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]

Overvie

The hallmark of traumatic brain injury is finding a positive history of headache, mental confusion, lightheadedness, dizziness, double vision, repeated vomiting or nausea, seizures, inability to awaken, dilation (widening) of one or both pupils, slurred speech.

History and Symptoms

Some symptoms are evident immediately, while others do not surface until several days or weeks after the injury.

With mild TBI, the patient may remain conscious or may lose consciousness for a few seconds or minutes. The person may also feel dazed or not like him- or herself for several days or weeks after the initial injury. Other symptoms include:

• Headache
• Mental confusion
• Lightheadedness
• Dizziness
• Double vision, blurred vision, or tired eyes
• Ringing in the ears
• Bad taste in the mouth
• Fatigue or lethargy
• A change in sleep patterns
• Behavioral or mood changes
• Trouble with memory, concentration, or calculation
• Symptoms may remain the same or get better; worsening symptoms indicate a more severe injury

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.

Small 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