WHAT IS A TBI?
The language used to describe Traumatic Brain Injuries (TBIs) can be confusing or misleading. For example, while most people are familiar with the word “concussion,” many do not realize that the term refers to only the mildest form of TBI. Understanding TBI categories, symptoms, and progression over time allows TBI patients to make informed, confident decision about their care.
The TBI Spectrum
Three TBI categories fall along a spectrum ranging from mild/short-term to severe/long-term. The TBI Spectrum illustrates the way a TBI may progress over time; however, most TBIs (70%) are mild and resolve within 10 days.
1 TBI / CONCUSSION
At the time of a head impact, all traumatic brain injuries fall under the “TBI” category. TBIs may be considered Mild, Moderate, or Severe, based on five criteria, including MRI results, duration of unconsciousness, amnesia, or altered mental state, and score on the Glasgow Coma Scale. Mild TBIs, known as Concussions, are the most common. They make up 70% of all TBIs and usually resolve in 7-10 days.
Accurate diagnosis, early treatment, and specific instructions about resuming activity helps keep a mild TBI from progressing to more severe stages of brain injury.
2 POST-CONCUSSIVE SYNDROME (PCS)
If Concussion symptoms last more than 10 days, the TBI is diagnosed as Post-Concussive Syndrome. Concussion and PCS symptoms are the same, but over time, their frequency and severity change until they are almost reversed in order.
PCS is classified as Acute if symptoms resolve within a few weeks, or Chronic if they last for more than 30 days. Left untreated, PCS can greatly impact daily functions and quality of life.
3 NEURODEGENERATIVE DISORDERS (NDD) / MEMORY DISORDERS
Over many years, a small percentage of TBIs may progress to memory disorders such as Alzheimer’s disease, ALS, Parkinson’s-like motor disorders, or Chronic Traumatic Encephalopathy (CTE). These disorders damage brain cells, causing difficulties with memory, mood/emotions, or movement. Symptoms of memory disorders can be debilitating, and typically worsen over time. Early treatment can help slow disease progression or reduce symptoms.
Recent research developments have produced new understanding of CTE. Studies are revealing a connection between head trauma and the incidence of CTE later in life. CTE symptoms can be severe and may include personality changes, impulse control, or even violent behavior. Researchers’ discovery of CTE in the brains of deceased NFL and ice hockey players, athletes in other sports, and veterans highlights the need to understand the long-term risks of multiple head impacts.
Because some symptoms of TBI/Concussion, PCS, and NDD/Memory Disorders are similar, an individual concerned with head impact or cognitive changes should be evaluated by a neurologist, neuropsychiatrist, or neuropsychologist specializing in TBI and memory disorders. Without expert, comprehensive assessment of injury, history, and risk factors, symptoms can be easy to miss or misinterpret, putting a patient at risk for an incorrect diagnosis. In addition, because scientists learn more about TBI symptoms and care every day, patients benefit from working with practitioners actively involved in research.
Symptoms of concussion are the way a brain indicates that something is wrong and requires appropriate care. Just as an athlete must treat the symptoms of a sprained ankle to help prevent future ligament problems, a person who experiences head trauma must treat symptoms of a concussion to help prevent future brain disorders. Early diagnosis and treatment by a TBI specialist can help improve or resolve TBI symptoms. Treatment depends on factors such as type and severity of injury, medical history, and genetics.