Though closed head injuries are not objectively apparent at the time of an accident, common indications that TBI may result are loss of consciousness, inability to recall events immediately before or after the accident, and alteration in mental state immediately following, such as feeling dazed, disoriented, or confused. After an accident, common symptoms of TBI in adults are the following:
- Persistent neck pain
- Ringing in the ears (tinnitus)
- Lapses in attention, perception, judgment, or information processing
- Difficulty with memory, concentration, or decision making
- Trouble with cognition, abstract concepts, and time and space relationship
- Limitations on reading and writing skills
- Slowness in thinking, speaking, or taking action
- Getting lost or easily confused
- Persistent low-grade headaches
- Feeling tired all the time, lacking energy or motivation
- Problems associated with sleep, such as insomnia or oversleeping
- Reduced strength, endurance, and coordination
- Onset of tremors or swallowing problems
- Feeling light-headed or dizzy
- Onset of seizures
- Volatility in your mood — apathy, irritability, anxiety, and/or depression
- Difficulty maintaining your balance
- Increased sensitivity to sounds, light, or distractions
- Blurred vision
- Reduction of sense of smell or taste
Because children are less aware of their habits and normal functioning than adults, it is important for adults to monitor children carefully if it is suspected that they are suffering from a TBI. Symptoms to look for in children include:
- Loss of energy or tiring easily
- Reduced interest in favorite toys or activities
- Irritability or crankiness
- Changes in eating or sleeping patterns
- Changes in the manner in which the child plays, both alone and with others
- Difficulties at school
- Deterioration of recently learned skills
- Loss of balance or instability while walking
The exact effects on an individual who suffers a TBI will vary greatly, depending on the force of impact the brain suffered and the location of the injury on the brain. It is important to obtain a thorough medical examination following any accident so as to immediately determine all injuries received. To appreciate the extent of an injury, it is helpful to understand medical scales used to measure injuries involving TBI.
The Glasgow Coma Scale rates a patient’s ability to open his/her eyes, and respond to verbal commands and responses. Each level of response indicates the degree of brain injury.
| Glasgow Coma Scale | |
|---|---|
| Eye movements | Score |
| Open spontaneously | 4 |
| Open to verbal command | 3 |
| Open to pain | 2 |
| No response | 1 |
| Best motor response to command | |
| Obeys verbal command | 6 |
| Best motor response to pain | |
| Localizes pain | 5 |
| Flexion – withdrawal | 4 |
| Flexion – abnormal | 3 |
| Extension | 2 |
| No response | 1 |
| Best verbal response | |
| Oriented and converses | 5 |
| Disoriented and converses | 4 |
| Inappropriate words | 3 |
| Incomprehensible sounds | 2 |
| No response | 1 |
The lowest score is a 3 and indicates no response from the patient. A person who is alert and oriented would be rated at 15.
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