Knowing the Signs, Recognizing TBI

By Danielle M. Bolton and Hospital Corpsman 1st Class Tyrone Kimbrough, Naval Hospital Camp Lejeune Public Affairs

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TBI’s among military members can occur from variable types of methods during war. However, studies show that TBI’s happen more frequently from everyday activities.

He used to be a good Marine. He was on point; always ready to go. He was the go-to-man; meritoriously promoted for his stellar performance. That was then. That was before. Now, he forgets simple things. He is late. He forgot to set an alarm again. He is always complaining of a headache. It’s like he is not really here.

Traumatic brain injuries can occur at any time, in any age and occupational or recreational settings.  An abrupt blow occurring from many everyday activities such as soccer, football, and vehicle accidents can cause traumatic brain injuries, and they normally go undetected because it can’t necessarily be seen.

“TBI is similar to some other brain disabilities, such as strokes and some genetic brain disorders, which are invisible to the human eye,” said Suzanne G. Martin, a senior scientist and clinical psychologist with Defense and Veterans Brain Injury Center and Intrepid Spirit Concussion Recovery Center. “If someone has a physical injury, such as a broken bone, it is obvious that there is an injury, while with TBI, it may not be obvious unless there is a clear deficit, such as loss of speech or paralysis. It is different from other brain disabilities in the causing mechanism – physical trauma, versus a neurological or genetic error.”

Brain injuries come in many forms – from mild to severe; mild brain concussions can happen among military personnel. The Glasgow Coma Scale is used to assess the severity of a brain injury and the Brain Injury Association of America warns readers not to be misled by the titles – a mild TBI is not something to be taken lightly.   Knowing the signs and symptoms is key to seeking treatment sooner, however individuals don’t because they confuse the difference between a concussion and a TBI.

“All concussions are TBIs, but not all TBIs are concussions,” said Capt. Thomas Johnson, the director of Naval Hospital Camp Lejeune, Intrepid Spirit Concussion Recovery Center, who explained that a TBI is an external force applied to the brain that makes a change in physical functioning or cognitive abilities. “A concussion is a mild type of TBI.”

Some symptoms of mild TBI include headache, fatigue, sleep disturbance, irritability, sensitivity to noise or light, balance problems, decreased concentration and attention span, decreased speed of thinking, memory problems, nausea, depression and anxiety, and emotional mood swings, according to the BIAA website.

The next classification of TBI is moderate, which occurs when there is a loss of consciousness that lasts from a few minutes to a few hours, when confusion lasts from days to weeks, or when physical, cognitive, and/or behavioral impairments last for months or are permanent, according to the BIAA website. “Mild and severe TBI can also have permanent effects,” said Johnson. The website explains that individuals with moderate TBI generally can make a good recovery with treatment.

Severe brain injury occurs when a prolonged unconscious state or coma lasts days, weeks, or months.

The myth about TBI’s among military members is that they always occur during combat, according to Louis M. French,  in an Annals of the New York Academy of sciences article that examines the important differences of TBI’s as they occur from variable types of methods during war. However, it has been shown in many studies that TBI’s occur more frequently due to everyday activities.

The truth about TBI’s is the signs and symptoms of concussions, and mild and moderate brain injuries are commonly overlooked because of how subtle they may appear in victims.

This factor within itself leads to various times of symptomatic experiences, some being as short as a few days, and others enduring for weeks or longer. Recognizing the symptoms after TBI injuries such as misperception, headaches, lightheadedness, and amnesia should be the deciding factor to eliminate vigorous activities until further instructions from a health professional, according to Martin.

Traumatic brain injuries can occur anywhere and can happen to anyone. However, knowing how to recognize the symptoms and knowing that it is treatable should be a relief to everyone, said Martin. If you feel like yourself, or anyone around you may have a TBI, contact your nearest health care provider for an evaluation.