What Happens Immediately After the Injury?

Icahn School of Medicine at Mount Sinai
What Happens Immediately After the Injury?

What happens to the brain at the point of injury?

Traumatic brain injury (TBI) refers to damage or destruction of brain tissue due to a blow to the head, resulting from an assault, a car crash, a gunshot wound, a fall, or the like.

In closed head injury, damage occurs because the person receives a blow to the head that whips the head forward and back or from side to side (as in a car crash), causing the brain to collide at high velocity with the bony skull in which it is housed. This jarring bruises brain tissue and tears blood vessels, particularly where the inside surface of the skull is rough and uneven; damage occurs at (and sometimes opposite) the point of impact. Thus, specific areas of the brain - most often the frontal and temporal lobes - are damaged. This focal damage often can be detected through MRI and CAT scans.

In closed head injury, the rapid movement of the brain can also stretch and injure neuronal axons - the long threadlike arms of nerve cells in the brain that link cells to one another, that link various parts of the brain to each other and that link the brain to the rest of the body. This widespread axonal injury interrupts functional communication within and between various brain regions and sometimes between the brain and other body parts. However, this type of diffuse damage typically cannot be detected through currently available imaging technology (but with new developments, this may change). Its existence is very clear, however, in the widespread effects it has on the individual's functioning.

In sum, after a closed head injury, damage can occur both in specific brain areas (due to bruising and bleeding) and also be found throughout the brain (due to stretched or destroyed axons). The results of a closed head injury tend to affect broad areas of the individual's functioning, primarily due to the diffuse axonal injury. The extent of damage is correlated with the force of the blow to the head; for example, a head forced into a car windshield at high speed will tend to sustain more tissue damage than when the car is traveling at a slower speed.

Open head injury, the second type of TBI, occurs when the skull is penetrated, for example by a bullet. Damage following open head injuries tends to be focal, not diffuse, and the implications for subsequent impairment tend, also, to be focal and limited. However, such injuries can be as severe as closed head injuries, depending on the destructive path of the bullet or other invasive object within the brain.

What happens immediately after TBI?

Immediately following TBI, two types of effects are seen. First, brain tissue reacts to trauma and to tissue damage with a series of biochemical and other physiological responses. Substances that once were safely housed within the cells now flood the brain. These processes further damage and destroy brain cells, in what is called secondary cell death.

The second type of effect is seen in the individual's functioning. For those with more severe injuries, loss of consciousness (LOC) occurs at the time of trauma, lasting from a few minutes or hours to several weeks or even months. Lengthy LOC is referred to as coma. In such serious injuries, the first few days after trauma may also produce negative changes in respiration (breathing) and motor functions.

As an individual regains consciousness (those with the severest injuries may never do so), a variety of neurologically based symptoms may occur: irritability, aggression and other problems. Post-traumatic amnesia (PTA) is also typically experienced when an injured person regains consciousness. PTA refers to the period when the individual feels a sense of confusion and disorientation - Where am I? What happened? - and an inability to remember recent events.

As time passes, these responses typically subside, and the brain and other body systems again approach physiological stability. But, unlike tissues such as bone or muscle, the neurons in the brain do not mend themselves. New nerves do not grow in ways that lead to full recovery. Certain areas of the brain remain damaged, and the functions that were controlled by those areas may emerge as challenges in the individual's life.

Before discussing in greater detail what happens to the person after injury, which depends to great extent on the severity of injury, "severity" needs to be defined (in the next question).

What is meant by "severity of injury?"

Typically, "severity of injury" refers to the degree of brain tissue damage. Although the degree of such damage cannot be directly measured, it is estimated typically by measuring the duration of loss of consciousness (LOC) and the depth of coma (and sometimes by the length of PTA).

The scale most commonly used to measure the depth of coma is the Glasgow Coma Scale (GCS). The GCS is used to rate three aspects of functioning: eye opening, motor response, and verbal response. Individuals in deep coma score very low on all these aspects of functioning, while those less severely injured or recovering from coma score higher.

A GCS score of 3 indicates the deepest level of coma, describing a person who is totally unresponsive. A score of 9 or more indicates that the person is no longer in coma, but is not fully alert. The highest score (15) refers to a person who is fully conscious.

Severity of injury is typically categorized into three levels: mild (or minor), moderate and severe. A commonly used rule of thumb is that mild injury refers to LOC of less than 20 minutes and an initial GCS of 13-15. Typically, an initial GCS of 9-12 defines a moderate injury and 3-8 a severe injury.

Although initial "severity" measures may generally predict long-term impairment, initial severity scores do not correlate well with negative consequences in a person's life. The effects of TBI on individuals and the meaning of those effects depend upon a wide variety of factors, only one of which is initial "severity of injury."

How long does recovery take?

Recovery after injury is usually quite different for those with moderate-to-severe injuries versus those with mild injuries. And, as must be constantly kept in mind, recovery varies greatly from person to person. Thus, recovery will not be the same for any two people with TBI.

In mild TBI, one person may recover quickly and completely, while another may experience significant challenges even several years after injury. (Recovery after mild TBI is discussed more fully in a later question, What Impact Will Mild TBI Have ona Person's Life?)

In more severe injuries, recovery is a multistage process, which typically continues in a variety of ways for months and years. However, the length of this recovery process is not uniform, and the stages of recovery that are typical when considering the population as a whole, may be very different for any specific individual. Stages may not proceed step-wise but may overlap, one stage with the next, or one or more stages may be skipped altogether. The early recovery process is discussed more fully in the next question.

How is recovery measured right after injury?

The progress seen during the immediate recovery period in individuals with severe to moderate TBI is often tracked using the Rancho Los Amigos Scale, which specifies eight levels - from the depths of coma to return to awareness and purposeful activity. These levels of recovery of functioning reflect processes within the brain, as it heals, stabilizes, and reorganizes itself to some extent.

Although the Rancho scale assumes that recovery will pass through eight stages, a small percentage of people with severe injuries remain stuck at Levels I to III for months or years. They remain in coma or in a relatively unresponsive state and fail to return to purposeful, appropriate functioning.

Rancho Los Amigos Scale

  • Level I (No Response): The individual is in deep coma and does not respond to any stimuli.
  • Level II (Generalized Response): The person sleeps most of the time, with periods of brief wakefulness. Responses and movements are largely reflexes not purposeful.
  • Level III (Localized Response): The person is alert for lengthier periods. He/she reacts inconsistently to commands, but his/her responses are related to the type of stimulus presented. For example, noises will produce a listening response.
  • Level IV (Confused and Agitated): As awareness increases, the individual's behavior reflects his/her sense of confusion and disorganization. Aggressive and/or silly behavior may be seen, with verbal abuse, agitated actions, and incoherent speech. The person's attention span is too short to allow full cooperation in treatment programs; and the person is unable to do basic tasks, such as eating, independently.
  • Level V (Confused, Inappropriate, Not Agitated): Simple commands are now followed consistently; the person's long-term memory is returning; and she/he can now carry out over-learned skills such as eating. Difficulty is evident in following complex commands, short-term memory, learning new skills, and concentrating for more than a few minutes.
  • Level VI (Confused, Appropriate): The individual begins to show goal-directed behavior, but usually still needs direction. The person is more aware of his/her deficits, family members, and so forth. He/she can carry out more tasks independently and retains relearned skills from one occasion to the next.
  • Level VII (Automatic, Appropriate): The individual performs daily routines automatically and is better able to learn new skills, although slower than before injury. The person still has poor short-term memory; judgment and problem solving are still impaired.
  • Level VIII (Purposeful, Appropriate): The person is able to function once more in the community. Impairments in cognitive, social, and emotional functioning, to a greater or lesser extent, may continue.
Posted on BrainLine July 25, 2008.

FromIcahn School of Medicine at Mount Sinai. icahn.mssm.edu

Comments (102)

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.

sorry for your loss.

The site has helped me my friend who was in a really bad car accident was thrown from the window and had taken a hard blow to the head it's only been a month and few days now he is out of ICU and it's in a rehabilitation center it is hard to see him like this I feel he got better a little bit but last night when the doctor had told me no changes have been made and when I had asked about his eyes not dilating he said it's because of seizure medicine he's taking for seizures killed ne thinging i dont know bad but this page is help me a little bit hoping that he will get better I feel he understands me but I don't I'm just really hurt by this hurt knowing that he might not get better he might not understand he can't talk he can't really move when he does is to pull his arn/hand back to his chest his right side of the body is still a bit limp he moved his right arm sometimes his right eye still has not opened his left eye is open and I'm happy because it's not going in the pattern as it used to he can keep it a little more steady and look at you for a second two days ago when I was with him and I was telling him I'll be back and tell him goodnight he started to cry so maybe he understands I'm not sure and I just really don't know it's only been a month in a few days my friend's mom who was shot in the head same side took her 6 months to get a little better and understand today she was walking around she can understand and talk she still has to use a cane but she understands talks and she can move so I know it takes a lot of time it's just hard watching someone you know so close go through this and you're trying to help them but you just don't know I keep praying for him and I pray for all of you and I thank you for help

Back in 07' my brother was struck by a car. He was riding a bicycle coming down a hill; when a car going more then the allotted 30mph around a sharp curve came flying around. He was struck by the car being tossed in the air and hitting the windshield and rolling on back. Immediately after he balled up into a fetal position and was unresponsive. The police department found him at fault for it because they said he failed to stop at the stop sign. When he got to the hospital they placed him in ICU. All the doctors and nurses said that there was no way he would make it passed that day, but they will do all they can. He had uncontrolled bleeding on the brain to the point they had to put him in an induced coma. While in the coma they operated and had to remove part of his skull and damaged brain tissue. He stayed in ICU for about 4 months but was still unresponsive. He was later stable enough to be moved to a facility in Atlanta where they tried physical therapy for about 5 months. Nothing was working and his legs became so stiff to the point that they are permanently straight. His left arm in bent up and right arm straight out. He also has severe foot drop (where your feet starts to fold downward). After Atlanta he was moved to a nursing home for 7 months. He got to finally come home on February 14th 2009. When he came home at the time I was 15. My life became taking care of him. I was unable to go places because he needed someone to take care of him. He was totally unresponsive unable to see, speak, move voluntarily and we were just hoping he could hear. He eats through a feeding tube cant take anything by mouth and wears briefs. The incident cause him to favor the left side. Now his head pulls only to the left and his upper body folds over to the left causing his left lung to collapse leaving one good lung. His mouth stays so tightly shut that you cant lean it. His hands stay in a fist position. Over time all of his care has fallen upon me. I have to be his sole caretaker. I am now 24 and October 28 2017 marked exactly 10 years that he has been in this state. Nothing has changed for him but I still believe that one day he might just come out of it. But if I never get that one day I'll just be glad with the time I've been given with him. He is still here and that's all that matters to me.

You are a remarkable person

He hears you, he feels you, he loves you.
He wants to meet your friends so you'll have someone answer you
He wants to answer so maybe your friends will make that easier or he will tell you what he thinks or just the sound of another voice
Maybe talk radio will want to make him shout after hearing the state of the world, that's what it does to me
Who knows maybe that will just make him mad that's what it does to me
Stay well

I pray for all of you as you care for your loved ones. You are the salt of the earth, all of you.

I was hit by a semi on my bike going to work a couple months ago. Though the bike was totaled and my left foot mangled ( just got last to pins out yesterday) my helmet just got scratched up real bad. So I guess their was no head or brain trauma even though I was unconscious when e.m.s. arrived. Well, I wonder since I haven’t slep more than three hours at a time since the wreck. I have mood swings that have me wanting to jump up and organize my knife collection or polish my other bike, to not even getting dressed for days. It should be noted, I think I had or have a bout of depression due to the death of my daughter back in March. But, I never did the stupid crap I do now. And I still remember nothing about the crash. Thank god for witnesses, or I’d be screwed. I don’t even remember giving the police my statement and thank god it matched. I,be also been waking up in middle of the night with headaches that are so bad, by the time they wake me, I litterally take four to six ibuprofen to calm them. And simple chores like taking out garbage, can take up to 45 min by the time I piddle around, forget what I m doing, side track, watch a commercial on tv, or just stand and stair into space. And all the above ?

To poppi and others suffering:

Upon reading about your situation and many of the others that have posted,
it appears that it would be wise for you to see a doctor. Symptoms of yours and the many others posted, should not be ignored. It is very important to face the facts and truth of the situation. I have had symptoms of PTSD / anxiety/depression for different reasons. We are physical and emotional beings. If we deal with the physical and not the emotional, we are not treating the entire person. It may be hard, but I took the challenging step to face the pain of loss, sadness, injury, trauma. I committed myself to seeing a counselor and committed to classes. I find many people have trouble facing themselves in this way. It's not always up to a doctor or someone else to fix us. We need to do the hard work. We have to commit to ourselves and understanding our unique situation. DBT is a not so well known resource found in Medical and Counseling Offices.
There may be other programs available in your city.
Research and Google this please.

DBT = Dialectical behavioral therapy.
Fancy name for an entire class focusing on extremely important, but very basic principles we all needed to learn from our Parents or Elementary school.

Mindfulness, Interpersonal Effectiveness, Distress Tolerance and Emotion Regulation
Translation: Mindfulness: becoming more aware of self and others.
Interpersonal Effectiveness: working towards positive and healthy relationships with others.

Distress Tolerance: Healthy tools to handle everyday stress. Tools that we develop in our mind or physical things that would not involve drugs, alcohol or unhealthy sexual addictions or habits, anything that is not something that will grow you as a human.

Emotion Regulation: balancing, coping and managing emotions effectively in order to build a more full life.
If anyone struggles with problems getting along with others after an accident or other trauma, it would be very wise to find this program, start this program or start some type of personal therapy with a Counselor.
Nothing to be ashamed of. We only are giving into our Pride if we do not get help. Getting help is finding real Freedom. Freedom is being Authentic and Honest with Ourselves. I did this for years. So save your life in another way before you lose it and lose family and friends.
This is written not only to who I replied to but a shout out for all of the comments I read today. These are all things I have been working hard on, not bc I'm a professional in the field. As all of you, I have lived and breathed mental and physical suffering and anguish.
This is probably why the earth and humans long for a Heaven.

it sounds like you have a mild traumatic brain injury. There is help you must look in your state for therapy and assistance.

I slipped Hard and fast hit the back of my head knocked unconscious three years ago. I'm still recovering I couldn't bend my head down lift a pound. It has been hell. I want to work out again but I can't put any pressure on the brain. Protect your head.

I was a pedestrian hit by a car going 30mph. I broke my left femur and right tibia. Along with my left elbow and face. I was in a coma for a month. I don't remember the following month (while I was transferred to DMC, post coma) I stayed in the hospital for 2.5 months. Its been a year and 6 months since the time I got hit by the car and I still can't walk. I was severly shaking and was very unbalanced. A doctor finally got me a pill that helped! Now, my shaking has gone 75% away. My balance is 50% better. I am 5'8", in the hospital, I went from 145 to 122. Then, just recently, went down to 109lbs. I just never have an appetite and I didn't realize the extent of my eating until my Dad took a picture of me. I saw it and I was completely grossed out and mortified. I now force myself to eat three meals a day + an ensure + protein shake!!

Had a blow to the side of my head 6 yrs ago from my daughter. My family decided that she wasn't really trying to hurt me (?). Forgetfulness started right after. Since I'm now 72 they decided its all from old age. Maybe it is. But I do remember that hit to my head & the start of forgetfulness. So I don't talk about it anymore.

Fire anyone who says something is because you're old! I'm 78 and hate the way older people are portrayed on TV like we're all some bumbling idiots. I too have bouts of forgetfulness but am far from feeble. I bike, roller blade, and skate ski. I have a goal of biking across the USA and back at 100. My hero was Jack Lalane, remember him? The secret to a healthy life is to keep moving. Don't let others define what you can do. Just do it and blow their socks off!

I am so sorry to read your story and about the dismissiveness of your family. Your daughter should be ashamed of herself.

I lost consciousness after a car accident , I don't remember the accident itself, I was told I had a large hematoma in the front left side of my head, now 9 months later, most symptoms like pain, increased agitation, problems with balance and headaches have decreased ,I have a indentation in that side of my head, did something happen with my skull? I still feel some kind of way, I can't explain. Fear is one my feelings .

My boyfriend was just in a bad car accident on March 10, 2017 he was thrown out the windshield, he was in a coma for at least a week and a half, he has all his tubes out now he can remember long term but is having troubles remembering the accident and with short term memory. Last night they said he can start eating anything he wanted! He has came a long way in only 3 weeks. Hoping for him to be home soon!

My 3 year girlfriend left me after my accident 3 months in. She said I was going crazy. I was so scared for my life I lost toilet function. 19 months later I'm still suffering lots of psychological problems. The PTSD came shortly after and I think is still with me, then I found out I had dysthymia a possible remission of PTSD. Now getting emdr and anger management and cognitive therapy thanks to the bloke who changed my life who knocked me off my motorbike  I feel either anger or just numb and life is so so shit. I wonder what I'm still doing here. I wish he cut my leg off with a bread knife .

If someone you love has a brain injury please be there for them. Don't just tell them they need to see a doc, understand and accept that even though they lived they aren't the same as before if you can't accept it they won't want to be around you anymore

Motorcycle accident few days ago for my brother and his gf. She's in trauma, bleeding on brain, out of ear due to fractured temple. She has woke up but out of her mind, doesn't know anyone. I do pray she'll get better soon.

I had met with an accident 2 years before since then I am unable to talk properly. I was in hospital for 11 days out of which 4 days in coma and when I regained consciousness I was unable to talk completely on that day. Adding to which my left part was temporarily paralyzed. This is my story. Still finding the way to talk properly.

Inspiring.  As the victim of an assault (the perpetrator received a 5 year prison term), and with it, a traumatic brain injury (TBI), all of your comments made me think.  Initially, I was going to say stories instead of comments, but these are people's lives, not stories.  I live on the continent, but I don't feel comfortable saying where.   With my injury, the medical establishment and a government department wiped me out.  Right down to the point I had no clothes.  They say, because the outlook for me did not look good and my family was not in the area.  I write this, a testament to say they were wrong, and give others the hope there is a way out.

Now, I am in the middle of a legal fight, after a coma and 4 months of intensive care, a year and a half of hospitalization.  What's the purpose of my legal fight?   To prove that the health care and government predictions were wrong and their loss of hope has cost me valuable time (and basic things like clothes), the part of time we we call living.  I take solace that there are people out there who may understand what life and survival can be like - those people are you.  Bless you all!

This is NOT entirely accurate. I flipped my car rolled several times blacked out had PCS etc for a yr anxiety. I was COMPLETELY healed. Led a completely normal life after that. I was 21. I am NOW suffering from a less of an impact concussion 20 yrs later worse than I was then. More symptoms just from whiplash. It matters on age, matters on many things. you CAN recover completely.

Really enjoyed reading this article, lots of great information on it in a condensed version. I recently formed a non-profit with my family where we are trying to connect health care professionals to educational opportunities about the brain and trauma. Check out our website www.smithbrainconnections.com for our story and more about our mission.

To the woman who was in an abusive relationship and finally left. Go to a battered women's shelter near you and get in a program. I was also abused and walked away the first time he hit me. You are out but you need special counseling and help, but not just for a head injury. You need someone to work with your abuse. Get help now and live.

Can criminal charges be forced if a person hits you in the head and you already have a brain injury? I was recently sucker punched in the head by a male. I was diagnosed with hydrocephalus at the age of 16. I am 40 now? Could his cheap shot cause physical damage to my already existing condition?

You may feel that you are alone but this is a safe place to vent. You may also feel that you have trouble putting your words together but you have done an excellent job of informing others of the horror that occurs "behind closed doors " Have you sought counseling specifically from a counselor that works with DV? Please know that God knows and cares deeply and He WILL heal you, if you let Him. No person can judge you, you need to surround yourself with good people. Often DV support groups only foster contempt for the batterer. Haave you prayed for your X? That may sound erroneous but my verbally abusive husband that left our family for another woman was dying. When I went to see him 4 days before he died from 7 yrs. of cancer, I asked God to let me see him through Gods eyes. Although he never apologized I knew that God knew what Id gone through and that he was a sick man; emotionally, mentally and now (then) physically. Only by Gods grace was I able to let go and let God. Prior to that final visit I prayed for him even though I hated him. The only reason I prayed for him was because I had learned that satan wants to kill and destroy us and I did not want to fall in that trap. I also learned that I could not go on with bitterness sucking the life out of me. Unforgiveness is like drinking poison and expecting the other person to die. I will pray for you. May you experience the peace that passes understanding as you live your life knowing that God has a plan for you; for hope and a future.

I am praying for you. I am so sorry you have suffered so deeply through no fault of your own and that you feel abandoned. Please make several copies of what you have written here and distribute them to people: to your doctor, family members, a women's shelter, counselling centre etc. There is help out there for you and there are people who care deeply. Know that you are loved even if it doesn't feel like it. I will continue to pray and I know that others are praying too.

I think you are strong to tell your story. Many prayers for you.

My story is one people never hear or talk about. Before i get this off my chest, they say that once you have a blow to the head, then another before the first is able to heal, you make very poor decisions, and which I did. I was in an abusive relationship for 8, yes, 8 long yrs. The first blow lead to countless others one after another, repetitive blows. I feared this person and somehow from injuries, thought in my mind I loved, needed and couldn't live without this person, like Stockholm syndrome. I thought I loved him soo much that I could fix him. My anger, sadness, depression and uncontrollable emotional outbursts got worse and no one, not even myself understood what was going on with me. I was 26, beautiful and very smart, funny and considered "the life of the party". Now I'm 42 and no one understands. I've been called bipolar, crazy, my own sister told me " get some help you crazy bitch". My mother doesn't want to talk about it, my 20yr old daughter is even pulling away from me. I've lost everyone since my symptoms have gotten worse. I feel soo alone, hell, I am alone. I'm scared. I took soo many hard blows, they're countless. My sister was murdered by her husband in 2008 and THAT, FINALLY got me away alive. I can't remember where I'm going, what I was saying, how to put words together, severe headaches, severe mood swings, uncontrollable crying and sadness because I don't understand why my thoughts work the way they do. I have no one to turn to, no help, that's turning to no hope. Domestic violence... Ppl say "why didn't you leave, I don't feel sorry for you, it's your fault". I hope I can pull through this, cause I fear such damage has been done that it's even far worse than the MRI showed, the frontal lobe TBI. I look normal but that evil person changed my life forever. Like football players that are committing suicide because it's too overwhelming and no one, not even I understand how to fix myself. Domestic violence is not because the woman is an idiot, is probably because damage has been done to the brain. I'm not me anymore and feel that I probably never will be, even though EVERYDAY I try my hardest to be normal. I miss ppl in my life, I feel that I've been deserted... And I have. If anyone reads this, please pray for me. I'm completely terrified.

I pray for you. You are a good person.

I have never been a believer in yoga and meditation but I have discovered they really can help. Try Bikram. It will be totally physical to start with but after time you realise it goes much deeper than that.

Years ago I was attacked and sustained a head injury. I was unconscious and I lost my memory. I don't know anything about the hospital stay or anything. I didn't even get a diagnosis. My mom and sister picked me up from the hospital and I have not talked about it till now. It happened in 1987.

my vision is like double and i get dizzy. i was in a bad car wreck . i was in icu for 2 days, i had 3 broken ribs , a cracked pelvic bone and 32 staples. i was in hospital for 5 days now im home. i had my wreck on nov. 7 2015. how long will it take for my vision to go back normal ???

How do you categorize brain injury due to radiation damage that was given for a brain tumor? This happened to me and left me barely able to function and had to access many resources and therapies.

Recent studies and treatments are showing there is more neuroplasticity than this article indicates. In addition and based on my husband's personal experience and our observation of other brain injured people, hyperbaric oxygen therapy (HBOT) provides very significant healing, even 20 years after a brain injuring event (see https://www.youtube.com/watch?v=4wa5Sjm_Nyo). For our veterans, the improvement HBOT offers is sufficient that state of Oklahoma has made law stating that veterans can get HBOT and the VA has to pay for it (see http://videos.oeta.tv/video/2365281649/). HBOT can give a person a life back instead of a life sentence.

I suffered severe brain trauma as a child and at the age of 58 became to have coherent return of my memory.  This article is very helpful.  I do wonder about the Rancho Los Amigos levels because my life is marked by much overlap.  I have always felt anxiety ridden and personally depressed while at the same time working, seeking out physical health and putting myself through college at night - very appropriate but intrinsically unhealed.  I feel I lived a bifurcated life.

What is a bifurcated life? I get the overlap but that would be sort of normal wouldn't it? I dont have a dictionary at hand and from the context I'm guessing just a bit screwed up, yes? That seems sort of normal as well so.......... what are you trying to say? How did you "become to have" coherent return of your memory at 58 , long after a childhood head injury? Did you suffer another head injury?
Have you finished your studies? You say you are anxious and depressed while working and going to school at night. That seems a good reason to be anxious but depression would be a shame while working so hard to improve yourself. Did your sudden return of memory stir up a previously unmanaged bit of your life?
Now would be a good time to manage that bifurcated intrinsically unhealed bit and get on with the rest of your appropriate life.
Stay well and get happy!!!!

What is a bifurcated life? I get the overlap but that would be sort of normal wouldn't it? I dont have a dictionary at hand and from the context I'm guessing just a bit screwed up, yes? That seems sort of normal as well so.......... what are you trying to say? How did you "become to have" coherent return of your memory at 58 , long after a childhood head injury? Did you suffer another head injury?
Have you finished your studies? You say you are anxious and depressed while working and going to school at night. That seems a good reason to be anxious but depression would be a shame while working so hard to improve yourself. Did your sudden return of memory stir up a previously unmanaged bit of your life?
Now would be a good time to manage that bifurcated intrinsically unhealed bit and get on with the rest of your appropriate life.
Stay well and get happy!!!!

The future in Brain Therapy is here. GyroStim therapy at www.cbp-centers.com gives new hope for patients with brain injury. The deep brain stimulation in the next generation activates the neuroplasticity of the brain - the brain's amazing capazity to "fix" itself.
CBP-Brain Centers in Colorado is the only place in the USA which offers this groundbreaking therapy. www.cbp-centers.com

This information is great and spot on but people with a brain tumor and brain surgery experience the same but do not get the TBI diagnosis. Is this because doctors are afraid to be sued. We need better awareness and support.

Damage can be seen through Spect-Imaging!!

How marvellous to read something that explains A.B.I. my son his two years into his recovery and his still in a rehabilitation unit.but l never give up hope.and visit every day. at

lovely explanation, this has been very help full in my revision for exams thank you.

Arthur Cortis, this comment of yours got me in a way I was completely unprepared for, like the two gunshots to the back of my head only few months back! But in this case, I've been there and I've seen it all happened. Life anew. Fears and many more fears. Trying to recognize the new person while still struggling to come to terms with the death of the old guy. It's an experience better imagined. The new normal is just as strange as the old death!

The "light" is full of fright...in your journey to return to normalcy from a TBI.

The above statement is chock full of misnomers,  but it is a beginning. Your journey has been heightened with opportunities never envisioned before. You just don't realize what is in front of you, yet. In time, everything comes into focus. How long this takes is different for everyone.

To come to terms with your new situation it must be realized you have entered into a new normal. Gone is the past you. Born again, with the benefit of prior knowledge. With benefits come anchors. Life is a balance...equalibrium is sought...you understand this much better after sustaining a TBI.

Once you come to terms with your new reality, then you can begin the road to enrichment of self. It is what it is because it is...searching, searching, searching...almost a requirement before you begin anew...make peace with new you and recall the situation is Just Right!!!

Preposterous, you say...begin anew!!!

Arthur Cortis

I'm very caught on this subject and really want to figure out how to heal axons. This article has helped me a lot and I hope to be back with more news. Thank you


A  scientist

Beautiful and encouraging. I once had a mild concussion as I took a spill from a bike 1977 just after graduating college. My concearn fits more with ptsd as a result of severe psychological trauma at age 10 December 21 1965 when I found my mother unconscious (turned out she was dead - a suicide self inflicted gunshot wound). The shock and after effect traumatized me to this day Nov 19 2014. Despite college grad school and work I first saw a therapist at age 27. And now I know that trauma had a long term effect on my brain. I am now on SSDI and I feel my mind relaxing and slipping backwards. All I can do is go with the flow. I just read that healthy eating exercise brain stimulation will help me. My emotions are heightened from my childhood and I have an excellent psychiatrist. Thank you for your Godly words.

May 12th 2001 (Mother's Day) at the age of 16 I experienced a severe tbi. I wrecked a motorcycle doing (from what the police said) anywhere from 75-120mph head on into a ford f-550 service truck. I was in a severe coma for 3 1/2 weeks and literally died 4 time throughout the initial hours/days in the hospital. I was in the hospital for approximately 4 months total. Including the inpatient rehabilitation center. I had to learn EVERYTHING down to tieing my shoes but for some reason maintained a two year college level reading ability....i have a hard time remembering much of anything before that wreck happened to me and except for triggers once in awhile that bring back memories that sometimes I wonder if they are actual or fabricated by my brain. Because a lot of times my friends or family don't even remember them happening. It is now 9-22-14 and I am still here to tell you that recovery has been very long and difficult...I still struggle with anger/temper issues as well as impulsive decisions I make without thinking things all the way through before I move forward with the decision. I am a single father at the age of 28 raising a beautiful 8 year old son, I have an associates degree and am working a job that brings in close to 70,000 dollars a year. Now, with that. I am by no means trying to brag or flaunt about my success but rather provide inspiration to victims of tbi and families of tbi victims showing them that everything can work out to be ok. With my personal tbi, I had what you would call a subduralhematoma with my brain hemoraging (bleeding) inside my skull with no room to expand due to it being a closed head Injury. The doctors put a drain into my scull to relieve the preasure until swelling and bleeding subsided. I still have a large problem relatively often with my short term memory but it has improved over the years and I am still at high risk for having seizures. (Haven't had one yet) but in closing, If you are a victim of a tbi or family of a victim of a tbi (traumatic brain injury) reading this comment. DONT LOSE HOPE!!! DONT GIVE UP!!!! PERSEVERE THROUGH IT!!! It may not be the end all be all! Everything happens for a reason!!! You may never understand why so don even bother wasting your breath asking yourself that over and over and over. Just see it through. I hope everything works out for you as it has for myself.....and if you ever doubt the ability you do have to see it through to the end. Say a prayer! I will say one with you! I'm sorry you have to/are going through this. Either way you look at things...it will all work out. God bless you!

My brother is on life support with a moderate-severe tbi. It's only been 2 days. I'm searching for hope. This story is exactly what I needed to see. Thank you for sharing

Immediately after Injury I was in a hospital ,but now I'm at home continue my recovery . I still work on my memory and I don't want memory of my accident back to me. What the doctors say I had one year in  front of me. During this time I try to help my body doing YOGA exercises and continue to wait. If you have something to say or share your own experience please just write I will be very pleased to read it.

Have a good time and enjoy your life.

Reading comment from May 4th. I have had 3 bad head injuries resulting in associated nasal, hand, and multiple rib fractures. Right side, left side, back of head. Had swelling and bruising from top of visible head from top of forehead to bottom of jaw, actual lacerations thought of contusions when actually lacerations when swelling subsided. But I have never lost conscioueness and can in fact give detailed information on entire event. Therefore I feel I have been underdisgnosed and sent walking while if I had even tole doctors I was just momentarily unconscious my care would have improved. I think the Glasgow scale is wrong, archaic and intolerable to people likeyself. I think E.R.s need to be better trained in modern lab tests for injury extent and treatment. This included immediate and followup care. I like others can be very pleasant in the E.R. then do the suffering at home in order to avoid being a beligerent patient. I am a past R.N. who lived and breathed E.R. medicine and as a student was taken under mentoring by Dr. John Weigenstein, Lansing, Michigan who founded the Vollege of Emergency Physians taking it from moonlighting to a accepted field of medicine. If he saw I was worth teaching I must have some capacity for the area. In general I think E.R. physians need to have more required ongoing education and empathy. At a hospital in Lansing, Michigan, I had the shift director actually come to me and tell me the E.R. was for emergencies, not people like me. I will fight till he I repreprimded. So if you have a head injury be your own advocate, losing consciousness is NOT a sign of severity and get rid of the Glasgow scale now. July 12, 2014