Five Long-Term Effects Of Traumatic Brain Injury: Signs, Diagnosis, And Treatments

If you or a loved one has experienced a traumatic brain injury (TBI), you may feel uncertain about the road to recovery. Depending on the severity, type of head injury, and various other factors, the process of healing from a TBI can vary widely among individuals. TBIs can be complex and serious, but there are several treatments and strategies available to help manage the effects. 

As you review the potential long-term effects of TBIs, please note that you should work closely with a trusted healthcare provider throughout your recovery. While mental health professionals can assist with the psychological aspect of healing, it is important to work with your doctor and/or medical team for an official diagnosis and appropriate treatment plan. 

Read on to learn more about the signs and symptoms of traumatic brain injuries, plus several of their potential long-term effects.  

What is a traumatic brain injury (TBI)?

TBIs can range in severity (mild, moderate, or severe), and they can be classified as either “penetrating,” also known as an open TBI, or “non-penetrating,” also referred to as a closed head injury or blunt TBI. An open TBI happens when an object pierces the skull and enters the brain tissue, such as a gunshot wound; a closed head injury occurs when an external force causes the brain to move inside the skull, such as a car crash. In some cases, a person can have both a penetrating and non-penetrating TBI from an accident. 

Signs and symptoms of a TBI

A traumatic brain injury can have a range of physical, behavioral, and sensory symptoms. If you notice any of the following signs and symptoms, particularly within the first 24 hours after a head injury, it is recommended to seek medical treatment immediately:

• Headache
• Convulsions or seizures
• Blurred or double vision
• Loss or change in consciousness
• Challenges with memory and concentration
• Frustration or irritability
• Changes in sleep patterns
• Changes in perception and sensation, including lightheadedness, dizziness, sensitivity to light or sound
• Mood changes or mood swings

Some of these symptoms may show up immediately, while others may arise days or even weeks after the injury. 

Diagnosing a TBI

To diagnose a TBI, your doctor will likely perform a neurological exam to assess your motor function, perception and sensory skills, memory, thinking, and any other noticeable changes.

Depending on the severity of the injury, a doctor may request a computed tomography (CT) scan or magnetic resonance imaging (MRI) to assess the injury and determine if surgery might be necessary to repair any serious damage to the brain tissue. CT scans can show skull fractures as well as brain bruising, bleeding, and swelling, while MRI provides extra-detailed images of brain tissue.

Based on this information, your medical team can create an informed plan for treatment. Treatment can vary depending on the severity of the injury. 

Five long-term effects of a traumatic brain injury

Depending on the type and severity of a TBI, the long-term effects can also vary widely. While some people may recover from a mild traumatic brain injury within a few months, a more severe TBI may result in lasting effects and even permanent disability.

Ultimately, every person’s experience and recovery may look different, but below, we’ll explore some of the possible long-term effects of a traumatic brain injury. As you learn more about the long-term effects of TBIs, contact your doctor with specific concerns and questions about your treatment plan. 

Changes in physical and motor abilities

If you’re recovering from a moderate to severe TBI, you may have experienced significant changes in your physical abilities. For people with more severe brain injuries, motor deficits such as poor coordination, tremors, weakness, and inability to plan motor movements could occur. Paralysis, poor balance, decreased endurance, and problems swallowing could also be possible effects of a more severe TBI.

To improve their motor skills and other physical movements, TBI patients may seek occupational therapy or physical therapy, either as an independent treatment or as part of a multi-disciplinary medical team. Over time, occupational and physical therapists can help patients improve their physical abilities and increase their overall independence. 

Challenges with memory 

Memory loss and changes are commonly associated with traumatic brain injuries. While memory loss can be short-term in some cases, other people may continue to have difficulties with recalling and applying information. According to some researchers, memory impairment affects between 54% and 84% of individuals with traumatic brain injury. 

In the context of TBIs, several studies have also examined the phenomenon of adult neurogenesis, or the generation of new neurons. Research has found that the process of neurogenesis can be negatively impacted by TBI, which may lead to sustained memory issues. On an individual basis, doctors may recommend cognitive rehabilitation therapy (CRT), an individualized training program that aims to help patients improve and restore their memory and other cognitive functions.

Fatigue and sleep disturbances

Among people recovering from TBIs, sleep disturbances and generalized fatigue are some of the most common effects. An estimated 30-70% of people with TBIs experience sleep disturbances, according to a 2013 review of TBIs and sleep disorders.  

And according to a 2019 overview of the impact of traumatic brain injury on sleep, around 46% of people develop sleep disorders after a TBI, including sleep apnea, insomnia, post-traumatic hypersomnia, and narcolepsy. Given the relationship between healthy brains and quality sleep, many TBI treatment plans also involve the treatment of sleep disorders and related challenges. 

Patients may be encouraged to try to improve their “sleep hygiene” by developing a bedtime routine, reducing caffeine intake, and generally creating a restful, non-stimulating environment for sleeping. Treatment plans may also include cognitive behavioral therapy (CBT) and potentially medication, depending on the severity of the TBI and sleep disturbances.  

Sensory changes

Sensory impairments can also be a common effect of traumatic brain injuries. These can include effects such as hearing loss, tinnitus, visual complaints, and smell and taste changes.

Research has found that people with TBIs may also experience retinal thinning, light sensitivity, and other visual processing problems. Across all senses, any changes warrant early diagnosis and treatment to try to prevent further changes or deterioration. In addition to specialized doctors, physical and/or occupational therapy may be necessary to strengthen certain senses and develop strategies to cope with sensory overload. 

Emotional and behavioral changes and psychiatric disorders

Traumatic brain injuries are also associated with a range of emotional and behavioral changes as well as psychiatric disorders. These include agitation, aggression, restlessness, anger, irritability, anxiety, and depression. 

Depression disorders are particularly common among individuals with TBI, with experts putting the frequency at around 25% to 50% in the first year after a TBI and a lifetime rate of 26% to 64%. 

Recovery from a TBI: The role of talk therapy 

While medical teams support patients with the physical effects of TBIs, mental health treatment can also have a significant impact and be an important part of your treatment and long-term recovery. Noting the mental health risks associated with concussions and other TBIs, people living with any kind of brain injury can benefit from working with a compassionate counselor.

You can connect with a trained counselor near you for in-person sessions, or you can meet with a licensed therapist online for virtual sessions. If you’re recovering from a TBI and unable to leave the house or drive to appointments, online therapy may be beneficial, as it allows you to connect with a licensed therapist from the comfort of your home, or wherever you have internet.

Research continues to show the value of online therapy for people with a range of physical and mental health concerns, including traumatic brain injury. For instance, one research study examined the effectiveness of an online cognitive behavioral therapy (CBT) program for individuals with mild or moderate TBI and depression. The study found that after the online program and at the 12-month follow-up, patient scores on the depression scales “were significantly decreased.”

If you are caring for someone with TBI, online therapy may also be helpful. In one study, researchers assessed the utility of counselor-assisted problem solving (CAPS) to improve the mental health of caregivers, specifically those to adolescents with TBIs. The CAPS program included online training in problem-solving, communication skills, self-regulation, and anger management. At 12- and 18-months post-baseline, the researchers measured significantly lower levels of caregiver psychological distress.