man in military uniform sitting next to wheelchair holding head

Watch Your Head: About Brain Injuries

We wrap up Brain Injury Awareness Month (March) with an overview of Traumatic Brain Injuries (TBIs): what causes them, how to recognize them, and how to prevent them.


The best-known causes of brain injury are blows received in war or contact sports. What’s less well known is that physical collisions have different TBI effects than concussive blasts (explosions).

BridgingApps Digital Navigator Walter Prescher, himself a Veteran with TBI, explains: “Where TBI is caused by an explosive blast, there’s a higher rate of damage to brain cells and connections, which means more pronounced effects and longer recovery time. After being close to several explosions on active duty, there was a point I couldn’t talk in a complete sentence without losing my place. A 2009 MRI found that the lower left part of my brain looked like it was hit by a shotgun. It took three years of cognitive and speech therapy to regain most functions, and I still have lingering effects: vertigo, controlled seizures, migraines. An impact injury will mostly cause swelling, and might break some neuropathways, but not to the same extent.” 

There are other, less obviously physical, causes for some brain injuries:

  • Temporary oxygen deprivation (e.g., choking or drowning that requires treatment for stopped breathing)
  • Electric shock
  • Seizure
  • Stroke
  • Brain tumor
  • Extremely high fever
  • Drug overdose

To most medical scientists, though, traumatic brain injuries are those caused by external physical force, and brain injuries as a whole are divided into two categories: acquired (including TBI) and genetic/congenital. Some scientists also distinguish “early childhood” brain injuries—those that happen before age two—from injuries that occur after someone achieves full muscle coordination. (Most cases of cerebral palsy are due to brain injuries before, during, or shortly after birth.)

Is It Really TBI?

Note also that TBI and other brain injuries may not surface immediately after an incident. A person may initially seem fine, then develop symptoms days or weeks later.

Most people, understandably, don’t want to rush to the doctor for every bump on the head. However, you definitely should get checked if a head injury:

  • Causes loss of consciousness
  • Is associated with a violent collision or explosion
  • Shows an open wound

And see a doctor for any of the following symptoms, whether or not you remember suffering a head injury:

  • Severe headaches
  • Blurred vision or odd pupils
  • Fluid in ears
  • Sudden recurring lapses in coherence, self-control, concentration, or memory
  • Visibly slowed reaction time
  • Repeated loss of balance or coordination
  • Unexplained seizures or loss of consciousness

(With young children, you may notice sudden regressive behavior or an increase in crying and meltdowns.)

Don’t just wait and hope the symptoms go away. As with most medical problems, the sooner TBI is diagnosed and treated, the better the outlook.

An Ounce of Prevention

Of course, the #1 best way to deal with brain injuries is to avoid them in the first place. Some injuries (especially those incurred in the line of duty) can’t be prevented, but many can.

  • Wear a helmet when biking, playing sports, or entering a construction area.
  • Keep your seat belt on while in moving vehicles.
  • Stay fit and flexible: you’ll be less likely to fall, walk into something, or otherwise bang your head.
  • Clear your home of tripping and stumbling hazards.
  • Don’t walk while distracted by a smartphone or carrying anything that blocks your view.
  • Keep your eyeglass prescription (or low-vision assistive technology) up to date to further reduce stumbling risks.
  • Be aware of medical conditions (and medication side effects) that could affect your balance or judgment, making you more prone to accidents. (Note: sleep deprivation has similar effects.)

(For a more comprehensive list of safety tips, see “Traumatic Brain Injury & Concussion: Prevention” from the CDC. See also “Fall Prevention Guidelines for Patients in Wheelchairs,” from the National Library of Medicine.)

Recommended Apps for Brain Injury Patients

For further help regaining quality of life after a brain injury, here are some tools from the BridgingApps database.

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