Traumatic Brain Injury Overview

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Human brain isolated on dark background. 3D render

Traumatic Brain Injury (TBI), often called the signature wound of the Iraq and Afghanistan wars, occurs when a sudden trauma or head injury disrupts the function of the brain. Common causes of TBI include damage caused by explosive devices, falls and vehicle or motorcycle accidents. Most reported TBI among Operation Enduring Freedom and Operation Iraqi Freedom servicemembers and veterans has been traced back to Improvised Explosive Devices, or IEDs, used extensively against Coalition Forces.

What is TBI?

TBI may happen from a blow or jolt to the head or an object penetrating the brain. When the brain is injured, the person can experience a change in consciousness that can range from becoming disoriented and confused to slipping into a coma. The person might also have a loss of memory for the time immediately before or after the event that caused the injury.  Not all injuries to the head result in a TBI. See our Glossary of TBI-related terms for more information.

How Does TBI Happen?

TBI can come from:

  • The head being struck by an object, such as a bat or a fist during a fight
  • The head striking an object, such as the dashboard in a car accident or the ground in a fall, or
  • The head being affected by a nearby blast or explosion.

Range of Symptoms

Symptoms can appear immediately or weeks to months following the injury. Depending upon the severity of the wound, TBI injuries fall into different categories: 

Mild TBI

Otherwise known as a concussion, mild TBI is more difficult to diagnose both in civilian life and on the military battlefield.

With mild TBI patients, full recovery can be within minutes to hours; a small percentage have symptoms that may persist months or years.

Symptoms of mild TBI include headache, dizziness, nausea/vomiting, trouble concentrating, memory problems, irritability.

Moderate TBI

This includes a population of patients that falls between the mild and severe spectrum. Moderate TBI patients have the most variability in their symptoms.

There is usually loss of consciousness, from an hour to a day; there can be confusion for days to weeks; and mental or physical deficits that can last months or be permanent.

Severe TBI

This injury usually results from a significant closed head injury, as in an automobile accident or most open or penetrating injuries, where there may be considerable residual deficits of brain function.

Depending on the injury, a severe TBI could impact speech, sensory, vision and cognitive deficits including difficulties with attention, memory, concentration, and impulsiveness.

What are the consequences of TBI?

TBI can cause a number of difficulties for the person who is injured. This can include physical changes, changes in the person’s behavior, or problems with their thinking skills.

After an injury, a number of symptoms might be noted including headaches, dizziness/problems walking, fatigue, irritability, memory problems and problems paying attention.

These changes are often related to how severe the brain injury was at the time of injury.

Diagnosis

Beginning in 2007, VA implemented mandatory TBI screening for all veterans accessing care in  that served in combat operations and separated from active duty service after September 11, 2001. The four question screen identifies veterans who were exposed to events that increase the risk of TBI and who experience symptoms that may be related to that specific event or events.

A positive screen does not diagnose TBI. It only indicates the need for further evaluation for possible TBI.  Veterans who screen positive with the TBI screening tool are offered a comprehensive TBI evaluation with a specialty provider who can determine whether they have suffered a TBI.

Depending on the needs of the veteran, other members of the rehabilitation team such as social workers, physical and occupational therapists, speech-language pathologists, psychologists, and others may be involved in the comprehensive evaluation to help determine whether the veteran has difficulties that may be helped with rehabilitation treatments.  

The results of the comprehensive evaluations are discussed with the veteran and recommendations are made for follow-on care with primary care and other specialty providers, as necessary.  If rehabilitation treatments are indicated, the veteran is asked to collaborate with the rehabilitation team to develop a care plan that addresses their recovery goals. The care plan includes information about the types of treatment recommended, their frequency, and the timeline for when the rehabilitation goals are expected to be achieved.

Care and Treatment

VA has a Polytrauma System of Care to treat and care for veterans with TBI.  Depending on their health care needs, veterans with TBI can get treatment at one of the specialized rehabilitation programs in the Polytrauma System of Care, or they can seek treatment through their local VA Medical Center or community healthcare providers. 

Treatments for TBI focus on the symptoms that cause most problems in everyday life. These can include:

  • Medications;
  • Learning strategies to deal with health, cognitive, and behavioral problems;
  • Rehabilitation therapies (such as physical therapy, occupational therapy, speech-language therapy);
  • Assistive devices and technologies.     

For more details on the VA's TBI System of Care please visit our TBI Rehabilitation Page.

Disability Compensation

Depending on the extent of the injury, vets are eligible up to 100% disability rating. If you are military veteran with a service-related disability you may qualify for compensation ranging from $133 to more than $3,300 in monthly benefits. Learn more about veteran disability compensation.

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