Traumatic Brain Injury Signs and Symptoms

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Signs and Symptoms (summer)

The signs and symptoms of a traumatic brain injury (TBI) can be subtle. Symptoms of a TBI may not appear until days or weeks following the injury or may even be missed as people may look fine even though they may act or feel differently.

If any of the following symptoms appear suddenly or worsen over time following a TBI, especially within the first 24 hours after the injury, people should see a medical professional on an emergency basis.

Common Signs and Symptoms of a TBI

People should seek immediate medical attention if they experience any of the following symptoms:

  • loss of or change in consciousness anywhere from a few seconds to a few hours
  • decreased level of consciousness, i.e., hard to awaken
  • convulsions or seizures
  • unequal dilation in the pupils of the eyes or double vision
  • clear fluids draining from the nose or ears
  • nausea and vomiting
  • new neurologic deficit, i.e., slurred speech; weakness of arms, legs, or face; loss of balance

Other common symptoms that should be monitored include:

  • Headache
  • Light-headedness, dizziness, vertigo, or loss of balance or coordination
  • Sensory problems:
    • blurred vision, seeing stars, or eyes that tire easily
    • ringing in ears
    • bad taste in mouth
    • loss of sense of smell or taste
  • Sensitivity to lights, sounds, or distractions;
  • Mood changes or swings. agitation (feeling sad or angry for no reason), combativeness, or other unuaual behavior
  • Feelings of depression or anxiety
  • Fatigue or drowsiness; a lack of energy or motivation
  • Changes in sleep patterns (sleeping a lot more or having a difficult time falling or staying awake), inability to wake up from sleep
  • Problems remembering, concentrating, or making decisions
  • Slowness in thinking, speaking, acting, or reading

Headache, dizziness, confusion, and fatigue tend to start immediately after an injury, but resolve over time. Emotional symptoms such as frustration and irritability tend to develop later on during the recovery period. Many of the signs and symptoms can be easily missed as people may appear healthy even though they act or feel different. Many of the symptoms overlap with other conditions, such as depression or sleep disorders.

In some cases, repeated blows to the head can cause chronic traumatic encephalopathy (CTE) – a progressive neurological disorder associated with a variety of symptoms, including cognition and communication problems, motor disorders, problems with impulse control and depression, confusion, and irritability. CTE occurs in those with extraordinary exposure to multiple blows to the head and as a delayed consequence after many years. Studies of retired boxers have shown that repeated blows to the head can cause a number of issues, including memory problems, tremors, and lack of coordination and dementia. Recent studies have demonstrated rare cases of CTE in other sports with repetitive mild head impacts (e.g., soccer, wrestling, football, and rugby). A single, severe TBI also may lead to a disorder called post-traumatic dementia (PTD), which may be progressive and share some features with CTE. Studies assessing patterns among large populations of people with TBI indicate that moderate or severe TBI in early or mid-life may be associated with increased risk of dementia later in life.2

Children: TBI Signs and Symptoms

Children with a brain injury can have the same symptoms as adults, but it is often harder for them to let others know how they feel. Call your child's doctor if they have had a blow to the head and you notice any of these symptoms:

  • Changes in eating or nurseing habits
  • Persistent crying, irritability, or crankiness; inability to be consoled
  • Changes in ability to pay attention; lack of interest in a favorite toy or activity
  • Changes in the way the child plays
  • Changes in sleep patterns
  • Loss of skill, such as toilet training
  • Loss of balance or unsteady walking
  • Vomiting
  • Tiredness or listlessness
  • Changes in performance at school

Effects on Consciousness

A TBI can cause problems with arousal, consciousness, awareness, alertness, and responsiveness. Generally, there are four abnormal states that can result from a severe TBI:

  • Brain death
    The lack of measurable brain function and activity after an extended period of time is called brain death and may be confirmed by studies that show no blood flow to the brain.
  • Coma
    A person in a coma is totally unconscious, unaware, and unable to respond to external stimuli such as pain or light. Coma generally lasts a few days or weeks after which an individual may regain consciousness, die, or move into a vegetative state.
  • Vegetative state
    A result of widespread damage to the brain, people in a vegetative state are unconscious and unaware of their surroundings. However, they can have periods of unresponsive alertness and may groan, move, or show reflex responses. If this state lasts longer than a few weeks it is referred to as a persistent vegetative state.
  • Minimally conscious state
    People with severely altered consciousness who still display some evidence of self-awareness or awareness of one's environment (such as following simple commands, yes/no responses).2
Posted on BrainLine December 1, 2017. Reviewed July 6, 2018.
1. Centers for Disease Control and Prevention (CDC), Facts about concussion and brain injury, 2017. www.cdc.gov/
2. National Institute of Neurological Disorders and Stroke, National Institutes of Health, 2015. www.ninds.nih.gov. Updated July 6, 2018.

Comments (26)

I'm a 57-year-old Army Artillery veteran that has had many blows to the head resulting in loss of consciousness. In my career, I experienced about 60,000 nearby blasts from a heavy artillery gun at 180-185DB and have experienced several gun tube explosions as close as 20 feet where 35 pounds of TNT and 70 pounds of propellant exploded almost in our faces. I have been knocked out several times in other jobs by falls or being hit with objects.

I have horrible tinnitus even though I am now sign language deaf...Lost hearing suddenly first in right ear and then left ear years later. I am having problems of forgetting things....stopping in mid-sentence not being able to keep my train of thought...remember words. I have severe headaches prescribed as "CLUSTER" headaches and frequently get sick for no reason and throw up.

Even though my experiences are far behind me, these symptoms seem to persist...and get worse over the years. I get healthcare through the VA but don't know if I should try to be seen or even if I possibly have a TBI. Due to having cochlear implants, I'm not sure if I can even have an MRI. I don't know what to do.

six weeks ago fell flat on bak causing severe spasams in back. Hit head, no brain bleeding however I have had nausea,vomiting, headaches agitation fatigue and crying spells. I am 75 years old. This eas my 3rd bad fall in 6 weeks but no breaks. I am concerned. have seen primary dr relucklily she is ordereing an MRI. I felt an indention with one finger indention. She seels it is normal. I never felt before and I am a trauma nurse. Am I being overly concerned????

Barbara, your doctor is concerned about mental health and is under the misconception that you are requesting more care than you actually need. Please be careful and give yourself a higher threshold for pain. You've been so strong so far!

Hi Everybody

I am based in the UK. I was hit by a car crossing the road in 1989 when I was 17. I lay the road for what seemed like ages before an ambulance took me to hospital. I then spent 6 hours waiting to be seen by a doctor. Because I was not screaming as I was completely numb from shock the doctor I finally saw tried to discharge me even though I had extensive facial injuries and a broken leg. After the ambulance crew pointed out the broken bones I was admitted.

My facial injuries were never assessed at all and I have a broken eye socket and gravel embedded in my scars to this day. The bust leg was in traction for a fortnight before it was badly plastered and I could at least leave hospital.

I have been suffering extremely poor health since the accident, including endocrine problems which I have recently realised were probably caused by the mechanical damage to my head in the accident. I have also had migraines, exhaustion, confusion, aversion to crowds and noise, paranoia and heightened emotional arousal etc.

I was in another minor road accident 3 years ago and it seems to have made the 'word-not-finding' and 'zoning out' much worse. I wish I could find a really good doctor in the UK.

Sorry to hear so many of you have also suffered so much, especially thanks to all the people who care for a head injured person - you are very kind. Thanks too for making this website where we can tell our stories.

In 1968, age 21, I was in a head on collision in a V.W. The other car was in a Mercury that hit us head on; and four of us were in a V.W. bug. My two friends were killed; my mother and I lived. I had all of my bones in my face from the forehead down to my jaws broken. The doctors in 1968, mostly were concerned with cosmetic surgery; not necessarily with my brain. My looks of course changed completely after the accident.

My brother and sister believe that perhaps I may have brain injury.

Since I am now seventy; I am falling over raised sidewalk. (3x)
Also, my balance is off. I have been tested for vertigo, but no problems in that direction. In 2017, I had a brain scan, treadmill testing, and a few other test.
My present doctor, has not said much.

I am getting pretty scarred since I have fallen three times during the last year.
My balance is getting bad. If I loose my balance; I cannot stop myself and continue to fall!

Any suggestions?

Lynne F.

I was in a motorcycle accident May 2016. Had brain bleed. Healed itself. Prior to accident I graduated from Wyo tech and was a motorcycle mechanic. I built my own bike and was the bike I was riding when a pedestrian walked out in front of me in the dark. I had worked as a mechanic for 3 years at the same job doing good prior to accident. After released from hospital a few weeks later I returned to my job. I wasn't able to perform and use my knowledge as before. Increased frustration and irritability. Couldn't remember things. Continued to things..tools..wallet..keys.. Depression and overwhelming anxiety has replaced my easy going personality. Unexplained Anger and outbursts have become my norm. I'm confused and haven't been able to hold down any job since. My relationships have desolved. Girlfriend gone. Friends gone. Family don't understand but are trying hard to get me help and stand by me. I feel like I'm not me anymore. Headaches are becoming severe and increasing frequently lasting days at a time. Pain meds don't control the pain. Anxiety meds don't help much either. I sleep more than 12 -18 hours daily to stop the pain and mental anguish. Then I can't sleep and pace all night praying for relief. Everything is different. I can't keep living like this.Ive filed for and being evaluated for disability to help me afford to live and help support myself while I can't work. Going to hospital again in the morning to beg for some tests and relief. I'm trying to overcome and conquer this misery. Help me please!

Man, you guys help me knowing I'm not alone. I lost my leg in a motorcycle accident, and then a year later was diagnosed with schizophrenia at eighteen. I don't think I ever had it. I think it was a misdiagnoses for PTSD. I used to be able to hold it together at least, before all this. I always feel aggitated. Always severe levels of anxiety. Night terrors, even terrors when I'm awake. There scary! My only solace sometimes is knowing I'm not alone. I'm thirty eight now, and I am learning to get along better. The best medicine for me is hope. I never learned how to have it, but I'm learning to have it. It helps to look at my life as highs and lows. I focus on the highs. When the lows come it feels like I'll never make it, but then I wake up the next morning feeling refreshed, or later that day the high feels so good I forget anything was ever bad, just like I can forget anything was ever good when I'm down. I think it's a mindset. Be a prisoner of hope. Focus on the positive, the highs. It's so hard man. I feel you in everything your saying. Your not alone. We'll be okay like the guy on the first reply said. Help is on the way. Sorrow endure for the night, joy comes in the morning. Hope this helped somehow, because you just helped me make it through this day a little better. Be well man. Peace

I am in your same boat. Hang in there and keep your head up. God hears your pain and he will see you through this. I know it hard. but it is going to be ok. I cried when I read your story. it is very true and inspiring. I have been through everything that you have been throw it touched me. I feel ur pain and disappointment. it sucks. but everything is going to be ok. take my word for it. just be strong and don't give up, folks will come in your life for a season then they are gone. I lost all my close friends and family but I am here. and I have god and better health and understanding. in my situation. see I was in a coma for 18 months and nearly died I had traumatic brain injury after the comma. I had amnesia, loss of use of my hands, I was paralyzed for 2 years, and had depression, mood swings, anger, confusion, memory loss from 2005 to 2014, divorced from my wife, lost custody of my kids, lost my high paying job, and my sex drive, my confidence, too name few things that happened to me. so I can relate to what happened to you because I had the same happen to me. I have been fired from jobs for getting angry and rage. so I know how you feel. I have lost it all since I was sick but hope is on the way. it takes time to heal from our brain injuries. time heals all wounds. I am doing better now. I went into the comma in 2005 and emerged out of my comma in 2007. I am doing much better now in 2018 but I am still disabled, I am able to work part-time a low-stress full job to earn money and feel a part of society. it feels good too work feel apart of something. i am starting too make new friends and and my anger and mood swings are improving. but still a work in process. so be encouraged my friend, hang in there and know everything is going to be alright, in Jesus name.

I suffered a TBI in 1986 when a guy took a running dive and dived onto the top of my head. I was sent to a psychiatrist in early 1988 and treated for depression. Nobody wanted to take me seriously about my head injury. The nerve pain and neck problems just kept getting worse & worse over time. I was even dismissed as a neurotic woman with a tension headache! Finally 8 years later in 1994 a sympathetic doctor believed me and sent me to an excellent neurologist who had some experience with head injury patients. I had almost lost faith in the medical profession! Now 30 years later I still have episodes with pain and discomfort. I take Lyrica and Cymbalta to help with nerve pain, but sometimes they are not effective enough. I had to use MS Contin for a time, but was able to cease that medication luckily. It looks like the government here in Australia is finally going to allow medicinal cannabis to be legally marketed and I'm prepared to try it for my neuropathic pain. After my early terrible run around with doctors I can only say that head injuries need to be taken seriously.

In April of 2012 my brother was assaulted and left in a ditch. A week later his brain was bleeding and he fell and hit the back of his head. He was in a coma for 3 weeks he had to learn to walk, talk. everything. He now has bad seizures and is an alcoholic. It is killing me. I don't know what to do anymore. We lost our Mom in January 2016. I need help. Anyone know what I can do?

I would like to get in contact with person in car accident (was hit by someone on speed) with neck injury and diagnosed with TBI. Their post was on 8-29-15. Pls and Thx rhondahi1991@gmail.com

I was diagnosed with TBI after a severe car accident, when I was hit by a man on the drug speed. The court awarded three million in damages to me, but he filed for bankruptcy and escaped all responsibility. TBI if not treated early can pose serious dangers. My TBI was severe, yet the medical establishment missed the mark, the first neurologist diagnosed me with a mental health condition and I was denied life saving surgery for a hematoma. That I lived without the necessary surgery was a miracle. My vision, hearing, and memory were all affected. I also developed a severe seizure condition, intermittent paralysis, severe neck and back pain, insomnia, changes in sex drive, chronic fatigue and mild incontinence. I was diagnosed eight years later via MRI, and other diagnostics. Cost of medical bills $400,000. TBI ended my 12 year marriage, changed the course of my life. DVR was no help, Physical Therapy did not help much. Neurology had no recourse. Reading and books gave more information. I tried alternative care it worked best. I was treated with Syntonic Photo therapy, got custom ear plugs, Chiropractic care, natural nerve therapy and other treatments. I will never recover the Math part of my brain function. However my working memory has improved. My advice is don't expect to ever be the same, but rejoice in what you have left. After three and a half years in a wheel chair, and then a walker, today I am wheel-chair free. I got off disability and run my own small business. TBI will change your life, but not your ability to still have a happy and rewarding life. However better diagnostics and medical care would help many persons to recover rather than become permanently disabled like myself. There needs to be more awareness about TBI. Treat it on time.

Hi Anonymous, First, congratulations on your recovery, I'm sure it was hard work and determination on your part.
I had a mild concussion from a fall, I hit the back of my head on the pavement and blacked-out for what I think was a minute or two ( not sure ). However, I was extremely good with math. I audited hospital bills as part of my work. After my "mild" concussion, I was unable to do simple math w/o a calculator and then I wasn't sure of what I was doing. It's been almost 25 years and I have never regained my math skills. All other symptoms, except neck pain, have resolved. You are the first person I have encountered with a problem with math skills post concussion. Everyone I mention this to, disregards it, including my neurologist. I would like to know more about your math issue, if you don't mind. Thank you.

I fell 6 months ago and am still struggling with math skills and organization. At first I couldn’t even organize my thoughts to carry on a conversation but that is improving. I get confused with anything requiring math... even the month or day. I’m easily overwhelmed. Hope you have improved!

In high school I got two concussions in 2014, one in January and on in December both from wrestling. I too have had a considerable drop in my math ability. I went from an A B student to a C D student in math. One weird thing though, after the concussions my English grade got higher.

2006/2008 i lost my mom and my grandparents within the span of 2 years 3 years, and was not prepared for my mom's death.

2010 Anybody have traumatic brain injury as a result to hydrocephlaus vp brain shunt put in, 2011  /2012 and then a year later was taken back to hospital and revisions which caused me to be in a coma, not expected to wake up - which i did but after a month - and then later that year i started to go blind having cataract clouds on my eyes that preventing me to function. then i had revisions to my eyes again that caused misaligned eyes blurred vision cob webs on the ways and eyes that are so tired like that im so exhausted - having cataract lenses in my eyes i can not rub my eyes, i can only rub the lenses. the day cataract surgery happened i lost the feel of eyes because of lenses (Both eyes were done at the same time) all the time and then this year i had 4 falls within the span of 6 months because of dizziness - and unbalanced. my speech is starting to be worked on tues, but this was after 5 years fighting for my drs to give me a chance @ one. Now my memory is affected because of all this trauma that my speech pathologist is testing me out for TBI, and my memory and my speech i have been so worried about that i don't know how to relax my brain because i don't want to disappoint anyone that was in my life as friends before surgery or after surgery cause right now because of trauma i don't have friends. Please reply would love to hear advice from anyone. if u all can follow /understand me because talking in sentences is a huge ___ but i can talk flowing on pc. drs said i had bipolar disorder and social anxiety but my shrink said i might NOT have bpd/and social anxiety because of Traumatic Brain injury which they are just finiding out about NOW after 5-6 years.
Anyone help recommend anything i welcome all opinions.

I've been to doctor it's not good news. I would like to play easy games I was real good on games

what if you hit your head on a metal door and you start feeling dizzy and 

thank you i am 12 i got layed out in footbll he hit me in the back penelty and i couldnt talk atall for a miniute or two but for some reason i went back inteh game and got 11 more tackles and 3 sack on the qb but in my back there was like nerve damage i think it hurt every time i took a shower it stjung

Thanks for the website and all info Sarah, psychology student, Iran
Auto accident at Wayne and Wilmington 24 June 2010 have all on list plus lower spine/back pain; still suffering at this writing. Some MD's and Neurologists have no experience in TBI. Especially be careful not to go to a MD who first practiced in a socialized medicine country- if you walk and talk your good to go. It happened to me at another place not KMC. Richard in Kettering 937.654.4771 Help with proper care please.
Was a security officer at a local club got bashed and kicked around. Unconcious 10 mins cant even spell my wifes name anymore all the symtoms. 10 days later whats next in my life.
was in fatal car accident, have not had any medical treatment since leaving hospital...three years ago, everything on this list is my daily life
after my hellicopter crash 12-25-72 i was having almost all the signs and symptoms so the doctors at sick call keep telling me its the flu syndrome here is some through losingers return to full duty or they would say general malisia fit for duty
Great article!
Is timing critical? Is there a 24=48 hour period where getting appropriate helps make a difference in the opportunity for full/significant recovery?