What really happens inside your brain after a head injury

Article Summary

A TBI occurs when a forceful impact disrupts normal brain function. Dr. Nicole Reams explains what happens inside the brain after a blow, symptoms, how injuries are managed, and why medical evaluation is essential for a safe recovery.

Maybe the following scenario sounds familiar: someone you know was playing a sport, hiking or walking down some icy steps when they fell and hit their head. While they initially got up and insisted they were fine, you saw the symptoms later: headache, a foggy head, irritability.

When it comes to a head injury, what you see on the outside doesn't always tell the whole story.

Traumatic brain injuries, or TBIs, can range from mild to severe. Symptoms don't always appear right away. Nicole Reams, MD, a general and sports neurologist at Endeavor Health, walks us through what actually happens after a blow to the head, and how long it takes to recover.

What is a TBI?

"A TBI occurs when a blow to the head disrupts the normal function of the brain," explained Dr. Reams. "A concussion is considered a mild TBI, while more serious injuries can involve bleeding, swelling, or significant damage to brain tissue."

TBIs can happen in car crashes, falls, sports injuries, or workplace accidents - any situation where the head experiences a forceful impact.

What happens inside the brain after a head injury?

The brain is a delicate organ that essentially floats inside the skull. When the head is suddenly jolted, the brain can collide with the inside of the skull. This movement can damage brain cells (neurons) and their connections to each other.

This damage can also trigger a cascade of chemical changes that affect how brain cells communicate and use energy. Damage to blood vessels can cause bleeding, and inflammation and swelling can develop around the injured tissue.

With more serious TBIs, bleeding or swelling can increase the pressure inside the skull, interfering with normal brain function.

"Sometimes effects happen immediately, while other symptoms can develop over hours or even days," said Dr. Reams. "That's why medical evaluation is important after a significant head injury, even if someone initially seems okay."

What are the symptoms of a TBI?

"TBI symptoms can vary widely because they depend on the severity and location of the injury," explained Dr. Reams. "Symptoms typically include headaches, dizziness, nausea, fatigue, blurred vision, and sensitivity to light or noise."

In the hours or days following a head injury, people may also notice problems with memory, concentration and coordination. They may also experience emotional and behavioral changes, such as irritability, anxiety, sadness or feeling unusually overwhelmed.

After a more serious TBI, symptoms may include confusion, loss of consciousness, seizures, weakness, or slurred speech. These symptoms require immediate medical attention.

How are TBIs treated?

Treating a TBI depends on the type and severity of the injury and the diagnosis. Someone with a mild TBI can usually manage it with rest, gradually returning to normal activities while they continue to monitor symptoms.

More significant injuries may require hospitalization. A neurologist may order imaging through CT or MRI scans and will monitor closely for brain swelling or bleeding.

"Sometimes, severe TBIs require interventions like surgery or medication," said Dr. Reams. "Recovery may also involve physical, occupational or speech therapy to help the patient regain skills and return to everyday activities."

What is the typical timeline for TBI recovery?

TBI recovery varies depending on the injury and the person. Many people with mild TBIs improve in a few days or weeks, although some symptoms can last for several weeks or longer. Moderate and severe TBIs generally take months or even years for a full recovery.

"When it comes to TBI recovery, the most important thing is to focus on the individual rather than the calendar," said Dr. Reams. "It's important that if you or someone you love experiences a head injury, don't 'wait it out' - see a neurologist who can assess the injury and help you make a full recovery."