A decade ago, TBI injuries were not well-publicized and the condition has long been referred to as the "silent epidemic".  Every year in the U.S. more than 2 million people sustain a traumatic brain injury (TBI) and tens of thousands of victims die from their injuries.

These figures do not include the percentage of people who do not seek treatment or have silently experienced the effects of TBI without realizing they've acquired a head injury.

TBI is a unique type of injury because no two brain injuries are alike. People who sustain a TBI may exhibit similar symptoms or behaviors, but the injury itself will not be the same. In addition, wounds from a TBI are most often not visible and, being injured brain cells do not heal the same way other bodily cells may heal, it is hard to predict how the injury will affect a person in either the short or long-term.

Complications associated with TBI will vary. Being the brain is the human body's central organ which facilitates the activity of other organs, any injury the brain sustains can be significant.

Currently, traumatic brain injuries are categorized in three different levels:

  • Mild
  • Moderate
  • Severe

When dealing with head injury it is important to understand the differences between the three.

Mild TBI

Mild traumatic brain injuries, also referred to as MTBI, are often difficult to distinguish because it is common for the individual to not even realize they've injured the brain. There are likely far more mild TBI cases that go undiagnosed than any other level of TBI. Concussions fall into this category.

Detecting a mild head injury is not always clear, and those who suffer minor blows to the head may not even seek treatment, which is one of the reasons why it is difficult for experts to pull together a full picture on TBI statistics. The fact is many people do not consult with a doctor after suffering what is deemed to be a minor blow to the head.

There are some signs that are characteristic of a mild TBI, and these are brief unconsciousness, headaches, persistent fatigue, irritability, a level of memory loss and confused feelings. Not all of these characteristics may be present, or it can be a combination of any or all of these symptoms.

In addition, a person may experience signs of depression, loss of balance and sensitivity to light or noise after sustaining an MTBI.

Concussion study
Credit: University of the Fraser Valley/CC by 2.0 with attribution (found on Flickr)

Years ago concussions were often looked at as "just a concussion", but today experts know concussions can be a serious injury.

Moderate TBI

When a person suffers a moderate TBI, the symptoms may include the same kinds of experiences that could occur with a mild TBI, however, the person may also experience a loss of consciousness that can last several minutes or even longer. Someone who sustains a moderate TBI may also experience prolonged confusion and exhibit cognitive, physical or behavioral differences than they had pre-injury.

Severe TBI

According to the Traumatic Brain Injury website,  a severe TBI is "defined as a brain injury resulting in a loss of consciousness of greater than 6 hours and a Glasgow Coma Scale of 3 to 8". 4 Signs a severe TBI is present include coma, persistent vegetative state or minimal response after the injury has occurred.

Many individuals experiencing a severe TBI often find they have extended or permanent problems with bodily functions such as vision, body temperature, auditory and physical movements. While all levels of TBI may find permanent injury in this area, those with severe TBI may also find long-term suffering of cognitive, behavioral, emotional and sensory problems. A person who sustains a severe TBI has more obvious symptoms than a mild or moderate head injury, and often has an extended period of hospitalization post-injury which may include in-patient rehabilitation. However, people suffering from a severe TBI can have a strong recovery.

TBI is a Life Changing Injury

Regardless of which level of TBI is sustained, it is important to recognize that a person who has suffered a head injury may never behave the same way he or she did before the injury. It is not always the case, but it is a possibility. Many people who have family or friends suffering from TBI have described their loved one as "becoming a different person", and this is a very real experience which can be frustrating for both the individuals injured and those who love them. This is not always the case, but it is a real occurrence and important for loved ones to understand.

When a mild, moderate or severe TBI occurs, it is essential to recognize that once a TBI diagnosis is made this is most often a lifetime affliction. What it doesn't mean is that there isn't a road to recovery, it just means that the brain is not going to ever function the way it did pre-injury. The earlier a TBI diagnosis is made, the better chance of recovery. Proper diagnosis and early treatment are valuable and critical as there are many physical, behavioral and cognitive therapies available that can mitigate symptoms and help a person recover. There is no set timeframe for recovery from any of the three levels of TBI as recovery can continue to occur many years after the initial injury.

brain power
Credit: aboutmodafinil. com (PinkPersimon on Flickr)/CC by 2.0 with attribution

While there is much work to be done, significant strides have been made in raising awareness of head injury. (The month of March has been designated as Brain Injury Awareness Month.) In the past many people quietly suffered with TBI because of a combination of the unknown and misdiagnosis, but with modern knowledge and tools this is fortunately starting to change. Today schools are better understanding of TBI with IEP plans and teachers are better prepared to work with students who have issues related to head injury. (This was not always the case and children with TBI had previously been placed in the wrong category before TBI was added to the list of categories for special education).

If you or a loved one has suffered a blow to the head, no matter how minor it may seem, it is a good idea to get it check out by a physician, especially if something seems or feels off after the injury.

In recent years some are suggesting there are more ways to categorize traumatic brain injury.

The Brain Injury Association is a wonderful resource for information to help individuals and families affected by TBI. 5