What Are The Symptoms Of Severe Traumatic Brain Injury?

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Traumatic brain injury (TBI) is a medical condition that can affect one’s physical, neurological, and/ or emotional functioning. The Centers for Disease Control and Prevention (CDC) defines a traumatic brain injury as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.” TBIs are classified as mild TBIs or moderate to severe TBIs. It is important to note that not all hits to the head inevitably result in a TBI. However, when an individual does sustain a TBI the symptoms will vary significantly. For some, a TBI may only affect the exact location on the brain where the injury occurred, while for others a TBI could also affect surrounding tissues and cause damage to one’s brain in other areas apart from the initial site. Some TBI symptoms may appear immediately and dissipate rather quickly, while others may present several days or weeks later, and further, persistent symptoms may evolve over time. 

Symptoms

The specific combination and severity of symptoms will depend on the type of injury, the severity of the injury, as well as the area of the brain that was injured. The Brain Injury Association of America list the following three primary symptoms that indicate a severe TBI:

  1. Unconsciousness exceeding 24 hours (coma)
  2. No sleep/ wake cycle during loss of consciousness (LOC)
  3. Signs of injury appear on neuroimaging tests

There are additional symptoms that are commonly associated with severe TBIs, including but not limited to the following examples, provided by the Mayo Clinic:

  • Persistent, worsening headache
  • Loss of consciousness from several minutes to hours
  • Convulsions and/ or seizures
  • Repeated vomiting
  • Dilation of one or both pupils of the eyes
  • Continued nausea
  • Inability to awaken from sleep
  • Loss of coordination
  • Combativeness 
  • Weakness or numbness in fingers and toes
  • Clear fluids draining from the nose and/ or ears
  • Slurred speech
  • Profound confusion
  • Agitation 
  • Coma and other disorders of consciousness

Individuals that sustain severe TBIs are also at increased risk for developing any combination of the common symptoms associated with mild TBIs (e.g., headache, feelings of fatigue and/ or exhaustion, difficulty falling asleep, memory impairment, confusion, dizziness, irritability, nausea, vomiting, blurred vision, anxiety, behavior and/ or mood changes, etc.). 

The CDC asserts that an individual with a severe TBI will score 3 to 8 on the Glasgow Coma Scale. According to the Royal College of Physicians and Surgeons of Glasgow, “the Glasgow Coma Scale provides a practical method for assessment of impairment of conscious level in response to defined stimuli.” The Glasgow Coma Scale is a 15-point test that checks an individual’s ability to follow directions (e.g., moving one’s eyes, limbs, etc.). Based on one’s abilities, the individual is then scored from three to fifteen, where lower scores are indicative of more severe injuries. In addition to the Glasgow Coma Scale, evaluating medical professionals also rely on the presence of certain symptoms (e.g., the coherence of the individual’s speech) when delineating the severity of his or her injury. 

For Information and Support 

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