Definitions of Head Injuries - What You Need To Know

Concussions To TBI-Traumatic Brain Injury

A Healthy Adult Human Brain

Anyone can have a brain injury. You can get one just by falling down and hitting your head, like my friend Constant Walker did. and he said that he just fell off his steps and hit his head three times before being knocked unconscious. He describes his TBI on his: I'm No Superman. It changed his whole outlook about life and his thinking. He is still dealing with his physical injuries to his ear as well as some dizziness and other complications that are now a part of his life.

One can also get a head injury by being in a Car Accident like my husband did. Each individual will have many different symptoms. Babies are not excluded in either because "Shaken Baby Syndrome" is a Traumatic Brain Injury that leads to death.

What Is A Traumatic Brain Injury

This is what the Brain Injury Association of America has to say about Traumatic Brain Injury.

"A traumatic brain injury occurs when an outside force impacts the head hard enough to cause the brain to move within the skull or if the force causes the skull to break and directly hurts the brain.
A direct blow to the head can be great enough to injure the brain inside the skull. A direct force to the head can also break the skull and directly hurt the brain. This type of injury can occur from motor vehicle crashes, firearms, falls, sports, and physical violence, such as hitting or striking with an object.
A rapid acceleration and deceleration of the head can force the brain to move back and forth across the inside of the skull. The stress from the rapid movements pulls apart nerve fibers and causes damage to brain tissue. This type of injury often occurs as a result of motor vehicle crashes and physical violence, such as Shaken Baby Syndrome."


A Closed Head Injury is one that occurs from Front To Back and Side To Side. An Open Head Injury, according to the Brain Injury Association of America,

Open Head Injury ..."If the force that hits a person's head is great enough, the skull can fracture or become out of place. When this happens, the person is described as having an "open head injury". This terminology is referring to the condition of the skull and not the brain. Separate terms are used to describe the condition of the brain. For example, a person may be described to have an open head injury with a severe traumatic brain injury."

A Closed Head Injury is ..."when a person receives an impact to the head from an outside force, but the skull does not fracture or displace this condition is termed a "closed head injury". Again, separate terminology is added to describe the brain injury. For example, a person may have a closed head injury with a severe traumatic brain injury. "

The Levels of Brain Injury

A Concussion occurs when there is a small interval where the person becomes unconscious. It doesn't always have to appear that way. The person may be dazed or confused.  Testing or scans of the brain may appear normal
A concussion is diagnosed only when there is a change in the mental status at the time of injury which means the person's brain functioning has been altered.

Symptoms of concussion:

• Headache
• Fatigue
• Sleep disturbance
• Irritability
• Sensitivity to noise or light
• Balance problems
• Decreased concentration and attention span
• Decreased speed of thinking
• Memory problems
• Nausea
• Depression and anxiety
• Emotional mood swings

A moderate traumatic brain injury occurs when:
A loss of consciousness lasts for more than a few minutes to more than an hour.  Confusion lasts from days to weeks,  Physical, cognitive, and/or behavioral impairments last for months or are permanent.

Persons with a moderate traumatic brain injury generally can make a good recovery with treatment or successfully learn to compensate for their deficits.

[1 of 6] "You Look Great!" : Inside a TBI

Severe Traumatic Brain Injury

Severe brain injury occurs when a prolonged unconscious state or coma lasts days, weeks, or months. Severe brain injury is further categorized into subgroups with separate features:

• Coma
• Vegetative State
• Persistent Vegetative State
• Minimally Responsive State
• Akinetic Mutism
• Locked-in Syndrome

A Coma is defined as a state of unconsciousness from which the individual cannot be awakened, in which the individual responds minimally or not at all to stimuli, and initiates no voluntary activities. Persons in a coma appear to be asleep, but can't be woke up.  There is no  response to stimulation.

Persons who have a Traumatic Brain Injury can make significant improvements, but are often left with permanent physical, cognitive, or behavioral problems.
Department of Defense and Veteran’s Head Injury Program & Brain Injury Association of America (1999). Brain Injury and You. Vegetative State (VS) Vegetative State (VS) describes a severe brain injury as "Arousal is present, but the ability to interact with the environment is not. Eye opening can be spontaneous or in response to stimulation General responses to pain exist, such as increased heart rate, increased respiration, posturing, or sweating
Sleep-wakes cycles, respiratory functions, and digestive functions return."
Currently there lacks a test to diagnose a Vegetative State; the diagnosis is made only by repeating neurobehavioral evaluations on the patients.

Persistent Vegetative State (PVS) Persistent Vegetative State (PVS) is a term used for a Vegetative State that has lasted for more than a month.
The criteria is the same as for Vegetative State

"The use of this term is considered controversial because it implies a prognosis." Giacino, J. & Zasler, N. (1995). "Outcome after severe traumatic brain injury: Coma, the vegetative state, and the minimally responsive state. Journal of Head Trauma Rehabilitation, 10, 40-56."

Minimally Responsive State (MR) is the term used for a severe traumatic brain injury in which a person is no longer in a coma or a Vegetative State. Persons in a Minimally Responsive State exhibit

• Primitive reflexes
• Inconsistent ability to follow simple commands
• An awareness of environmental stimulation

"The frequency and the conditions in which a response was made are considered when assessing the meaningfulness or purposefulness of a behavior." Giacino, J. & Zasler, N. (1995). Outcome after severe traumatic brain injury: Coma, the vegetative state, and the minimally responsive state. Journal of Head Trauma Rehabilitation, 10, 40-56".

Akinetic Mutism is a neurobehavioral condition that results when the dopaminergic pathways in the brain are damaged. Damage to these pathways results in:

• Minimal amount of body movement
• Little or no spontaneous speech
• Speech which can be elicited (For example, the person can answer a question if asked, but otherwise does not voluntarily start saying anything).
• Eye opening and visual tracking
• Infrequent and incomplete ability to follow commands
• Vigilance and agitation for Frontal Akinetic Mutism

Locked in Syndrome is a rare neurological condition in which a person cannot physically move any part of the body except the eyes. The person is conscious and able to think. Vertical eye movements and blinking can be used to communicate with others and operate certain machines that are available for the use by these types of patients.

Brain death can result from a very severe injury to the brain. When brain death occurs, the brain shows no sign of functioning. The physician performs a specific formal brain death examination. For information and resources about brain injury, please contact the Brain Injury Association of America’s Helpline at 1-800-444-6443"

In The News

They are now finding out that those soldiers who are coming from war zones such as Iraq and Afghanistan have come back with mild traumatic brain injuries.which they think can cause the Post Traumatic Stress Disorder.

A snippet from this news article, Soldiers' Head Injuries May Contribute to PTSD, by Alix Spiegel
"Traumatic brain injury has been labeled the signature injury of the Iraq war. It's estimated that between 10 percent and 20 percent of soldiers who have served in Iraq have suffered from this kind of wound."

In another article of a study in the New England Journal of Medicine suggests that even concussions, may be associated with long-term health problems, specifically post-traumatic stress disorder, or PTSD.

In an article on Medical News Today research has been done and found that Moderate Alcohol Helps You Survive Brain Injury. You can read the full article there. Some of what is in that article:

"The study is published in the Archives of Surgery and was led by Dr Homer Tien, trauma surgeon at the Sunnybrook Health Science Centre in Toronto. Dr Tien and his team looked at 16 years of trauma registry data from 1988 to 2003 describing patients admitted with traumatic brain injury (TBI) due to blunt head trauma, resulting from a road accident for example. They analysed the results of 1158 patients according to their blood alcohol level: None (0 milligrams per decilitre, 0mg/dL), low to moderate (under 230mg/dL), and high (230mg/dL and above)."

I suggest you watch the video below. It is chock full of information about Brain Injuries. There are many peoples who have their stories about how they are coping with their own Brain Injuries.

If you know someone who has had a brain injury please be patient with them and love them with all your heart--no matter what happens. They need consistency and love and to know that someone is there for them when things get out of hand or frustrating. Sometimes that may be simply walking away for a few minutes, hours or days. Get into a support group for the both of you. They will teach you things and you will have others to share your story with. Remember they also came from an accident or injury as a totally different person. It isn't their fault and it isn't an ending but a new beginning.

• Brain Injury Association of America
• National Institute of Neurological Disorders and Stroke --TBI Information Page
• Mild Traumatic Brain Injury 
• The Perspective Network The Perspectives Network, Inc.'s primary focus is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury.
• Mind Menders Support Group The Mission of Mind Menders is to empower survivors of brain injury as they learn, work, and play in the community.
• SECOND CHANCE TO LIVE Empowering Individuals to Empower Themselves, Their Dreams and Their Destinies
• Dealing With Invisible Disability: But You Look Well!
• I have a brain injury - this is a typical day!