Traumatic brain injury (TBI) refers to damage or destruction of brain tissue due to a blow to the head, resulting from an assault, a car crash, a gunshot wound, a fall, or the like. In closed head injury, damage occurs because the person receives a blow to the head that whips the head forward and back or from side to side (as in a car crash), causing the brain to collide at high velocity with the bony skull in which it is housed. This jarring bruises brain tissue and tears blood vessels, particularly where the inside surface of the skull is rough and uneven; damage occurs at (and sometimes opposite) the point of impact. Thus, specific areas of the brain – most often the frontal and temporal lobes – are damaged. This focal damage often can be detected through MRI and CAT scans.
As a person regains awareness (those with the most serious injuries may never do so), they may have a variety of neurological symptoms such as anger, violence, and other issues. When an injured person regains consciousness, they often develop post-traumatic amnesia (PTA). PTA is a moment in which a person is confused and disoriented – where am I? what happened? – as well as unable to recall recent events.
These responses usually fade with time, and the brain and other bodily systems return to a state of physiological balance. The neurons in the brain, unlike other tissues such as bone or muscle, do not heal on their own. New nerves do not grow in such a way that they will allow you to fully recuperate. Certain parts of the brain are still injured, and the functions regulated by those parts of the brain may present difficulties in the individual’s life.
Before discussing in greater detail what happens to the person after injury, which depends to great extent on the severity of injury, “severity” needs to be defined (in the next question). Recovery after injury is usually quite different for those with moderate-to-severe injuries versus those with mild injuries. And, as must be constantly kept in mind, recovery varies greatly from person to person. Thus, recovery will not be the same for any two people with TBI.
In the case of more serious injuries, recuperation is a multistage process that might take months or years to complete. The length of this healing process, on the other hand, is not consistent, and the stages of recovery that are normal for the population as a whole may be substantially different for any given individual.
Phases may not be sequential and may overlap with one another, or one or more stages may be skipped entirely. The next question delves deeper into the early recovery phase.