment
• Decision Making
• Starting and completing tasks
• Speed of mental processing
• Concentration or attention
• Organization
• Multitasking

Communication problems: Communication and language problems are almost as common following traumatic brain injuries as are cognitive problems. Communication problems can be the most frustrating and often cause the most problems for those with injuries, as well as for their family and friends.

Communication and language difficulties: Symptoms can present themselves in a number of ways including:

• Trouble understanding writing or speech
• Trouble writing or speaking
• Troubles with nonverbal cues
• Disorganized ideas and thoughts
• Loss of the use of muscles needed to form words (called dysarthria)
• Difficulty starting/stopping conversations
• Difficulty selecting topics or taking turns
• Difficulty following conversations

Behavioral changes: Changes in behavior are not uncommon in those who have experienced traumatic brain injury and can include:

• Self control problems
• Unaware of abilities
• Risk taking
• Distorted self-image
• Difficulty in social situations
• Physical or verbal outbursts

Emotional changes: Emotional changes are also common and can include:

• Insomnia
• Irritability
• Anxiety
• Lack of empathy
• Depression
• Self esteem changes
• Mood swings
• Anger

Sensory problems: Sensory problems encountered by those with TBI include:

• Ringing in the ears
• Lack of hand-eye coordination
• Double vision or blind spots
• Bad smells
• A bitter taste in the mouth
• Skin itching or tingling
• Balance problems or dizziness

Degenerative brain diseases: The risk of developing a degenerative brain disease such as Parkinson’s, Alzheimer’s or dementia is increased in those who have suffered a traumatic brain injury.

Preventing Injury

The following tips can reduce the risk of a traumatic brain injury:

• Whenever you are in an automobile or truck you should wear your seat belt. Small children should ride in the back in a size appropriate safety or booster seat.
• Never drive under the influence of alcohol or drugs (including prescription drugs) that can impair your driving skill.
• Always wear a helmet or appropriate head protection when applicable.
• Prevent falls around the house by using a nonslip mat in the shower, removing loose area rugs, installing adequate lighting, keeping floors and stairs clear of clutter, and using handrails.

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