Traumatic brain injury (TBI) afflicts millions of people every year. These injuries are unlike some other types of injuries because, for many, life will never be the same. Even for those who do not experience dramatic life changes, the reality is after any head injury occurs, the brain is not exactly the way it was before nor will it ever function precisely the same way as it did before. Broken legs or arms can heal, but the brain is forever changed in some shape or form after it has been injured.

A CT of the head years after a traumatic brain injuryCredit: James Heilman, MD/Creative Commons-Attribution/Share AlikeFor many individuals who have sustained a TBI, there are long-term consequences directly associated with the injury. The Centers for Disease Control estimated in 2010, as a result of TBI, at least 3.17 million Americans were left with a long-term or lifelong need for help to perform activities of daily living. 1

Brain injuries sustained are usually categorized as mild, moderate or severe. What type of help or adaptations an individual needs post-injury will depend on the area of the brain that had been injured and its severity. As different parts of the brain control various functions, and factor in that no two brains are alike, it is often hard to predict exactly what long-term consequences an individual that has suffered a TBI will sustain.

Additionally, in the case of mild traumatic brain injury, also known as MTBI, problems associated with the head injury may not be noticed or looked for immediately, as these are not always easily detected. The CDC estimates 75 percent of TBIs that occur each year are categorized as mild. While these injuries are not life threatening, like moderate or severe injuries, can have serious effects. And multiple MTBIs can further increase risks.

At this time while progress is being made both scientifically and technologically in the field of neurology, there is still much that is not known about the brain. However, it is known for certain there are long-term effects of TBI. It is important to understand that, while there may be similarities, not everyone will exhibit the same symptoms or experience the same consequences as no two brain injuries are "exactly the same", as the Brain Injury Association of America notes. 2 This is true even if two people are injured in the same exact way.

Physical and Senses

Depending on the area of the brain injured, many physical problems  may emerge that can be either short or long-term for a TBI survivor. Areas of the body which may be affected will depend upon the injury, and this can range from physical mobility of different body parts to balance issues to different levels of seizures.

Senses such as speech, hearing and vision can also be impacted after a head injury occurs. Survivors may be plagued with headaches or have difficulties with frequent fatigue. In some instances, the sensations of touch, taste and smell can also be affected. For others, speech and language is disrupted.

For physical disabilities that arise after a head injury has been sustained, therapy can help to reduce, or even eliminate, some issues. It is not uncommon for TBI patients to participate in physical, occupational or speech therapy.

Cognitive, Behavioral and Emotional

TBI also can bring on cognitive and emotional difficulties. Depending on the nature of the physical injury of the brain, cognitive effects can result. For instance, issues with memory, reasoning, problem-solving, decision-making and executive thinking, often arise.

Emotional and behavioral issues are also not uncommon. Those who have sustained a TBI often may incur issues with sudden outbursts, impulsive choices or actions, temper, depression, anxiety, personality changes, social inappropriateness, and a lack of inhibition. Or any combination of these and/or other behavioral changes. Therapy, counseling and/or monitoring under a doctor's care can also help in these areas as well. In some instances, medication can help.


Perhaps one of the largest long-term consequence of TBI is the uncertainty. It is not easy for an individual to accept changes caused by the TBI, and it can be difficult for their loved ones as well. Since so little can be predicted and there is still much unknown, the uncertainty can be difficult to cope with at times.

Some consequences of brain injury may emerge immediately and other symptoms may not become clear until much later in the recovery. This is true for all individuals, but perhaps especially true in children who suffer a TBI since their brains are still developing. It is not usually apparent what long-term injuries have been sustained. It can be months or years to see the impact as the child grows, especially from a cognitive and emotional perspective.

The CDC has categorized TBI as a serious health issue in the United States. 3 As all individuals will travel a different path on their journey of TBI, and it is not always easy to predict long-term consequences, as these will vary. While the effects of TBI may vary, the one constant all experience is the person will most likely experience some sort of change.

Over My Head: A Doctor's Own Story of Head Injury from the Inside Looking Out
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