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, the evolution and the progression of symptoms.

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
• 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