Traumatic brain injury (TBI) can cause a wide range of clinical features depending on the severity and location of the injury.
Symptoms that may appear immediately:
Loss of consciousness (can range from brief seconds to prolonged coma)
Headache
Dizziness
Confusion
Nausea or vomiting
Fatigue
Blurred vision
Ringing in the ears
Difficulty concentrating
Difficulty speaking
Seizures
Symptoms that may develop over time:
Emotional problems such as irritability, frustration, or depression
Difficulty sleeping
Difficulty thinking clearly or making decisions
Memory problems
Speech problems
Sensory problems (like numbness or tingling)
Balance problems
Coordination problems
Weakness in arms or legs
Here are some additional points to consider:
Infants and young children may not be able to communicate their symptoms.
People with pre-existing medical conditions may experience different symptoms or have a more complex recovery.
When a detailed history is unavailable, remember: the loss of consciousness may have preceded (and possibly have caused) the trauma. Therefore, maintain an index of suspicion for e.g. aneurysmal subarachnoid hemorrhage, hypoglycemia, etc. in the differential diagnosis of the causes of trauma and associated coma.
≈ 15% of patients who do not initially exhibit signs of significant brain injury may deteriorate in a delayed fashion, sometimes referred to as patients who “talk and deteriorate” or when more lethal, patient who “talk and die”.