Symptoms of a Brain Injury

The symptoms of a traumatic brain injury are many, and much depends on the area of the brain injured, the severity of the injury and the predisposition of the injured party. It's important for medical providers and attorney's to document these symptoms at the onset as this becomes a baseline for gauging whether symptomology is increasing or decreasing.

Symptoms of a brain injury may occur immediately or may be delayed. Often the immediate  focus is on other apparent injuries such as fractures or surgical interventions and the occurrence or extent of brain injury symptoms may be delayed for weeks or months.

Symptoms can last for days, weeks or months and this is very frustrating to the person suffering the brain injury and to the family. People want to know “When will I be back to normal?” and, unfortunately, no-one initially can answer that question.

It's important to know what symptoms "Typically" occur as many people with brain injuries look normal and feel they are going crazy because of all the changes they see in their lives. They are not crazy, they are just undergoing profound problems cause by traumatic brain injury (Tbi).

Signs and symptoms of a mild traumatic brain injury include:
  • Being dazed, disoriented or confused
  • Brief loss of consciousness, less than a few minutes
  • Nausea and/or vomiting
  • Headache
  • Problems sleeping
  • Drowsiness or fatigue
  • Amnesia for events before or immediately after the injury
  • Dizziness or loss of balance
  • Excessive sleeping
  • Blurred Vision
  • Ringing in ears
  • Loss of smell or taste
  • Difficulty with the sensory systems
  • Excessive sensitivity to sound or light
  • Concentration or memory problems
  • Mood swings or emotional lability
  • Depression or anxiety

Usually someone with an alteration or a loss of consciousness of 30 minutes or less will be diagnosed with a “concussion”. This is another word for mild brain injury,

It’s important to remember than even though a traumatic brain injury is listed as “mild”, it is still serious and needs prompt attention and medical care.  A “mild” brain injury may have overwhelming negative and long-lasting  effects.  An accurate diagnosis is important for treatment to be properly directed.

Moderate to severe traumatic brain injury symptoms include the following:
  • A loss of consciousness that lasts longer than several minutes up to several hours
  • Repeated nausea and/or vomiting
  • Persistent headache
  • Seizures
  • Pupil dilation on one or both sides
  • Being unable to awaken
  • Weakness or numbness in toes or fingers
  • Lack of coordination
  • Clear fluid coming from the ears or nose
  • Extreme confusion
  • Social isolation
  • Constant fatigue
  • Being agitated or combative
  • Being in a coma
  • Having slurred speech
  • Emotional lability
I’ve mentioned emotional lability in both lists above and because it’s so common I’d like to talk a bit more about it.

Emotional lability  refers to quick, exaggerated changes in mood, such that the mood is exaggerated and strong emotion is exhibited, such as extreme laughing or crying, irritability or a bad temper.  While the emotions are strong, they are not always related to the individual’s real emotional state.

Emotional lability happens because there has been damage to the areas of the brain that control the awareness of emotions and that control how emotions are expressed.  This leads to an inability to stop or inhibit feelings from coming out.   When the individual is emotionally labile, these emotions can be out of proportion to the environment or situation the person is in.

The person may cry, even when they aren’t unhappy. They may simply be responding to another’s strong emotion. Crying or laughing can seemingly come out of the blue without a trigger.

The brain-injured person might have little control over how they express emotions so that the expression of emotions may have little to do with the external environment.

They may overreact to certain people or to events around them.  Certain conversations about sad movies, funny movies, or books may trigger a person with weaker emotional control along with lowered frustration tolerance will exhibit extreme changes in emotional responses.

“Abnormal emotions“ might occur in situations where they would previously been in control, such as in church or listening to a lecture.  These lapses in behavior can be embarrassing and confusing for the brain-injured person and for those around them.

The emotional reaction to a situation might be completely unexpected considering the event; however, the behavior or expression of the feeling may be stronger, last longer and be louder than otherwise expected in another person.

They may be happy about something but once the laughter starts, the individual can’t stop the expression of their laughter.   Following a brain injury, the person may show extreme, genuine emotions, including despair, grief, sadness, despair, anger, depression, joy, happiness and pleasure.  The emotions may be completely appropriate and may be normal emotions.   People with emotional lability need to become aware of what triggers them and should try to avoid the triggers  when possible. Triggers can be anything and can include stress, worry or anxiety, excessive fatigue, situations of high stimulation, situations of too many people or too much noise, strong emotions, very sad or very funny situations, discussing emotional topics, or talking in front of a group.

Some of these things put the brain-injured person under a great deal of pressure so that their capacity to control their emotional behavior is reduced.  They may overreact to people or events around them. Weaker emotional control and lowered frustration tolerance, particularly with stress and fatigue can combine to provoke more extreme changes in emotional responses.  The trick is to take a break away from the situation so as to diffuse the emotions.  Try to regain control over the emotions and give time for the emotions to settle. It sometimes takes taking a walk, doing a different activity or something that takes you away from the situation can help the person cope with the presence of strong emotions.

People with these symptoms and their families should do all they can not to “Take it personally”. The person with the brain injury is not intentionally doing these things..these are very common symptoms after a brain injury. 
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