What is a Traumatic Brain Injury (TBI)?

Traumatic brain injury is an injury to the head and brain usually caused by physical impact. Commonly referred to as TBI, traumatic brain injuries cause damage and dysfunction to the brain, which may be permanent in more severe cases.

Types of Traumatic Brain Injury

The severity of a traumatic brain injury is typically determined by the Glasgow Coma Scale. The Glasgow Coma Scale uses the table below to categorize injuries as mild, moderate or severe TBI. To use the scale, a medical professional determines the response, then adds the corresponding value to each response to understand the severity classification of a brain injury. 

The Glasgow Coma Scale

Best Visual Response Best Verbal Response Best Motor Response
  1. None
  2. To pain
  3. To speech
  4. Spontaneous
  1. None
  2. Incomprehensible
  3. Inappropriate words
  4. Confused
  5. Oriented
  1. None
  2. Extends to pain
  3. Flexes to pain
  4. Withdrawl to pain
  5. Localizes to pain
  6. Obeys commands

Classifications of Brain Injury

Mild Traumatic Brain Injury

Mild traumatic brain injuries are caused by a blow to the head or violent shaking that can cause temporary brain damage and impairment of cognitive ability. Repeated mild TBI can potentially cause long-term cognitive issues. Most people who experience a mild TBI, though, can expect a full recovery. A mild TBI is categorized by a score ranging from 13-15 on the Glasgow Coma Scale.

Many mild TBI injuries can be defined as concussions, and consciousness is rarely lost for longer than 30 seconds for a mild TBI. Despite the “mild” label, mild TBIs can have significant impacts on cognition and behavior, and recovery may vary from person to person.

Mild TBI Symptoms

  • Fatigue
  • Headaches
  • Light sensitivity
  • Dizziness and balance problems
  • Irritability
  • Depression and mood swings
  • Nausea
  • General confusion and mental fog

Moderate Traumatic Brain Injury

Moderate brain injuries score between 8 and 13 on the Glasgow Coma Scale. Consciousness is often lost for a significant amount of time (ranging from several minutes to several hours), and post-injury recovery may last for months. In certain cases of moderate TBI, full recovery may not be a possibility.

Typically, a person with a moderate TBI who regains consciousness will have symptoms similar to those of a person with a mild TBI, but the symptoms will be much more severe. Symptoms also may persist for a significantly longer duration or be permanent.

Moderate TBI Symptoms

  • Fatigue
  • Strong recurring headaches
  • Light sensitivity
  • Amnesia, memory Loss
  • Dizziness and balance problems
  • Fluids Draining from ears and nose
  • Dilation of pupils
  • Depression and mood swings
  • Seizures
  • Nausea
  • General confusion and mental fog
  • Slurring of speech 

Severe Traumatic Brain Injury

A severe TBI is typically characterized by comatosis (coma) and often permanent brain damage. Death may occur in extreme circumstances. A severe TBI is any brain injury that results in a score of 8 or lower on the Glasgow Coma Scale.

Severe traumatic brain injuries can result from blunt trauma, but also can be the result of penetration of the skull from external objects.

Severe TBI Symptoms

  • Headaches
  • Difficulty coordinating balance
  • Blurred vision in one or both eyes
  • Mild vision problems
  • Seizures
  • Changes in sensory perception
  • Trouble speaking and swallowing
  • Changes in sleep patterns
  • Lack of bowel and bladder control
  • Changes in sexual function
  • Motor impairment (trouble moving body normally)


  • Difficulty forming sentences
  • Confusion
  • Trouble communicating
  • Difficulty with reason and logic
  • Memory impairments
  • Depression
  • Poor concentration
  • Mood swings
  • Limited attention span
  • Disorientation
  • Forgetfulness
  • Acting inappropriately

Common Causes of Traumatic Brain Injuries

Traumatic brain injuries can occur from a wide range of accidents. There are a few common causes of TBI, though, that are worth noting. According to the Center for Disease Control, these causes include

  • Causes of TBI pie chartFalls (40.5%)
  • Motor vehicle-traffic crashes (14.3%)
  • Struck by/against (15.5%)
  • Assaults / Abuse (10.7%)
  • Blasts are a leading cause of TBI for active duty military personnel in war zones.

Get more info at http://www.cdc.gov/traumaticbraininjury/get_the_facts.html

Treatment and Care for Traumatic Brain Injury

Immediate care is the most critical aspect of treating a traumatic brain injury. An optimal outcome can be achieved by caring for the initial injury in moderate to severe TBI cases.  After stabilization, a patient will likely be transferred to an intensive care unit (ICU).

Shepherd Center’s Intensive Care Unit’s goal is to manage a patient's medical status and get him or her ready for comprehensive rehabilitation. This includes everything from monitoring drug therapies, monitoring for secondary complications, and getting the patient mobile and out of bed as soon as possible. All care is provided case-by-case, as each individual has their own needs.

Brain Injury Rehabilitation Process

The rehabilitation process begins after the patient regains consciousness. With rehabilitation, patients begin to recover lost skills and regain their cognitive function. Some effects of the brain injury may be permanent. Some patients may need to learn to cope with a disability and learn to manage their life differently than before their injury.

Throughout the rehabilitation process, patients may work with a wide variety of staff members, including occupational and physical therapists, psychiatrists, psychologists, and more.

Learn More from Shepherd Center

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Please contact us at 404-352-2020 if you have additional questions about traumatic brain injuries, concussions, or anoxic injuries.