As we round out the latest year in the twenty-first century, most people these days are familiar with the acronym “TBI” standing for “traumatic brain injury.” Most of us know someone who has one. We may even have a TBI survivor in our immediate or extended family. Perhaps you are even a survivor yourself. Whatever your relationship to TBIs may be, you likely know some of their most common causes.

According to the Mayo Clinic, some of the common causes for brain injury include falls, car crashes, sports injuries, and explosions experienced in combat. One of the lesser-discussed causes of TBI is intimate partner violence. Every year more than ten million women and men in the United States suffer injury at the hands of the person they are closest to – a spouse or domestic partner. Some of those injuries are traumatic brain injuries that can go un-diagnosed for months and even years – often delaying critical treatment.

Some misdiagnoses that I had been handed include personality disorders, generalized anxiety, post-traumatic stress, and moderate to severe depression. I sustained my brain injury as a result of my marriage to Richard Kodadek in 2013. Even the man I lived with who saw me every day did not recognize the signs – changes in personality, eating habits, new food preferences/intolerance, insomnia, night terrors, etc. I cannot say for certain whether his failure to notice these changes was his incompetence as a husband or whether he was intentionally gas lighting me by perpetually denying any notice of these obvious changes in my thinking and behavior. At any rate, his confirmation of what the doctors had claimed – that I was mentally ill – only reinforced their inaccurate and harmful claims.

My goal for this post is critical to anyone who may love or care about someone who has or does sustain a traumatic brain injury. Please review and make a mental note of the signs and symptoms of a brain injury. I lost several years that I could have been in treatment for my brain injury to spending time in and out of psychiatric wards, losing jobs, losing dear relationships, and losing my very sense of self. You may be able to help set someone on the correct path to recovery by suggesting they get screened by a brain injury specialist.

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The following information is from Mayo Clinic:

Complications

Several complications can occur immediately or soon after a traumatic brain injury. Severe injuries increase the risk of a greater number of and more-severe complications.

Altered consciousness

Moderate to severe traumatic brain injury can result in prolonged or permanent changes in a person’s state of consciousness, awareness or responsiveness. Different states of consciousness include:

• Coma. A person in a coma is unconscious, unaware of anything and unable to respond to any stimulus. This results from widespread damage to all parts of the brain. After a few days to a few weeks, a person may emerge from a coma or enter a vegetative state.
• Vegetative state. Widespread damage to the brain can result in a vegetative state. Although the person is unaware of surroundings, he or she may open his or her eyes, make sounds, respond to reflexes, or move.It’s possible that a vegetative state can become permanent, but often individuals progress to a minimally conscious state.
• Minimally conscious state. A minimally conscious state is a condition of severely altered consciousness but with some signs of self-awareness or awareness of one’s environment. It is sometimes a transitional state from a coma or vegetative condition to greater recovery.
• Brain death. When there is no measurable activity in the brain and the brainstem, this is called brain death. In a person who has been declared brain dead, removal of breathing devices will result in cessation of breathing and eventual heart failure. Brain death is considered irreversible.

Physical complications

• Seizures. Some people with traumatic brain injury will develop seizures. The seizures may occur only in the early stages, or years after the injury. Recurrent seizures are called post-traumatic epilepsy.
• Fluid buildup in the brain (hydrocephalus). Cerebrospinal fluid may build up in the spaces in the brain (cerebral ventricles) of some people who have had traumatic brain injuries, causing increased pressure and swelling in the brain.
• Infections. Skull fractures or penetrating wounds can tear the layers of protective tissues (meninges) that surround the brain. This can enable bacteria to enter the brain and cause infections. An infection of the meninges (meningitis) could spread to the rest of the nervous system if not treated.
• Blood vessel damage. Several small or large blood vessels in the brain may be damaged in a traumatic brain injury. This damage could lead to a stroke, blood clots or other problems.
• Headaches. Frequent headaches are very common after a traumatic brain injury. They may begin within a week after the injury and could persist for as long as several months.
• Vertigo. Many people experience vertigo, a condition characterized by dizziness, after a traumatic brain injury.

Sometimes, any or several of these symptoms might linger for a few weeks to a few months after a traumatic brain injury. When a combination of these symptoms lasts for an extended period of time, this is generally referred to as persistent post-concussive symptoms.

Traumatic brain injuries at the base of the skull can cause nerve damage to the nerves that emerge directly from the brain (cranial nerves). Cranial nerve damage may result in:

• Paralysis of facial muscles or losing sensation in the face
• Loss of or altered sense of smell or taste
• Loss of vision or double vision
• Swallowing problems
• Dizziness
• Ringing in the ear
• Hearing loss

Intellectual problems

Many people who have had a significant brain injury will experience changes in their thinking (cognitive) skills. It may be more difficult to focus and take longer to process your thoughts. Traumatic brain injury can result in problems with many skills, including:

Cognitive problems

• Memory
• Learning
• Reasoning
• Judgment
• Attention or concentration

Executive functioning problems

• Problem-solving
• Multitasking
• Organization
• Planning
• Decision-making
• Beginning or completing tasks

Communication problems

Language and communications problems are common following traumatic brain injuries. These problems can cause frustration, conflict and misunderstanding for people with a traumatic brain injury, as well as family members, friends and care providers.

Communication problems may include:

• Difficulty understanding speech or writing
• Difficulty speaking or writing
• Inability to organize thoughts and ideas
• Trouble following and participating in conversations

Communication problems that affect social skills may include:

• Trouble with turn taking or topic selection in conversations
• Problems with changes in tone, pitch or emphasis to express emotions, attitudes or subtle differences in meaning
• Difficulty understanding nonverbal signals
• Trouble reading cues from listeners
• Trouble starting or stopping conversations
• Inability to use the muscles needed to form words (dysarthria)

Behavioral changes

People who’ve experienced brain injury may experience changes in behaviors. These may include:

• Difficulty with self-control
• Lack of awareness of abilities
• Risky behavior
• Difficulty in social situations
• Verbal or physical outbursts

Emotional changes

Emotional changes may include:

• Depression
• Anxiety
• Mood swings
• Irritability
• Lack of empathy for others
• Anger
• Insomnia

Sensory problems

Problems involving senses may include:

• Persistent ringing in the ears
• Difficulty recognizing objects
• Impaired hand-eye coordination
• Blind spots or double vision
• A bitter taste, a bad smell or difficulty smelling
• Skin tingling, pain or itching
• Trouble with balance or dizziness

Degenerative brain diseases

The relationship between degenerative brain diseases and brain injuries is still unclear. But some research suggests that repeated or severe traumatic brain injuries might increase the risk of degenerative brain diseases. But this risk can’t be predicted for an individual — and researchers are still investigating if, why and how traumatic brain injuries might be related to degenerative brain diseases.

A degenerative brain disorder can cause gradual loss of brain functions, including:

• Alzheimer’s disease, which primarily causes the progressive loss of memory and other thinking skills
• Parkinson’s disease, a progressive condition that causes movement problems, such as tremors, rigidity and slow movements
• Dementia pugilistica — most often associated with repetitive blows to the head in career boxing — which causes symptoms of dementia and movement problems