Picking Up the Pieces After TBI: A Guide for Family Members

Angelle Sander, PhD, Baylor College of Medicine
Picking Up the Pieces After TBI: A Guide for Family Members

In the book Missing Pieces: A coping Guide for the Families of Head Injury Victims, Marilyn Colter Maxwell wrote, “Living with head injury is like trying to work a jigsaw puzzle without all the pieces.” You may have felt this way at times since your family member was injured. Even if you have not felt this way, you may still have some questions about the injury and some concerns about the changes it has caused in your life. We hope that the following information will help to answer some of your questions and help you learn some things to make your everyday life a little easier.


What is a Traumatic Brain Injury?

What Problems May Your Loved One Have After TBI and What Can You Do To Help? Problems With Physical Abilities
Problems With Thinking Abilities
Changes in Behaviors and Emotions

How Long Will These Problems Last?

How Does Brain Injury Affect Family Members?

Ways to Reduce Stress

Will My Family Ever Get Back to Normal?

Where Can You Turn for Help?

Muscle Tensing and Relaxing Exercise
Evaluating Coping Strategies
Evaluating Thoughts

CHAPTER 1: What is a Traumatic Brain Injury?

TBI is an injury to the brain caused by something outside the body. It is different from a stroke, which is caused by something inside the body: weak blood vessels, blood clots, etc. There are many things that can cause a TBI. Some of them are: a car accident; a hit to the head with a bat, bottle, or other object; hitting the head during a fall; or a gunshot wound to the head.


  • Closed head injuries happen when the brain is damaged without opening of the skull. Think of the brain as being like jello in a container. If you move the container quickly then suddenly stop it, the jello will bounce off the sides of the container. In the same way, the brain bounces off the skull when the head stops suddenly after being in motion. Damage to the brain is caused by bruising and bleeding within the brain, tearing and stretching of nerve cells, swelling of the brain, and the building up of extra fluid.
  • Penetrating (open) head injuries happen when a sharp object goes through the skull and enters the brain tissue. Examples of objects that can cause a penetrating brain injury are a bullet, a sword, and a knife. In these cases, the most damage occurs to the part of the brain that the object goes through. But damage to other parts of the brain can occur because of bleeding and swelling.

The brain controls most of our abilities, including memory, speech, vision, movements, making decisions, and our ability to get organized and get things done. Our brains also affect our emotions, such as whether we feel sad or happy, or whether we’re easy-going or irritable. The brain is divided into many parts, and each part controls different abilities and behaviors. For example, one part may be important for talking and another part may be important for understanding other people’s speech. Brain injury can lead to different problems, depending on the parts of the brain that are damaged. Each person’s brain is like everyone else’s in some important ways, but each brain is also unique. Because of this, there are some problems that are the same for all persons with brain injury, and some that are different for each person.

Here is the full Family Education Manual.

Posted on BrainLine March 31, 2009.

From Baylor College of Medicine © copyright 2011 and Memorial Hermann |  TIRR’s Brain Injury Research Center. Printed with permission. For more information, go to www.tbicommunity.org.