Traumatic Brain Injury

Traumatic brain injuries affect millions of people each year

A traumatic brain injury (TBI) is a physical injury to the brain caused by a bump, blow, or jolt to the head or a hit to the body that causes the brain to move rapidly inside the skull or from an object entering the skull and brain. A TBI is not just a single event. It can begin a chronic process that may contribute to or worsen other health conditions over time. That’s why TBIs are considered a chronic health condition. For some people, the effects of a TBI are not always visible. Symptoms may be missed, misunderstood, or never diagnosed. Because of this, TBI is often called a “silent epidemic” and remains a major public health concern.

While anyone can experience a TBI, some groups are at higher risk, including:

• Young children and older adults
• Survivors of intimate partner violence (domestic violence)
• People with substance use disorders
• Public safety professionals
• Service members and veterans
• People in correctional facilities

People with a TBI need to be checked by a medical professional

Contact your medical professional as soon as you can if you think you or a loved one has a TBI, including a concussion. Medical professionals will assess symptoms and check for secondary injuries after a TBI. Secondary injuries are health problems that are linked to physical changes in the brain, such as swelling, bleeding, or changes in blood flow and oxygen, that can cause more harm to the brain. Medical professionals will create treatment plans to help address or lessen the effects of secondary injuries on the brain. Learn more about the possible effects of a brain injury.

Talk to your or your loved one’s medical professional about treatment options and for tips to aid in recovery

Some health problems after a brain injury show up right away and need emergency care, while others may not show up for days, weeks, or even months following the injury. Medical professionals can create treatment plans to help address many of these health problems.

Ask your or your loved one’s medical professionals for instructions on how to safely return to activities following a TBI. Be sure to follow these instructions carefully. Read more about:

• Where to find care and support after a TBI
• Types of rehabilitation services
• Community-based treatment options
• Getting back to activities like school, work, driving, and physical activities

A TBI can affect many parts of a person’s health and daily life

A TBI is linked to symptoms that can affect how a person thinks and remembers, moves and functions physically, feels emotionally, and behaves in everyday life. A person’s recovery journey after a TBI may be short (days to weeks) or long (months, years, or lifelong). These effects may stay the same over time, get better, or get worse. Sometimes, symptoms seem to go away but come back later—especially during times of illness, stress, or fatigue.

People with long-term effects from a TBI may need ongoing care and support to return to daily life, including work, school, and community activities. Access to rehabilitation services can improve recovery. However, much of the day-to-day care often falls to family members and loved ones. About six million family caregivers in the United States support someone living with a brain injury. Caregivers may experience stress, poor health, and high levels of burden. Learn more about caring for a loved one with a TBI.

Advances in research and care are improving outcomes for people living with TBI

We now know that the brain can adapt and heal in many cases. Research shows:

• The brain can form new connections (neuroplasticity)
• Recovery can happen across the lifespan, no matter a person’s age

Doctors and researchers are working on a better way to understand and diagnose TBI using the CBI-M (Clinical, Biomarker, Imaging, Modifier) framework. For decades, TBIs have been classified as mild, moderate, or severe. This system is often too simple and does not reflect what people experience. The CBI-M framework was created to give a clearer, more complete picture of what is happening in the brain and represents an advancement in brain injury diagnosis. This four-pillar approach includes:

1. Clinical: The clinical pillar retains the Glasgow Coma Score, which evaluates a person’s level of consciousness along with pupil reactivity, as a central element of the assessment. The framework recommends including the scale’s responses to eye, verbal, and motor commands or stimuli, presence of amnesia, and symptoms like headache, dizziness, and noise sensitivity.
2. Biomarker: The biomarker pillar uses biomarkers identified in blood tests to provide objective indicators of tissue damage. Low levels of these biomarkers determine which patients don’t require CT scans, helping to reduce unnecessary radiation exposure and health care costs. Biomarkers can also identify patients to enroll in clinical trials to develop new medications for TBI.
3. Imaging: CT and MRI imaging are important in identifying blood clots, bleeding, and lesions, particularly in patients with more severe injuries, which can point to present and future symptoms.
4. Modifiers: While the C, B, and I pillars look at what a brain injury does to a patient, the modifiers pillar looks at what the patient brings to the injury. This can include things like age, sex, and preexisting conditions, such as medications a person is taking, their health care access, history of prior TBI, substance abuse, or mental health issues.

Learn more about the new CBI-M framework here.

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community