Traumatic brain injury history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Joanna Ekabua, M.D. [2]

Overview

The symptoms of TBI are diverse and can range from an asymptomatic mild TBI to instant death. The wide spectrum of the disease makes it possible to present in several different ways. Here in this section, we discuss a few important historical findings and symptoms of the TBI. For the purposes of this discussion, we will only be referring to symptomatic TBI.

History and Symptoms

The most important information to obtain in the history of any TBI patient is the nature of the injury, baseline patient's health, presence or absence of syncope, the evolution and the progression of symptoms.

The nature of the injury is one of the most important information to obtain as that gives an insight of possible underlying effects of the trauma. Often times, the nature of injury in elderly people could be as simple as an unwitnessed fall. In younger population, especially athletes, the nature of injury is often unnoticed.

With moderate or severe TBI, the patient may show these same symptoms, but may also have:

  • Loss of consciousness
  • Personality change
  • A severe, persistent, or worsening headache
  • Repeated vomiting or nausea
  • Seizures
  • Inability to awaken
  • Dilation (widening) of one or both pupils
  • Slurred speech
  • Weakness or numbness in the extremities
  • Loss of coordination
  • Increased confusion, restlessness, or agitation
  • Vomiting and neurological deficit (e.g. weakness in a limb) together are important indicators of prognosis and their presence may warrant early CT scanning and neurosurgical intervention
  • Children with moderate to severe TBI may show some of these symptoms as well as symptoms specific to young children, including:
  • Persistent crying
  • Inability to be consoled
  • Refusal to nurse or eat

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