What are the long-term effects of a traumatic brain injury?

What a traumatic brain injury is

A traumatic brain injury is damage to the brain caused by an outside force: a blow or jolt to the head, a sudden acceleration and deceleration, or an object penetrating the skull. The brain can move inside the skull in a sudden deceleration, which is why brain injuries occur in collisions with no head strike at all.

Clinicians grade TBI as mild, moderate or severe, based mainly on how the person presented at first: loss of consciousness and how long it lasted, confusion, memory loss around the event, and imaging. A concussion is a mild TBI. The word "mild" describes how the injury presented in the first hours, not how much it will affect a life.

Common causes include falls, car and motorcycle crashes, pedestrian and bicycle collisions, workplace accidents and assaults.

The long-term effects, by area of life

The National Institute of Neurological Disorders and Stroke and the CDC describe lasting TBI effects across several areas. They vary widely from person to person:

• Thinking: slower processing, trouble concentrating, short-term memory gaps, difficulty planning, organizing or doing two things at once
• Mood and behavior: irritability, depression, anxiety, emotional swings, reduced impulse control, and changes in personality that family members often notice first
• Physical: persistent headaches, dizziness and balance problems, fatigue, and after more serious injuries, weakness, coordination problems or seizures
• Senses: sensitivity to light and noise, vision changes, ringing in the ears, changes in taste or smell
• Sleep: insomnia, excessive sleepiness, or disrupted sleep that worsens every other symptom
• Communication: word-finding trouble and difficulty following fast or complex conversation

Research supported by the National Institutes of Health has also linked moderate and severe TBI with a higher risk of some later conditions, including epilepsy and dementia. A risk is not a certainty, and a doctor is the right person to explain what applies to you.

How the effects show up at work and at home

The effects that matter most are often invisible on paper. A person may pass a basic neurological exam and still be unable to handle the pace of their old job, follow a meeting, or manage the family finances. Fatigue that arrives by mid-afternoon can end a career that depended on long shifts.

Family members frequently describe a changed person: shorter temper, less patience with children, withdrawal from friends. Those changes strain marriages and caregiving arrangements, and they are part of the harm the injury caused.

For children, some effects only become clear as they reach later developmental stages, when school demands more of the skills the injury affected.

What long-term effects mean for proving a claim

Because imaging often looks normal after a mild or moderate TBI, lasting effects are proven with other evidence:

• Neuropsychological testing, which measures memory, processing speed, attention and executive function against expected performance
• Treating specialists: neurology, neuropsychology, rehabilitation medicine, speech and occupational therapy
• The documented course of symptoms, which is what separates a lasting injury from a hard few weeks
• Before-and-after witnesses: employers, co-workers, teachers and family who can describe specific changes

Brain injury claims draw surveillance and social media review more than almost any other, so it helps to assume anything posted publicly will be read by the insurer.

Why timing matters in a brain injury claim

The full extent of a brain injury often takes many months to become clear. A settlement accepted before then is priced on incomplete information, and once a release is signed, the claim is usually over. Serious cases are valued with future care costs, lost earning capacity and non-economic losses, and Maryland caps non-economic damages and adjusts that cap over time. See damages in a Maryland personal injury case.

Waiting has limits too. Most Maryland injury lawsuits must be filed within three years of the injury. Claims for someone who was a minor at the time, or for someone who died, follow different timing rules, and claims against a government body can require written notice much sooner. For injuries in crashes, see car accident claims and delayed symptoms after a crash.

Common questions