Recovering from Mild Traumatic Brain Injury

Mary Ann Keatley, PhD, CCC and Laura L. Whittemore, Brain Injury Hope Foundation
Recovering from Mild Traumatic Brain Injury (MTBI)

The Important Role of Brain Filters

Much of the brain’s energy is used to filter out irrelevant or unnecessary information. Just imagine what it would be like with no filter on your brain. All the sounds, smells, images, and feelings would come crashing in at the same time. The overstimulation would probably paralyze you and prevent you from taking any action.

After sustaining MTBI, most of the brain’s energy is diverted to basic functioning, and little is left over for filtering or censoring. Trivial or insignificant thoughts may often have the same weight in your mind as important ones. This can make decisions difficult. You may find that your brain gets stuck on an idea or phrase that keeps replaying, and this uses a great deal of brain energy.

New sensitivities can be very challenging and baffling for the injured person and their loved ones. Going into a restaurant or store where there are fluorescent lights, background music, or a great deal of visual stimuli may cause the brain to shut down. Most people say that they want to get into a quiet place and rest their brain after that experience. That is why it is so important to plan your social activities when fewer people are around and when there is less commotion.

Hearing Problems and Hypersensitivity to Sound

As mentioned above, a common symptom of traumatic brain injury is hypersensitivity to sound. This is called hyperacusis. The auditory system becomes very sensitive to environmental noise, and you may discover that you have great difficulty going to restaurants, the grocery store, or social gatherings.

Many individuals report staying at home to avoid the assault and feelings of being overwhelmed in these noisy situations, or they may go out only at times when places are less crowded and less noisy. Any noise can assault and overwhelm a person with MTBI, including a vibrating refrigerator, heating system, or humming fan, etc.

An excellent accommodation for hyperacusis is ear filters. The actual name is ER 15/25 noise-dampening ear filters. These are custom-fitted earplugs, originally made for musicians, but they now have been adapted for individuals with traumatic brain injuries. Consult an audiologist at a speech and hearing clinic to obtain filters. Current studies show that filters can reduce overstimulation to the auditory system and allow you to participate in social situations without becoming overwhelmed. An advantage of using ear filters is that you can put them in for brief periods of time and take them out when you don’t need them. They can be made with clear materials and are therefore less visible. The ear molds for these filters are made by an audiologist, or a specialist trained in testing hearing and treating hearing problems.

The ear is susceptible to blast injuries. Unique patterns of injury occur with bombs and explosions that are seldom seen outside of combat. The eardrum or tympanic membrane may be perforated in the blast and should be evaluated with an otologic evaluation and audiometry (hearing evaluation) to determine whether there is an injury to the ear.

Eardrums can be replaced, but observational studies over the years have shown a high rate of spontaneous healing of ruptured eardrums following blast injuries. Whether a perforated eardrum heals spontaneously depends on the size and placement of the perforation.

Two types of hearing loss are associated with blast-induced injuries. One type is called conductive hearing loss, and the second type is sensorineural hearing loss. The high-frequency sounds are more likely to be affected in blast injuries. Many individuals complain of tinnitus or ringing in the ears, and it is common to have balance problems, dizziness and/or vertigo associated with perforated eardrums. It is very important to keep the ear canal dry until the eardrum has healed.

Vision Problems and Sensitivity to Light

You may notice that your eyes don’t seem to be working in the same way that they did before your brain injury. Some eye doctors specialize in vision problems resulting from an acquired brain injury. They can help diagnose visual problems related to the injury and provide exercises or special glasses to help with recovery.

Because the visual changes are sometimes subtle, you may pass them off as being related to fatigue or brain fog. Aiming and focusing the eyes are linked, and that is why objects may appear to move, be seen as double, or blur in and out. Some individuals also complain that it is difficult to focus quickly from near to far or far to near.

Vision problems and cognitive deficits may compound one another. The most common complaints related to visual problems associated with brain injuries include light sensitivity, headaches, double vision, fatigue, dizziness, difficulty reading, or loss of peripheral visual fields. You may feel a heightened sensitivity to light and may even need to wear your sunglasses inside. You may have to request that fluorescent lights be turned off. Computer and reading tasks may take longer than usual, and tend to be more confusing and tiring.

A behavioral optometrist or a doctor who belongs to the Neuro-Optometric Rehabilitation Association can perform a comprehensive vision evaluation and help you determine the best course of action. Some individuals with visual deficits can benefit from specific lenses or prisms in their glasses and/or from vision therapy.

If you have vision problems associated with MTBI, this may deplete your energy and decrease your ability to perform daily living tasks. It is unrealistic to return to work
until vision problems are addressed. If your job requires a great deal of reading or moving your eyes between the desk and a computer screen, you may find that your errors increase because of difficulty tracking. It is very important to address visual problems, as they can increase the recovery time.

Dizziness and Vertigo

Feelings of dizziness and nausea are common after a head injury. You may notice that these symptoms come and go depending on the activity you are doing. Dizziness may refer to distinct symptoms, one of them being vertigo. This is when you feel as though you are spinning, and sometimes you feel nauseated or like you may lose your balance. Researchers have discovered various causes for this symptom, such as problems with your inner ear, impairments in eye movements, clenching and grinding your teeth, tightness in the neck muscles, etc.

Dizziness may also originate from cervical neck injuries. The primary symptoms with this type of dizziness include feeling off balance, lightheadedness, and the sensation of floating. If you have what is called benign paroxysmal positional vertigo (BPPV), you may notice that you have a sudden attack of spinning when you turn over in bed, change your head position quickly, or reach for an item above your head. This usually lasts for less than a minute, but you may be left with feelings of nausea and dizziness for a longer time.

The Mayo Clinic developed a technique called canalith repositioning (1994). where the head is maneuvered in various positions to help eliminate the dizziness. This is accomplished by moving the calciumcrystals in the inner ear. Medications that can help dizziness are also available. Be sure to consult with your doctor to see if you need a referral to an ear doctor who specializes in traumatic dizziness and/or an eye doctor who specializes in traumatic vision syndrome.

Changes in Energy Reserve After Injury

Healing takes a tremendous amount of energy. The diagram in Figure 1 illustrates functioning before and after the injury. It shows how the uninjured brain can perform many activities that are physical, cognitive, and emotional throughout the day, and still have a reserve of energy. After a brain injury, it takes more energy to deal with cognitive and emotional issues, leaving little or no reserve.

The brain uses more energy than any other organ in the body. Before you were injured, you had a pool of reserve energy available when you overextended yourself. Following your injury, nearly all of your energy is required to perform the most basic functions just to get through the day. If you are continuing to work, you may find that when you get home, you must rest and not engage in other activities as before.

Your energy reserves at this point are almost nonexistent. When you push too much you may reach overload, and the extreme fatigue may cause your brain and body to shut down. This exhaustion can also amplify all of your symptoms, and cause an emotional reaction.

Almost Immediately after an injury it becomes clear that you don’t have the same amount of energy that you previously did. It is important to emphasize the need for rest and conserving energy. For a while you may be unable to do as much as you used to and may need to take time out for rest — Brain Rest. Lay down during the day for naps. Even if you don’t sleep, resting your head and lying down may make a significant difference in your recovery.

Posted on BrainLine November 20, 2009. Reviewed July 26, 2018.

From Recovering from Mild Traumatic Brain Injury: A handbook of hope for our military warriors and their families by Mary Ann Keatley, PhD, CCC and Lauar L. Whittemore. Copyright © 2009 the Brain Injury Hope Foundation. Reprinted with permission. www.braininjuryhopefoundation.org.

Comments (76)

I had a TMI from a bike accident October 2018 and went to the ER. I was wearing a helmet, and the CT scan indicated no bleeding. 2 months later, however, after experiencing dizziness, and weakness on my right side, and being miss diagnosed, I was admitted to the ER with a subdural hematoma. Had emergency brain surgery and now recovering. I'm still resting a lot and can't handle fluorescent lights. Headaches come and go.

What an excellent understanding article. I received mild TBI after a rear end car accident in August 2017 and am still suffering. I felt like nobody believed me other than my lovely wife. They finally found I had broken a few bones in my inner ear and I developed Tullio. My doctor had never heard of the condition which causes vertigo on certain pitches of noise. I suffered from the hyper sensitivity to noise but was told to get the ER 25 custom ear plugs. Yet again my doctor had never heard of this and the insurance company is currently refusing to fund but they really work well in busy situations. If your having issues with sound in public places please see your consultant and look into the ear plugs. They cost me $250 AUD for the pair (custom made). I was told I should expect all the healing to be completed within 18mths. It looks like the new me is here to stay and that's no picnic. Good luck to everyone else experiencing these issues. Your not alone.

I have a mild TBI - got a concussion by hitting my head off 2 walls. Left side at the back hit first and ricochet to the the wall on my right. I also have whiplash. I've been getting acupuncture to help. My fatigue if awful though. By afternoon I'm exhausted. I sleep for 2 hours and am ready for bed by 9 pm. My eyes are still very light sensitive. My balance isn't quite right either. Has anyone ever tried on of though vibration exercise machines to help with symptoms? would it even help? My physio doc said low impact exercise would help with the fatigue.

Been out of work for 8 months due to TBI...I have apparently suffered multiple undiagnosed concussions and the last one did it. Didn't have any symptoms for about 2 months, besides a wicked headache and then the other symptoms hit me like a truck! I have all of the symptoms mentioned in the article and more. The worst part is the feeling that other people think you are making it all up because the symptoms are not "visible". To the point where sometimes I'm thinking it too...and then I try to move quicker than I should and realize it is still there! I'm glad I am not the only one out there going through this. Haven't started treatment yet as the doctors took forever to figure out what this was, looking forward to it though and hopefully finding some relief

You certainly are not the only one. I suffered a similar injury to the face two years ago. Unknowing the effects it would eventually have, I just carried on as usual. Some days soon after, my symptoms developed and worsened to the point where I thought I was losing my mind. The diagnoses as you said before can't be determined by a test. So in the event of expressing my concerns to my dr, he diagnosed me with anxiety and clinical depression. It wasn't till I was I recalled the injury did we piece it together. By then weeks had gone by and was suffering immensely. My mind had stopped functioning; I began mixing up my words, stumbling my sentences. I no longer was able to follow conversations. Incoming memories were dissolving in my mind. My depth perception was effected, as I found my self bumping into things. It takes me so much time to collect a thought that when I finally do, I'm just so frustrated, I let it go. And to endure each day in darkness is terrible. I can't imagine how people with even worse symptoms manage to exist. Because my inactive mind has deterred my ability and drive to exist. I only exist currently on a physical realm, but mentally I'm lost, and in a constant fear that ill never return to the person I was, The constant obsession of my injury which plays continuously in my head, pollutes me. And at times is the only reachable thought I can consume from memory. It's ironic how the most obtainable thought is one which delivers the memory of my issues. I guess that's just life's cruel little joke.

Oh god yes. That's exactly what I'm experiencing, headache from the start but took a few weeks to notice the other symptoms. Its worse when it feels like doctors don't believe you but they have no idea. One opthamologist told me my vision was a bit off because I was just getting old despite it being perfect before the injury then it was like someone flicked a switch. Then a behavioural optometrist said no you have perfect vision but you have a horizontal misalignment caused by the blow. Damn idiot is supposed to be a specialist if I can find and understand these symptoms here why can't he. Also people at work don't care as you say they can't see it. I want the lights off but I get overridden by the majority. Then I'm in agony, mood plummets and I tell you I feel like just giving up.

Even being the one having the symptoms, I can't shake the feeling that my TBI isn't "real" or "worthy" because the physical damage was so minimal (barely broke the skin), I never even lost consciousness at all, and I made mistakes (even knowing better) in my initial healing, which was only four months ago anyway.

Being around people who don't understand TBI -- who does, really? -- and all but roll their eyes when we talk doesn't help my misconception. It's a common one, eh? Thank God and Physics and whoever you pray to, too, that my husband is so extraordinarily compassionate and understanding. Even so, I could really go for a conversation with someone else in my specific situation. Such a personal experience as TBI recovery sure can get ...so very... lonely.

Even so, here I am and I'm pretty convinced the light and sound sensitivity will be my final frontiers of healing. I just have to keep the faith that there will be a "final," ever. I have to, because whenever I forget to have faith, right down I go into the spiral of frustration and self-recrimination. Happened just two nights ago, and then I found this page. Thank you all for helping me get back to faith and hope.

Take it easy, and keep the faith. This is my new mantra.

Hi, I had a concussion over a year and a half ago it was due to a bicycle accident. I worked my way through it. But just recently I went for a massage and it brought back my symptoms. I think it was due to my head being face down in the cradle too long. Anyway, all I can say is hang in there you will get better it takes time and your energy levels will be different but eventually the brain heels. Just listen to your body and do what is best for you and get enough rest. Keep the faith try not to go down a rabbit hole I know it's hard but keep a positive attitude really helps in the end. Take care

Hi Scott, I recently had a bicycle accident too and now suffering from TBI. I just wanted to say your comment is very positive and inspiring, thank you. I hope your words of wisdom stay with me during my recovery.

I understand your need to talk to someone going thru this. I went shopping with my mom on Black Friday. Trying to explain my noise sensitivity and my mom seeing what happens is different.We were at the cash register and almost done when a store alarm started going off. My hands automatically went to cover my ears. This shocked both my mom and the employee.
My injury happened in July 2018.

Hi

I had injury end of Sept 2018, head hit corner of chair had buzzing sound, still have headaches, dizziness nausea , especially when concentrating, or movements, feel frustrated , people around dont understand , ppl shd be educated by professionals on concussion, cant handle noise, crowds, light, cant handle conversations, slowed me down in life, going for treatment, hope i get better soon, its 3 mths now still struggling.. mild concussion, dont know when and how dizziness will go away w nausea. Cant handle skytrain rides . Its crazy.

I had a similar injury in September of 2018 also. I’m experiencing all the same symptoms. I’m currently on disability and doing vision and vestibular therapy and have to take an anxiety depression medication. I also just saw a neurologist and he is doing several tests including EEG, MRI and a few other tests. I feel very frustrated and hope this goes away soon.

I had a car accident I was hit by a bonanza but broadside when you was 16 years old bath passenger died. I was in a coma for 11 days but I remember my father telling me about o squeeze his has, I remember my mom asking he blood from my hair and Man other small memories. I am fine today. Have hearing loss in both ears from broken middle ear bones, neck pain, and leg pain. I handle all pain throu exercise. I have a masters degree and I’m a teacher. Do all coma patient have I near death experience? I did not. I am curious about what kids H.G. of brain injury I had. I had a hole in my head drilled to relieve pressure and had seizures. No one looking or speaking out to me would I know hat I’ve been th ough. I am very fortunate to recover. Why don’t I have more effects?

I had a CVST (Cerebral Venous Sinus Thrombosis) 6 years ago and have suffered from severe ringing in the ears since. All of my doctors have been baffled by this as I never suffered from this before the clot was discovered. Nothing I have done works to mask the ringing. If anyone can help with this, I would appreciate it.

I am TBI survivor trying to figure out my issues after 8 years

Carol, for what it's worth, know that your simple comment made a huge difference for me. I'm a mere four and a half months into figuring out how to live life now and was feeling very down about my progress and mistakes I initially made, and hearing that it's a figuring out and it takes time gave me a lot of hope. Thank you, a lot.

I may have ABi. Or tbi. After your brain injury did you notice that you had a major sensitivity to caffeine? Did you also notice that you were getting your words and sentences all mixed up. I’m going through this right now

Yes. I have moderate TBI and I was caffine sensitive. At first, all I could drink was decaf. With caffine, CRAZINESS! Although, I am able to drink a coffee after about 10 years! Then for my 2nd cup, I will drink decaf! I love coffee!

Have you read this survival guide??

I actually suffer from Hyperacusis (hypersensitivity to sound) unrelated to my concussion. Let me tell you it is awful. Especially when I lived with it when it was very severe for nearly 7 months. It was related to a hearing injury a while back. Its typically from Chronic loud noise exposure. That's how I got mine.

It is not even nearly close related to the eardrum. The eardrum is just a sliver of skin protecting contaminants from your middle ear. Its connected to the 3 bones in your ear that contracts when you hear loud noises. Your ears pop when you swallow due to the eardrums connections to the Estachian tubes. Which regulate pressure to the middle ear. Its a rare condition. It has believed to either be related to an aggravated auditory nerve or the hearing organ (the cochlea) itself.

I am very fortunate to not have any setbacks in my Hypercausis department once my concussion. I just wondered onto this page because I'm still recovering and I have awful reading difficulty at the moment. I would highly recommend anyone to check out Hyperacusis Network Forum. Someone may be able to help you there. When it comes to this. Every cause to the problem is different. I've met people who got hypersensitivity of ototoxic drugs, ear infections (middle and inner), loud noise, a blow to the head, and one even having theirs related to Epilepsy. Everyone is different. Therefore, your healing is different.

So this is going to sound crazy, but I've been having all the symptoms described here, but I haven't had an injury. The doctors have been totally baffled, but I finally landed in the hands of a physical therapist who is helping with my vision and vestibular issues. She's the one who suggested that I might have a brain injury since I have all of these symptoms of one. Has anyone ever heard of spontaneous brain injury? Just wondering if this is really what is going on since every article I read about brain injury seems to fit with what I'm experiencing!

Mindy, thanks for asking this question because I have every symptom mentioned and no brain injury. Definitely will be reading this thread and you're not alone in this!

Another thing to consider is your unknown history, before your brain began to retain memories. It is possible that you may have experienced a fall on your own or a drop from someone when you were an infant and of course have no recollection of it. I've seen kids fall pretty hard and many parents will pick their child up and hold them until they stop crying but they rarely consider or understand how a simple jolt can damage the brain, especially when it is in it's infancy. Another possibility is that your TBI was so severe that you can't even remember it happening. Seems very unlikely but I've had several concussions and at least one I can't remember anything leading up to it. I've spoken with others about their TBI and one guy told me that evidently he rode his bike all the way home and didn't remember it. In both of our cases there were witnesses, and I ended up in the hospital and he had bruises to indicate an injury, but I do wonder if someone were to hit their head alone at home and then wandering to bed if they just wouldn't wake up with a mild headache thinking it was all a nightmare or not even remember the hear injury at all. Far-fetched perhaps, but reality has some strange stories that seem less likely than fiction. Like someone else suggested, just jolting your head fast enough, from a car accident or something similar, can cause injury to the brain too. Wish you well and good luck with your recovery!

Do you have hearing loss and tinnitus? If so, you may want to be screened for a vestibular schwannoma.

I have moderate (closed head) TBI from the major jolt in my auto accident. Have you ever experienced a jolt? That "jolt", may have been the cause. Ex: falling down, being pushed against a wall.

I just had an MRI due to a second concussion this year. I had no idea the testing was so loud. I had sound and light sensitivity due to the concussion so the 20 minutes was pure torture. It was like having a jack hammer being used on your head. Music added to the noise level. I could hardly function once I was done. Anyone else ever experience this?

Yes, just went through that

Yes, mris are very noisy with body and brain shaking vibrations. Construction grade ear plugs, and choosing no music from the headphones can help. Bringing your own thin pillow can help isolate your head off the table. The use of an mri to diagnose concussion is also questionable but I am not a doctor, just recovering myself.

I had the same response during an MRI of a knee...I 'd had ones before my concussion ( nearly 2 years ago) but still wasn't prepared for the impact of the noise plus feeling like I was trapped.. Even though I had listed post concussion syndrome in the medical history, the tech was oblivious...

Yes, I have experienced these same symptoms during an MRI but also when trying to use a computer and early on, while trying to read.

I am always disoriented after an MRI - a feeling of having been in another world and having to re-adjust to what we tend to think of as "reality." It usually takes a little while to regain my balance and normal function. However, even though I have ongoing hyperacusia, I have learned to love the weird, loud sounds of the MRI machine. I know that sounds strange! I just relax into it and let myself be intrigued with the variety of sounds. I even fall asleep!

I had a head injury resulting in hypersensitivity to motion, light and sound. After getting nowhere with my ENT department for ear filters, I got some Bose noise reducing earphones. They have saved my sanity. I just pop them in whenever there is noise my brain can't handle. I also wear sunglasses a lot to dampen down the light sensitivity. When driving, because I am holding the wheel which stabilizes my head more than being a passenger, that is also beneficial. Also avoiding vehicles with less shock absorption and not sitting over wheels or near side cambers. It's been a year of discovery of what works. Hope this is helpful to you.

I'm in my 2nd year of rehabbing from a severe motorcycle accident where I was busted up from head to toe. Of my injuries, I received my 3rd diagnosed concussion (this concussion and my first I was knocked out by). I add "diagnosed" because I played ice hockey for over 20 years and trained in MMA and boxing for three years so I doubt three is the actual number. I'm sure there were more. My brain must hate me for all this.

Anyway, as a result of this head injury, two of my symptoms are frequent hypersensitivity to light and sounds. When it does happen, I have to stay in a room, lights off (but not completely dark), and with zero sound. The sound sensitivity is far worse than the light. Sometimes they happen together, sometimes individually.

It can often take about 48 hours of almost complete isolation to get rid of the symptoms. If I don't get that time frame, it drags on and I get really irritable. I don't want to be around anyone at all.  My girlfriend, who was in the accident with me (but wasn't injured) and I live with, understood and was supportive when I couldn't walk, feed or bath myself but she doesn't understand and gets angry when I try to tell her about not playing music in our apartment. I use earphones for everything I watch or listen to so I don't disturb her but after many arguments asking her to use them and refusing, I gave up asking.

I don't get much quiet time at home because she does about 75% of her work from home. When we didn't live together, I had lots of quiet time and it helped stabilize these symptoms.

Anyway, I have seen three neurologists for this and other injuries from this accident and one tried to get me in a traumatic head injury program. I have other problems too (concentration, focus, memory loss, vision problems etc) but they won't accept me because my insurance doesn't cover the treatment.

I think because there's no cast, crutches, or wheelchair with these brain injuries coupled with the fact that people cannot understand why something like music can bother someone makes it difficult for people to accept these conditions. It leads to too many arguments with my girlfriend because it's difficult to live with me when these flair up. That stress is another problem that compounds all of this too.

I'm going to show my girlfriend these articles to see if it helps her understand. I've tried to explain it to her before but it didn't accomplish anything.

I might move back to my parents house because they have a second floor to their house that they don't use and I can stay there and have the quiet I need to heal. That may salvage my relationship with my girlfriend too.

This will be short, on 11th month of mtbi...still rough. Get book "chicken soup-tramatic brain injury survivor stories". It will help both of you. Praying for your recovery...you are not alone.

The day you posted this was the day of my injury. I can relate to a lot of the things you said. For me though I didn't have any symptoms until about 9 months post injury. The decline was rapid and is destroying my life. I'm unable to work or socialize like I did post injury. Nobody understands what's wrong with me and doesn't really seem to even try. My car fell on my head and fractured my skull. I live with my mother now because I'm unable to work or function in the world. This is the worst place I could live because she's a hoarder and has stuff everywhere. I feel constant fear of getting hurt again living here on top of the fear of life in general. I'm so fearful of what the future holds for me and if I'm going to continue to decline. My anxiety is debilitating. I miss my old life. I miss the old me. I don't know how much longer I can go on like this.

I'm sorry you experienced something so devastating. I've learned that the trials that befall us we can endure, because our creator promised he wont allow us to bear more than we can handle. To me what you have been through and are going through is testimony to that fact, so first i want to say," DONT GIVE UP!" Have you talked to your mom about tidying up and getting rid things you all dont need? Maybe you and her together along with a little help could start out little by little or a room at a time if need be, would go a long way!! I know my mood an outlook are better in a cleaner place as well. Do you take anything for your anxiety? If not it be worth looking into, I'm speaking from experience. Again dont give up, you may not believe it right now but what your going through is only temporary. This is how i know, make time to read this scripture Revelations 21:4 - it's God's promise to us. In the meantime i think things can get better for you and i hope they do. Please take care!!

I understand how you feel. I have 3 daughters, 2 who live with me, and I have to constantly tell them to clean up after themselves or I'll fall. I passed out in my backyard and hit the back of my head hard enough I died. After reviving me, they had to put me in an induced coma. I woke up hooked up to all these machines. I tried to get up and fell straight on my face. The nurses rushed in and told me I couldn't walk... I'm like what you mean I can't walk?? It's crazy the little things in life we do every day that we take for granted until you are literally not able to do it anymore. It sucks because nobody knows how you feel.

Your brain is still healing. Be patient with yourself. Check to see if there is help for hoarders in your area. One of my friends suggested a parasite cleanse can also cure propensity for hording. You can also go on anxiety meds temporarily to reset your brain chemistry and get you out of the tailspin. Talk to a doctor.

My doctor is useless, he’s telling me I have nothing neurologically wrong with me because my MRIs are completely normal. He’s telling me I’m just really depressed more so than I have been in the past. I don’t understand how he could possibly think that. I had a fracture to my skull base and to my temporal bone. I had a hemorrhage in my left temporal horn but my Intercranial pressure never went up so high that they had to do surgery. I had a brain contusion and I think another hemorrhage somewhere. I started to feel less cloudy but also have confined myself to the house completely. As soon as I started feeling a little better my ears started feeling full and then all the sudden I had tinnitus and hearing loss. I am really depressed and some really sad things happen in my life before my head injury but I had sick a bad injury that I can’t understand how I have no permanent brain damage. Something is wrong and I feel like I wait to see a doctor and they just tell me I’m fine and push me out the door when I know I don’t feel right. Everything scares me....I wasn’t like this before. I felt fine after my head injury and it wasn’t until nine months later that I felt like something was wrong.

Mike, it sounds like your symptoms came on quite a while (9 months?) after your TBI, which is unusual - maybe this is why the doctor isn't listening. Some things to consider - from one layman to another. First, when you have a TBI, it makes you VERY susceptible to additional head injuries - even from knocks that you wouldn't think would cause a problem. Is it possible you engaged in an activity more recently that could have caused this? Some examples are riding a bicycle, motorcycle, or even a vehicle on a bumpy road, using power tools, or playing a sport where impact can occur or you are running hard, like soccer, football, or basketball. I have experienced a recurrence of post-concussive symptoms from banging my head against a headrest of a car in a tiny fender-bender, which took months to dissipate. Long story short - you are at a higher risk for more injury, and maybe this is playing into your symptoms. Second, depression and anxiety are VERY common post-TBI symptoms and they are affecting your life significantly enough that you should look into treatment. (if you haven't already) This may involve medications for a little while. Some people have a hard time with taking a prescription, but it's very important that you get help or it will not get better. Last, but not least - YOU know how YOU feel. Something, as you said, is not right. It is rare for the effects of a TBI to be visible on an MRI months later. I would not call a normal MRI in any way conclusive for the symptoms you are describing. TBIs usually mean a new "normal" - things aren't ever going to be the same as they were before the injury. But that doesn't mean you just have to sit with what you got. You may need to see some specialists to get help for the various issues you are experiencing. A neurologist can speak to the tinnitus and fullness in your ears, and/or an audiologist may be able to prescribe special earmuffs or earplugs, or a smartphone app that can help. A psychologist and psychiatrist can help you with your depression and anxiety - you'll need the psychologist for some weekly appointments until you can get your feet back under you, and the psychiatrist for any medication management. I don't know your financial situation - but at the same time, this is help you really need to get better - I ended up feeling like the medical bills were worth it in the long run. Don't give up, speak your truth, and keep asking questions. Recovery takes a long time - it took 5 years before I felt remotely normal, and at 10 years out I still have (permanent) symptoms. Go easy on yourself and try to stay patient. Be open to finding things to be grateful for every day. Good luck, I hope this helps.

To the post on fish oil causing gout are you sure that wasn't concentrated fish oil in gel caps?  You can OD on that stuff.  Best to use none concentrated.  They are a lot bigger but its fish oil not concentrated for more vitamin contents. Does the ringing in the ears ever go away?  My constant headaches did go away after 10 weeks,  but now the ringing in ears is unbearable.

I have suffered from PTC, Pseudo Tumor Cerebri other wise known as IIH Idopathic Intracranial Hypertension, which is a disease that causes to much CSF and literally squeezes the brain putting increased pressure on brain, which causes brain injury, I also was in a car accident that gave me whiplash and ruptured 2 discs in my neck, so I had to have neck fusion surgery. All the syptoms you have described apply to me, I am going on 14 years with this disease and these problems. I have a VP Shunt in my head that is supposed to keep the pressure off but unfortunately they have a tendency to have a lot of problems and bread down often which requires another surgery. I have no quality of life at all, but my faith gets me through.

There's a therapy called Cranial Release Technique, CRT, that might be useful to investigate...it's been a great help to me. My extremely-layperson understanding is it frees up space and mobility in your skull to give your brain half a chance to get on with healing.

Thank you so much for this article. I'm a couple of weeks shy of 2 years recovering from a head injury due to a fall during snow skiing. I've been so isolated and lonely because over-stimulation from sound, music, lights, crowds, environment. I've never been told by the neurologists or primary care doctors to see a neuro optometrist or audiologist. I made these appointments after reading this article. I know have noise dampening ear-molds made specifically for my ears (ER 9, 15, 25). They come with 3 filters depending on how much filtering I need in any social setting. I'm out of the house more enjoying music and people for the first time without being miserable and causing more pain. I still have to pace myself as to not over do it. Bouncing back is hard with pain and insomnia. With neuro optometrist testing I now have names to put with the symptoms of my vision. She can help me & that is so encouraging! I've also had cognitive testing with results coming next week. I feel like I'm finally making progress in my recovery. Thank you for this article. Sometimes you just have to be your own healthcare advocate. Research, read and do it! Thank you for pointing me in a direction I didn't even know about!!!

Suffering from mild tbi and not having the right Doctor its big question mark about your life. I have been complaint for 9 months about my fatigue, migraine, pre-syncope, and pain in my eyes etc... I end up making an appointment to a vision therapy doctors and told me i can not be able to do daily activity or my therapy due to severe post concussion. But my therapist kept saying all of this month that nothing is wrong and I could go to work. Thank God I did not have passed out during driving a car .

Thank you all for the comments and the article.  I had my fourth concussion this Memorial Day.  Was playing a softball tournament and got hit in the orbital area by a ball that took a bad bounce.  Had three prior ones when I used to snowboard - but those were over 10 years ago.  I'm 42 now and the recovery from the last concussion took way longer.  The sensitivity to light was something I never noticed before.  I had to hole up in my apartment with the lights off and blinds drawn for 10 days.  The CAT scan said I was fine but I just don't feel the same as before the accident.  I'm now four months out and am just now admitting to myself that things are different.  I am having such a hard time with work - focusing on one task is so hard.  I am a CPA and spend all day every day under florescent lighting looking at dual monitors. Just driving back and forth to work aggravates me like never before and noises frequently startle me or make me feel a bit of panic.  There has been alot of construction in around my work and home this summer and I get on edge going though every day. I dislike being in crowded restaurants now and social activities are something I no longer look forward to.  I am losing contact with people that I used to socialize and play softball with.  They don't understand why I've pulled away from things and I can't really get through to them what I am dealing with.  I will be looking into some of the resources I've found here to hopefully find my way back.  It's very hard to admit to myself that I may have some permanent loss of function after the last concussion. 

I never had a reason to think about TBI. I only heard about it in the military. Until I had a head on collision with another vehicle and then the totally hectic things begin! My whole life just went down hill! first my job,my home,my wife and then my son dies of a brain aneurism. Then my automobile crash and my girlfriend! She has been an angel and I thank GOD for her everyday! So now I see that material things are really just that material!!! But special people are a true gift! Mike

Sympathized. A lot. Especially /because/ my TBI was so minor in the scheme of things, a lot of people have been very dismissive and simply don't understand (but act like they do). Every day I'm grateful for my husband, who has never once demanded anything from me I can't provide and who's been completely understanding and compassionate at every turn.

I have hope that I can be normal soon. I have 4 children and they are so little. I'm sorry this happened to all of us. I'm praying to god for all of us to get better.

It is very difficult to sleep and to stay positive. I have to over think every sentence I write. Even still I miss words and the ability to communicate well. My family tries to understand and so do my friends. However, that is almost more frustrating. The first specialist I went to see was stuck on the fact that I had fluid on my brain. Which I did. However, refused to acknowledge a recent traumatic event I had been a highly active person. I lived in a ski resort for roughly eight years, snowboarding, jumping off cliffs, car accidents, and then I met a violent individual that had decided I wasnt worthy of my teeth or brain. He just took me out in one violent act. It was one time. I went to the authorities. He was incarcerated for two and a half months. I am living in a world I try so hard to understand. I left the first two drs. behind. Both woman and both poorly managed me and my tragic event. I did the the things I knew would help. Lose weight, exersize and managed to get the fluid off my brain after two and half years. However, I found this out after I found a new specialist that had basically said what I had originally told the original drs., that I thought I had a t.b.I that I read I should see a neurologist/ cognitive doctor. The neurologist who did my spinal tap then said," you do not need to see one of them, the pressure on your brain isnt do to a t.b.I. " I responded, " I was thrown through a three teared coffee table with thick glass and wood. I guess he didnt like that I broke his table because he repeatedly beat me in my mouth until I was almost unconscious and my teeth were loosened had to be braced and are not salvageable. My missing teeth were extracted for my braces." Then again how do you piss off a woman about to stick a huge needle in your back? I am a stubborn individual. I read alot about what was going on with me. I want to believe in the medical world. I want to believe those drs. had my best interest in mind. Except it is my mind, my brain, and my worries. I have to change my life. I am use to taking care of up to sometimes thirty tables in a restaurant. Laughing and joking with a full bar, while playing keno, and enjoying the rush of it all. Now I am happy I can sometimes catch a ball. I refuse to give up on life and my recovery. It looks like now I have damage to my visual cortex which sometimes is secondary to epilepsy. Which would explain a lot. Good luck! Keep on searching for your answers!

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