What Impact Will Moderate or Severe TBI Have on a Person's Life?

Center of Excellence for Medical Multimedia
What Impact Will Moderate or Severe TBI Have on a Person's Life?

The effects of moderate to severe TBI can be long lasting or even permanent. While recovery and rehabilitation are possible, most people with moderate to severe TBI face life challenges that will require them to adapt and adjust to a new reality.

Moderate to severe TBI can cause permanent physical or mental disability. Because polytrauma is common with moderate to severe TBI, many patients face additional disabilities as a result of other injuries. Even patients who appear to recover fully may have some long-term symptoms that never go away.

Challenges with work and completing tasks that were once routine can be much more difficult than before the injury. Some patients find that the skills and abilities that they used before the injury to meet these challenges are not as sharp as they once were.

These ongoing challenges can also affect the patient’s personal life. People who have experienced brain injuries may take longer to do cognitive or “thinking” tasks associated with memory, such as coming up with the correct change in the checkout line at the grocery store or placing an order at a restaurant. Family relationships will almost certainly change, and in some cases the patient will be totally dependent on their caregivers.

Despite the advances in early diagnosis and treatment of moderate to severe TBI, the fact remains that traumatic brain injury will be a life-changing experience for many patients. Helping the patient, family members, and caregivers to cope with these long-term consequences is an important part of TBI rehabilitation.

Motor Deficits and Disabilities

For many patients, the damage to the brain resulting from a moderate to severe TBI may lead to life-long disabilities or motor deficits. The term disability in relationship to TBI means a loss of physical or mental function caused by damage to the brain. Motor deficits refer specifically to the effect of damage on motor skills or movement.

Examples of disabilities and motor deficits caused by moderate to severe TBI include:

  • Paralysis
  • Spasticity (muscle stiffness) or uncontrolled movements
  • Problems walking, talking, or swallowing
  • Difficulty carrying or moving objects
  • Vision problems
  • Loss of fine motor skills, such as buttoning a shirt
  • Inability to recognize something based on touch
  • Difficulty thinking and remembering
  • Difficulty with social relationships

Other challenges that a patient with moderate or severe TBI may experience include:

  • Difficulty making and keeping personal and professional relationships
  • Difficulty being part of social activities
  • Difficulty taking part in recreational or leisure activities
  • The decreased ability or inability to keep a job or go to school

During the rehabilitation and transition phases of TBI treatment, members of the healthcare team will provide information to the patient and their family members about dealing with these issues. Specific tools and coping strategies will be suggested. Examples of coping strategies and tools include:

  • Writing a detailed list of steps needed to complete a task
  • Using prompts or visual aids to help remember things
  • Using assistive devices to move around, such as a walker or a wheelchair

Learning new ways to do things is a very important part of recovery.

Other Potential Effects

The long-term symptoms of TBI can be divided into several categories, including physical changes, cognitive effects, sensory effects, perceptual effects, social-emotional changes, and others. You’ll find a partial list of these symptoms and possible effects below. Keep in mind that the severity and duration of symptoms and effects will vary greatly from one patient to another, depending on the severity of the TBI.

Physical effects

  • Sleep disorders
  • Loss of stamina (easily fatigued)
  • Appetite changes
  • Difficulty swallowing
  • Physical paralysis or spasticity
  • Chronic pain
  • Loss of control of bowel and bladder functions
  • Seizures
  • Difficulty regulating body temperature
  • Hormonal changes

Cognitive effects

  • Difficulty with attention, focus, or concentration
  • Distractibility
  • Memory problems
  • Slow speed of processing
  • Confusion
  • Perseveration, which is the abnormal persistent repetition of a word, gesture, or act
  • Impulsiveness
  • Difficulty with language processing
  • Problems with executive functions, which include planning, cognitive flexibility, abstract thinking, rule acquisition (determining right from wrong), initiating appropriate actions, and inhibiting inappropriate actions

Speech and language effects

  • Aphasia (difficulty with talking or expressing ideas, understanding everyday language, and problems with reading and writing). Types of aphasia can include:
    • Receptive aphasia, which involves difficulty understanding the spoken word, or
    • Expressive aphasia, which means the patient knows what they wish to say but is unable to get the words out. In some cases, the patient is able to perceive and comprehend both spoken and written language, but is unable to repeat what they see or hear.
  • Slurred speech
  • Speaking very fast or very slow
  • Problems with reading comprehension

Sensory and perceptual effects

  • Difficulty recognizing and distinguishing between touch and pressure sensations
  • Difficulty perceiving temperature
  • Difficulty perceiving movement and positions of the arms and legs
  • Difficulty with fine discrimination (for example, distinguishing between small everyday objects, like coins)
  • Difficulty integrating and understanding information gained through the five senses (sight, smell, touch, hearing, and taste)

Effects on vision

  • Partial or total loss of vision
  • Diplopia, which is weakness of eye muscles that causes double vision
  • Blurred vision
  • Problems judging distance
  • Involuntary eye movements, called nystagmus
  • Photophobia, which is intolerance of light

Effects on hearing

  • Decrease or loss of hearing
  • Tinnitus, which is ringing in the ears
  • Increased sensitivity or intolerance to sounds

Effects on smell and taste

  • Anosmia, which is loss of or diminished sense of smell
  • Loss of or diminished sense of taste
  • Bad taste in the mouth

Social-emotional or behavioral effects

  • Dependent behaviors
  • Fluctuating emotions
  • Lack of motivation
  • Irritability
  • Aggression
  • Depression
  • Lack of inhibition
  • Denial or lack of awareness
Posted on BrainLine August 9, 2018. Reviewed March 28, 2019.

About the Author

The Center of Excellence for Medical Multimedia (CEMM) is a dynamic initiative from the Office of the Surgeon General, supplying award-winning interactive multimedia for patient education throughout the Military Health System.

Center of Excellence for Medical Multimedia. (n.d.). Moderate to Severe TBI: Long-Term Effects. Retrieved March 28, 2019, from https://tbi.cemmlibrary.org/Moderate-to-Severe-TBI/Long-Term-Effects

Comments (618)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

My brother had a motorcycle accident on Sept 19, 2012 and has severe tbi. He is still in a coma but moves slightly and opens his eyes at times. My question is to the person who had severve tbi when he was beaten in a bar and left face down. Can you tell me how long you were in a coma?
I experienced moderate to severe TBI at 12 years of age. It was a skull fracture in the back of my head that resulted in coma for a couple of weeks. Over time with not much therapy, I seemed to make a significant recovery. However, I am now understanding that it has been a partial recovery. I have been plagued for the last 38 years with life long depression, apathy, dizziness, and aggression. I just assumed it was bad genes, but am now realizing that part of my struggle has been due to the brain injury. I've had to work VERY hard to overcome these lingering long lasting effects. The thing that continues to trouble me the most is the following: "cognitive abilities referred to as executive functions - the complex processing of large amounts of intricate information that we need to function creatively, competently and independently as beings in a complex world. Individuals with TBI may be unable to function well in their social roles because of difficulty in planning ahead, in keeping track of time, in coordinating complex events, in making decisions based on broad input, in adapting to changes in life, and in otherwise "being the executive" in one's own life." I have often felt like a failure in life because of these difficulties. I have considered suicide dozens of times. However, I have always battled HARD and managed to have a modicum of success in life. I managed to get a college education. I managed to be relatively successful in a career as a musician. The thing that really saved my life, however, was a deep spiritual connection based on the practice of meditation. I've worked with different spiritual teachers who have helped me tremendously. Although I've always know that trauma was at the root of many of my problems, I now discover that part of the reason for my life long STRUGGLE to survive and thrive may have roots in my brain injury. Wish I had known about it long ago. Perhaps I can improve some of these difficulties. I have heard of a therapy called EMDR that supposedly helps with PTSD which I've also always suffered from. I plan on exploring that and seeing where it takes me on my life-long healing journey. To everyone who has experienced this trauma I say this: make your LIFE about healing. Focus on it. Commit to it. Pray for it. Or unresolved trauma will destroy you. It very nearly destroyed me numerous times but it hasn't yet, and I keep battling. Good luck!!!
i am 47 and had my moderate TBI in january 2012 while ice skating. was initially conscious but luckily knew the signs of head injury and went to the ER. was unconscious for 12 hrs, hospitalized for 4 days, and the 'improvement' has continued since then. i returned to work - full time - after 5 wks to a demanding environment which was only made more so after my injury. despite going to my boss on a monthly basis to let him know i was very overwhelmed and that all of my paperwork wasn't getting done, i was terminated' on october 1 for not having my work done. it is a healthcare environment and timely compliance is very important. many of my co-workers, and my boss i think, thought that because i was back at work and looked fine that i was in fact fine.....which i was not. i would urge everyone facing this type of ongoing issue to be very honest about your limitations! i was......but i got no assistance. i have really good days and really bad ones, balance and dizziness continue to be an issue as does my lack of appetite. in time i know i will make a new normal for myself......
10/10/12 I am 21 years old and I have suffered a TBI from a car accident in May 2012. My memory has been lacking in a few areas, mostly the memory of the month of May. In the same car accident I received a back and neck fracture and collapsed lung. I look back on my injuries and think of how lucky I am even though my life has been a struggle. I refuse to give up.
i was involved in a head on auto collision november 9 1995 i have suffered years of bad migranes and depresson and memory problems and i have tried not to seek medical attention after spending time in hospital and close head injury clinic i,am getting older and experiences more symptoms i know i must seel medical attention but i find it hard to tell my self i need to i have had people tell me i need to seek counceling
My tbi happened sept. 24 2009. It was classified as a severe tbi. I was over double the legal limit a .18 alcohol blood level and 38 years old. I was left in a coma. I left a wife and 2 kids at home so I could do my daily drugs and alcohol binging. I was severely beaten at a bar and left face down for dead on a highway. Wow what a day. The greatest day of my life! why? Because I found a relationship with god. God can turn the worst tragedy into your greatest accomplishment. Relationships I had severed have been restored. I have not missed a day of work in almost 2 years and have not had a job complaint either. No Iam not a rocket scientist, lol, but I work with materials that have only .031 1/32 tolerance that must be precise and making a good living in the worst economy I have ever seen. Iam supporting my family. Dont give up whom ever you are. All things are possible with god. Iam living proof.
I had a severe TBI when I was 12. My parents were Christian Scientists and did not take me to the hospital even though I had a large fracture of my skull, was unconsious for over an hour, and had complete amnesia for 5 to 6 hours after regaining consiouness. I really never associated this event with the many of the personality changes that occurred with me shortly there after until recently. I went from a very athletic, A student, to doing drugs and failing in school. I was able to make it through college and get off of drugs but this event clearly was a pivot point in my life. I am now 47 and to tid day still struggle with some issues. It does get better with time.
my TBI anniversary is coming up october 29th. it will have been 5 years now. i'm sorry that i can't be positive and say in this 5 years i have found all of the answers. quite the opposite really. i was and am today, so determined to be who i was. this person that i'm clearly not anymore and that i have no recollection of. 5 years this october.. and i'm just now starting to try to google answers. my parents are in denial in the sense that they don't think i can make my own decisions, all of my old friends became confused with all of my personality changes. my memory continues to be not so good, which aggravates me on a whole other level. i NEED to find someone to talk to that understands this "invisible disease". if anyone knows of any indiana support groups, please share!
First, to the person who posted on Aug 16th, 2012 12:49pm. You did not fail in life. What you have been through and are currently going through now does not make you a failure. I can relate a little with you on some of what you say about no social life, relationship and such but please realize you are a surviver. That alone makes you anything but a failure. I wish I could get in contact with you some way because I would gladly be your friend. Take care.
I am 10 years into my TBI injury. My life and those of my husband and two kids have been turned upside down. I feel for anyone who has to live with this! hopefully my work injury claim will settle accordingly
my heart go out to yall my daughter got a TBI and I know how life can handle people.I just told my little girl she can beat the odds because Jesus use the strong people not the weak ones so look at it like this God made you special for a living testimony for his kingdom.
I had severe TBI as a child(pre 10 years old) and i'm in my 30s now. I've failed in life. Have no career and no social life. No love life. And i've been fired and not hired from any of my temp jobs. LIfe is difficult because i lack maturity and have memory and speech problems. I dont understand many things typical adults can understand. I can't join discussions or anything because i have Auditory processing problems. In Sum, i've had a hard time and i had no help ever because my parents were in denial and thought i was just normal. And they scolded me, teachers also scolded me and i was bullied al my life. So basically i'm a failure but recently i've been trying to get help in disability and also i joined a tbi support group
I am 1 year and 10 months post TBI due to my fall 5 rows down face first on steel stadium seats. I was knocked out momentarily and have been through speech therapy, cognitive therapy, physical therapy, vision therapy, and currently am getting vestibular therapy along with continuing vision therapy. Because my incident was during coaching, it is a work related injury and being handled by workman's comp, which means I've been given poor care. All they've told me is to give it time. I am a teacher who taught Reading and Language Arts and Writing. I have had speech delays, trouble with spelling & writing, can't find my words, memory issues, not remembering short term or much of the last two years, balance issues, loss of vision fields, vision memory, and vision flexibility (can't focus far or near), light & sound sensitivity, not to mention mood swings, migraines, passing out and throwing up. Can't plan or handle much stress without shaking or crying. Every new challenge seems to set me back months in progress. I have daily migraines and can't drive. I have given up my masters classes, coaching, and after school teaching and activities. I have tried antidepressants, migraine medicines, am currently on Ritalin for attention and memory problems. My hormones have quit. I am still holding onto my teaching job, but have found new ways to teach. Technology has become my new best friend. Using it, allows me to keep the lights down low and I can create lessons at home in the quiet. I have relied on old memory (old lessons and knowledge of novels that I have read in the past) to allow me to keep teaching. One thing I can say is that I now truly understand my students who are autistic and learning disabled as I, myself, have to use many new tools to learn. Reading has just recently been a gift I have received back, only silently though. Though I may not be able to multi-task the way I used to and I can't dance, I still have heart to reach out and make the world a better place. I may not be the old me, but I will continue to strive to be a better me. Keep striving and learn to be thankful for little gifts, like a good day! God is Good and He is making me stronger! This article, helped me make sense of the loss that I have encountered and look at it with more realistic views, instead of believing what the Dr.s and Therapists have said, "that in time, I will wake up one day and be just like I was." I now know that I will not, and I can accept that if I can hope for a better tomorrow. No more tears for what I have lost, but a smile for what tomorrow holds. Thanks again! English Teacher in Kansas My only advice is to pray and be thankful for any small progress! Take all the therapy you can, because you will find amazing people who care!
this is to the lady who had the tbi on the 7-11-11, get in contact with headway in your area, i have a tbi and they have been fantastic with me, they give me all the help i need and support me, it would be good for you, keep your chin up hun, all the best, martin mcgovern, south wales
I have went 26 years with undiagnosed TBIs. The one to my forehead left me with nearly 100 stitches worth of three scars. I have had other serious TBIs before and since that time. The only reason they were recognized and now are diagnosed is because of me. I read about TBIs ina book and put two and two together. The medical professionals and health care industry has been of little to no help. They are mostly all bozos and idiots. The Social Security Administration is even worse. SSA is NOT your friend and they are NOT there to help you. They are there to try and make things worse. Seek out groups local to you that are for TBI survivors. Look on-line for Traumatic Brain Injury forums and websites. You have to help yourself as much as you can. People (including family, friends, co-workers, employers, and med pros) simply do not care, are ignorant, and have no interest in learning about TBIs. Educate yourself. Have TBI educational info sent to your health care providers and your doctors - and your family too. Also, speaking as a multiple TBI survivor, learn to meditate. It helps greatly. Yoga can be very good also. And, frankly, smoking pot will greatly help reduce your anxiety and reduce your anger and hostility. It is good natural medicine - just don't have it in your car. The police are NOT your friends. Avoid them. Pester your doctor for help with your TBI. Be relentless. Also check all your local hospitals for any programs they may have or know of for people with TBIs. Do the same on line. Email people. Email doctors. Email the mayo clinic. Email TBI specialist lawyers. Get all the advice and help that you can and then put it together and organize it in a way that you can deal with it and make use of it. Lastly, if your TBI related behavioral/emotional/social dysfunctionalities persist, MAKE SURE they are documented. Make your doctor address them and document them - and then start working up a SSA disabilities claim. Odds are for you will be turned down on your first try. Do an appeal. Be persistant. You may be unemployable due to your TBI. I am, so I speak from experience. Check into Prepaid Legal. It is a way to pre-pay for legal services and to get them at reduced rates. They may have changed names, but look on-line and you will find them. They are VERY useful - for many more things than just TBI related issues. Get a speeding ticket? if you have a Pre-Paid legal services plan you can request an attorney to come with you to the court hearing and get you out of trouble - at no extra charge to you (cops HATE it when people come to contest their traffic tickets and bring a lawyer with them). I hope this helps.
November 7 2011 car accident. Diagnosed mild TBI but then got so upset all the time i was asking for help the police broke my leg. now scared not sure how recover. people not sure how deal with me now. miss my ex boyfriend so much but i scared him away after my accident. he will not speak to me. my accident was 6 months post breakup. just b4 breakup lost job. how do i get help for this it is invisible injury people don't understand
I'm supposed to be a reasonably smart guy. Sure I'm no genius but you know what I mean. I did the V.C.E. (Victoria, Australia's Year 12) with an average of around a B. Nearly 3 years ago I got hit by a light truck doing 80kph during appalling weather. I suffered a 3 on the Glasgow Coma Scale and they put me in an induced coma for 10 days. I can't remember any of this, it has been told to me by the people that I love. At the beginning of this year I enrolled in a T.A.F.E. course. It isn't college but higher education. Because I've got so much spare time I decided to use it to advance myself getting a better education and thus a better job. But even though the course is basic I find it a bit to hard at the moment. Sadly I think my brain is letting me down which makes sense to me recently as I suffered a severe traumatic brain injury. Sorry and I feel bad but I'm hoping that my brain will get better over time. I didn't have much patience before but I've got vast quantities now. I think I am just realizing how close to death I was. Some of my mates, who are as a tough as nails, started crying after my accident. That's it for my epistle. To all the people who have suffered a brain injury I say please persevere, the Human Mind is such a powerful thing.
This article is actually quite encouraging! I am a year and four months past my severe TBI, after which I was unconscious for eleven days. I am an honor graduate of Harvard and was a college professor until my injury, so it's nice to be encouraged by the acknowledgment that while my life is very different now, it's far from over, and I can still find ways to be valuable and contribute.