What is TBI? Understanding Traumatic Brain Injury: Causes, Symptoms, and Treatments

A traumatic brain injury (TBI) occurs when an external force causes damage to the brain. This injury can result from a forceful bump, blow, or jolt to the head or body, or when an object penetrates the brain tissue. It’s important to note that not every impact to the head leads to a TBI, but when it does, the consequences can range from temporary to severe.

Depending on the nature and severity, a TBI can disrupt brain function, leading to temporary or long-term problems. These issues can affect various aspects of a person’s life, including their cognitive abilities (thinking, understanding), physical functions (movement), communication skills, and emotional regulation. In the most serious cases, TBI can result in permanent disability or even be fatal.

The timeline of damage in TBI is crucial. Some injuries are primary, meaning the damage is immediate and occurs at the moment of impact. However, secondary injuries can develop over hours, days, or even weeks after the initial trauma. These secondary injuries are the result of complex biological processes triggered by the initial head trauma and can significantly worsen the overall outcome.

Traumatic brain injuries are broadly categorized into two main types: penetrating and non-penetrating.

1. Penetrating TBI (Open TBI): This type of injury happens when an object breaches the skull and enters the brain tissue. Common causes include bullets, shrapnel, bone fragments from skull fractures, or other sharp objects. Penetrating TBIs are often localized, damaging a specific area of the brain directly in the path of the penetrating object.
2. Non-penetrating TBI (Closed Head Injury or Blunt TBI): This is caused by an external force that is strong enough to move the brain within the skull, without penetrating it. Common causes of non-penetrating TBI include falls, motor vehicle accidents, sports injuries, blast injuries (like explosions), or being struck by a blunt object. The brain can be injured by impact against the inside of the skull.

It is also possible for a single traumatic event to cause both penetrating and non-penetrating injuries in the same individual.

Signs and Symptoms of Traumatic Brain Injury

Symptoms of a TBI can manifest immediately after the injury, while others may appear or become more noticeable over time. Headaches, dizziness, confusion, and fatigue are common initial symptoms that often improve in the short term. Emotional symptoms, such as frustration and irritability, may emerge as the person recovers.

It is critical to seek immediate medical attention if someone experiences any of the following symptoms, particularly in the first 24 hours after a head injury:

Physical Symptoms of TBI

• Headache, especially if it worsens
• Convulsions or seizures
• Blurred vision or double vision
• Unequal pupil size or dilation of pupils
• Clear fluid draining from the nose or ears (this could be cerebrospinal fluid)
• Nausea and vomiting, especially persistent vomiting
• New neurological problems such as:
  • Slurred speech
  • Weakness in arms, legs, or face
  • Loss of balance or coordination

Cognitive/Behavioral Symptoms of TBI

• Loss of consciousness or altered consciousness, even briefly (from seconds to hours)
• Decreased level of consciousness, such as difficulty waking up or being unusually drowsy
• Confusion or disorientation about time, place, or person
• Memory problems, difficulty concentrating, or problems making decisions
• Changes in sleep patterns, including:
  • Sleeping more than usual (hypersomnia)
  • Difficulty falling asleep or staying asleep (insomnia)
  • Inability to wake up
• Emotional and behavioral changes such as:
  • Frustration, irritability
  • Increased anxiety or agitation
  • Unusual or inappropriate behavior

Perception and Sensation Symptoms of TBI

• Lightheadedness, dizziness, vertigo (spinning sensation), or loss of balance or coordination
• Vision changes like blurred vision or difficulty focusing
• Hearing problems, such as ringing in the ears (tinnitus) or decreased hearing
• Unexplained bad taste in the mouth or changes in the sense of smell
• Increased sensitivity to light (photophobia) or sound (phonophobia)
• Mood changes or swings, agitation, combativeness, or other unusual behavior
• Feelings of anxiety or depression
• Fatigue or drowsiness, lack of energy or motivation

TBI in Children

Children may not be able to effectively communicate how they feel after a head injury, making it crucial for caregivers to be vigilant. Adults should closely observe a child’s behavior and ask about potential symptoms following any head trauma. Signs and symptoms of TBI in children may include:

• Changes in eating habits or nursing habits (in infants)
• Persistent crying, irritability, or increased crankiness; inconsolability
• Changes in attention span or ability to focus
• Loss of interest in favorite toys or activities
• Changes in sleep patterns
• Seizures
• Expressing sadness or appearing withdrawn
• Loss of previously acquired skills, such as toilet training
• Loss of balance or unsteady walking
• Vomiting, especially repeated vomiting

TBI’s Effects on Consciousness

Severe TBI can significantly impact a person’s state of consciousness, awareness, alertness, and responsiveness. There are generally four abnormal states of consciousness that can result from a severe TBI:

1. Minimally Conscious State (MCS): Individuals in this state show inconsistent but discernible signs of self-awareness or awareness of their environment. This may include following simple commands, responding with yes/no gestures or words, or visually tracking objects.
2. Unresponsive Wakefulness Syndrome (UWS) (Vegetative State): UWS results from widespread and severe brain damage. People in this state are unconscious and unaware of their surroundings. They may have periods of being awake (eyes open) but show no purposeful responses to stimuli, only reflexive actions. They may groan, move limbs without purpose, or exhibit reflex responses.
3. Coma: A person in a coma is completely unconscious, unaware of themselves and their surroundings, and unable to respond to external stimuli such as pain or light. Coma is usually a temporary state, lasting from a few days to a few weeks. After this period, individuals may regain consciousness, transition to a vegetative state, or, unfortunately, die.
4. Brain Death: Brain death is the irreversible cessation of all brain function, including brainstem activity. It is diagnosed after a prolonged period of no measurable brain function or activity. Tests confirming the absence of blood flow to the brain are used to confirm brain death.

How Does TBI Affect the Brain?

The damage caused by TBI can be localized to a specific area of the brain (focal injury) or spread across a wider region (diffuse injury). The type of injury mechanism also influences the pattern of brain damage. Common types of brain damage seen in TBI include bleeding, swelling, and tearing of nerve fibers. This initial damage can trigger a cascade of secondary events, leading to inflammation, further swelling, and metabolic changes within the brain.

• Diffuse Axonal Injury (DAI): DAI is one of the most prevalent types of brain injury, characterized by widespread damage to the brain’s white matter, the nerve fibers that transmit signals throughout the brain. DAI commonly occurs in events like auto accidents, falls, and sports injuries where there is significant acceleration and deceleration of the head. DAI disrupts communication between nerve cells in the brain, leading to a breakdown of neural networks. It also triggers the release of brain chemicals that can cause further damage. The resulting brain damage can be temporary or permanent, and recovery from DAI can be a long process.

• Concussion: Concussion is considered a mild form of TBI, but it’s still a significant injury that can have lasting effects. It’s caused by a bump, blow, or jolt to the head or body that causes the brain to move rapidly inside the skull. Common causes include sports injuries, falls, motor vehicle accidents, or violent shaking. Concussion may or may not involve a loss of consciousness, but there is always a change in awareness or consciousness. A particularly dangerous scenario is a “second hit” concussion, where a second concussion occurs before full recovery from the first. This can lead to severe, even fatal, consequences. Post-concussion syndrome refers to persistent symptoms that last for weeks, months, or even longer after the initial injury.

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  Hematomas: Hematomas are collections of blood within or around the brain, usually caused by a ruptured blood vessel. Different types of hematomas are classified by their location relative to the meninges, the protective membranes surrounding the brain:

  • Epidural Hematomas: Bleeding occurs between the skull and the dura mater (the outermost layer of the meninges). These hematomas can develop rapidly, within minutes to hours after injury, and are particularly dangerous due to the pressure they exert on the brain.
  • Subdural Hematomas: Bleeding occurs between the dura mater and the arachnoid mater (the middle layer of the meninges). Similar to epidural hematomas, they compress the brain. Subdural hematomas are common in older adults, especially after falls.
  • Subarachnoid Hemorrhage: Bleeding occurs between the arachnoid mater and the pia mater (the innermost layer of the meninges). This type of bleeding is often associated with aneurysms but can also be caused by trauma.
  • Intracerebral Hematoma: Bleeding occurs directly within the brain tissue itself. This damages the surrounding brain tissue and can cause significant neurological deficits.

• Contusions: Brain contusions are bruises or swelling of the brain tissue, caused by small blood vessels leaking blood into the brain tissue. Contusions often occur due to the brain striking the inside of the skull. A coup injury is a contusion directly under the point of impact. More commonly, a contrecoup injury occurs on the opposite side of the brain from the impact, as the brain rebounds against the skull. Contusions can appear immediately or develop over hours to a day after the injury. They are frequently seen in high-speed car crashes or in shaken baby syndrome, where rapid deceleration forces the brain to move back and forth within the skull.

• Skull Fractures: Skull fractures are breaks or cracks in the bones of the skull. They are caused by blunt force trauma. While skull fractures themselves may not directly cause brain damage, they can injure the underlying meninges, blood vessels, and brain tissue. Helmets are crucial in preventing skull fractures during activities like biking, skateboarding, and contact sports.

• Chronic Traumatic Encephalopathy (CTE): CTE is a progressive neurodegenerative disease associated with repeated TBIs and subconcussive blows to the head. Symptoms of CTE can include cognitive impairment (problems with thinking, memory, and understanding), movement disorders, behavioral and mood disturbances (impulse control problems, depression, aggression), confusion, and irritability. Initially identified in boxers, CTE is now recognized in athletes participating in other contact sports like soccer, wrestling, football, and rugby, and in military personnel exposed to blasts. CTE develops over years and symptoms may not appear until years or decades after the repetitive head trauma. Research is ongoing to refine diagnostic criteria for CTE and to develop methods for diagnosing it in living individuals.

• Post-traumatic Dementia (PTD): PTD is a form of dementia that can develop after a single moderate to severe TBI. PTD can be progressive and shares some features with CTE. Studies indicate that moderate to severe TBI, especially in early or mid-life, may increase the risk of developing dementia later in life.

Beyond the immediate, primary damage, TBIs can trigger secondary damage processes that unfold over time. Secondary damage refers to changes that occur hours to days after the initial brain injury. Examples of secondary damage include:

• Hemorrhagic Progression of a Contusion (HPC): HPC occurs when a brain contusion continues to bleed and expand in the hours and days following the initial injury. This expansion creates a larger lesion within the brain, increasing swelling and causing further brain cell loss.

• Breakdown of the Blood-Brain Barrier: The blood-brain barrier (BBB) is a protective network that regulates the passage of substances between the bloodstream and the brain. TBI can disrupt the BBB, causing it to become leaky. This allows blood components, plasma proteins, and other substances to leak into the brain tissue. This leakage triggers brain swelling (edema) and inflammatory responses, which can be harmful if prolonged. Disruption of the BBB can also lead to the inappropriate release of neurotransmitters, which can further damage or kill nerve cells.

• Increased Intracranial Pressure (ICP): Increased ICP is a common and dangerous complication of TBI. It is usually caused by brain swelling within the confined space of the skull. Elevated ICP compresses brain tissue and restricts blood flow to the brain, depriving it of essential oxygen and nutrients. This can lead to further brain damage and is a life-threatening condition.

Other secondary damage mechanisms include brain infections, decreased blood pressure or oxygen supply to the brain due to the injury, hydrocephalus (an abnormal buildup of cerebrospinal fluid in the brain), and seizures.

Who is More Likely to Get a Traumatic Brain Injury?

While TBI can happen to anyone, certain populations are at higher risk. Adults aged 65 and older have the highest rates of TBI-related hospitalization and death, primarily due to falls. Across all age groups, men are more likely to experience serious TBI than women. Men are hospitalized more frequently and are almost three times more likely to die from a TBI compared to women.

The leading causes of TBI vary by age group but overall include:

• Falls: Falls are the most common cause of TBIs, particularly among young children and older adults. The CDC reports that falls are the leading cause of TBI across all ages.

• Blunt Trauma Accidents: These accidents involve being struck by or against an object. Sports-related injuries, playground accidents, and other incidents where a person is hit by a moving or stationary object are significant causes of TBI, especially in children and young adults.

• Vehicle-Related Injuries: Motor vehicle accidents (cars, motorcycles, bicycles, pedestrians struck by vehicles) are a major cause of TBI across all age groups.

• Assaults/Violence: Intentional acts of violence, including domestic violence, assaults, child abuse (shaken baby syndrome), and gunshot wounds or other weapon-related head injuries, are significant causes of TBI.

• Explosions/Blasts: Blast-related TBIs are a common injury in military personnel, particularly from roadside bombs and other explosive devices in combat zones. These are often classified as mild TBIs, but repeated exposure can have cumulative effects.

How is a Traumatic Brain Injury Diagnosed and Treated?

Preventing TBI

Prevention is the most effective approach to TBI. Unlike many other neurological disorders, traumatic brain injuries are often preventable. Key prevention strategies include:

• Wear a Seatbelt: Always use seatbelts when driving or riding in a vehicle. Seatbelts significantly reduce the risk of head and brain injury in car accidents.
• Wear a Helmet: Wear appropriate helmets during activities that carry a risk of head injury, such as:
  • Bicycling
  • Skateboarding, scootering, and rollerblading
  • Motorcycling
  • Contact sports like football, hockey, and skiing/snowboarding.
    Ensure the helmet is the correct size and fits properly for the specific activity.
• Never Drive Under the Influence: Avoid driving or operating machinery under the influence of alcohol or drugs. Impaired judgment and slowed reaction times significantly increase the risk of accidents and TBIs.
• Improve Balance and Strength: Regular physical activity programs can improve balance and strength, especially in older adults, reducing the risk of falls.
• Make Home Safety Modifications to Prevent Falls:
  • Install window guards and safety gates for young children to prevent falls from windows or stairs.
  • Improve home lighting, especially in hallways and stairways.
  • Remove tripping hazards like rugs, clutter, and electrical cords from hallways and walkways.
  • Use non-slip mats in bathrooms and kitchens.
  • Install grab bars next to toilets and in showers/tubs, particularly for older adults.
  • Install handrails on stairways.

Diagnosing TBI

Any suspected TBI requires immediate evaluation by a healthcare professional experienced in head injuries. Diagnosis typically involves:

• Neurological Examination: A thorough neurological exam assesses motor and sensory skills, hearing and speech, coordination and balance, reflexes, vision, and cognitive functions (memory, attention, orientation). Changes in mood or behavior are also evaluated.

• Screening Tools: For mild TBI or concussion, particularly in sports, screening tools are used by coaches and athletic trainers to identify individuals who need further medical evaluation.

• Brain Imaging: Medical imaging is crucial to assess the extent of primary brain injuries and determine if surgery is needed. The decision to use imaging depends on the physical examination and the person’s symptoms. Common imaging techniques for TBI include:

  • Computed Tomography (CT) Scan: CT scans are often the first line of imaging in acute TBI. They can quickly detect skull fractures, brain bruising (contusions), bleeding (hematomas), and swelling.
  • Magnetic Resonance Imaging (MRI): MRI is more sensitive than CT and can detect subtle brain changes that CT scans might miss. MRI is often used for more detailed assessment and to evaluate for diffuse axonal injury and other soft tissue damage.

  Significant advances in imaging have improved the detection of even mild TBI. Advanced techniques include:

  • Diffusion Tensor Imaging (DTI): DTI can visualize white matter tracts and detect subtle damage to these nerve fiber pathways.
  • Fluid-Attenuated Inversion Recovery (FLAIR): FLAIR MRI sequences are sensitive to small areas of brain damage, edema, and inflammation.
  • Susceptibility-Weighted Imaging (SWI): SWI is highly sensitive to detecting even small amounts of blood in the brain, which can be indicative of microbleeds associated with TBI.

  Despite these advancements, current imaging technologies may not always detect mild concussive injuries.

• Neuropsychological Testing: Neuropsychological tests are used to evaluate cognitive function, particularly in individuals with mild TBI or persistent symptoms. These tests assess various cognitive domains, including:

  • Memory (verbal and visual memory)
  • Attention and concentration
  • Information processing speed
  • Executive functions (planning, problem-solving, decision-making)
  • Reaction time
  • Language and communication skills
  • Visual-spatial abilities

  Many sports organizations recommend baseline neuropsychological testing for athletes at the beginning of each season. These baseline tests provide a pre-injury assessment of cognitive function. Repeat testing after a suspected concussion allows healthcare providers to compare post-injury function to the baseline, helping to identify deficits and guide return-to-play decisions. Repeat testing can also be done periodically (every 1-2 years) to monitor cognitive function over time.

Treating TBI

TBI treatment is highly individualized and depends on the severity, location, and type of brain injury, as well as the individual’s overall health and other factors. Immediate medical attention at a certified trauma center is crucial for severe TBI, as this improves health outcomes. Treatment strategies differ for mild and severe TBI.

Genetics, age, and the number of prior head injuries can influence recovery from TBI. For example, the apolipoprotein E ε4 (ApoE4) gene variant, associated with Alzheimer’s disease risk, has also been linked to poorer outcomes after TBI. Younger individuals may experience more rapid brain swelling than older adults. In CTE studies, younger individuals (20-40 years old) tend to exhibit more behavioral and mood changes, while older individuals (50+) may have more cognitive difficulties. Older adults with TBI are also more likely to have lasting symptoms and may have pre-existing medical conditions and medications that complicate treatment.

Mild TBI Treatment

Mild TBI, such as concussion, often requires primarily rest and symptom management. Treatment focuses on:

• Rest: Physical and cognitive rest are essential for brain recovery. This means avoiding strenuous physical activity and activities that require significant concentration or attention (e.g., work, school, screen time). “Brain rest” is crucial in the initial days after a concussion.
• Pain Relief: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage headaches and pain. Aspirin should be avoided due to its blood-thinning effects.
• Monitoring: Close monitoring by a healthcare provider is important to track symptoms and watch for any worsening or new symptoms.
• Return to Activity: For children and teens with sports-related concussions, it’s crucial to stop playing immediately and only return to play after being cleared by a concussion specialist, following a graded return-to-play protocol.
• Prevention of Future Concussions: Preventing subsequent concussions is critical, as recovery from repeated concussions can be slower and more complicated.

Even after symptoms improve, a gradual return to daily activities is recommended, with medical clearance. More research is needed to fully understand the effects of mild TBI and to refine guidelines for resuming normal activities.

Individuals with mild TBI should:

• Schedule a follow-up appointment with their healthcare provider to monitor recovery.
• Discuss any new or persistent symptoms and how to manage them.
• Be aware of any new signs or symptoms, even if they seem unrelated to the injury, as they could still be connected to the TBI, even weeks later.

Medications may be used to manage specific symptoms of TBI, including:

• Pain Medications: Over-the-counter or prescription pain relievers for headaches and other pain.
• Anticonvulsants: To prevent or treat seizures.
• Anticoagulants: To prevent blood clots, although these are used cautiously due to the risk of bleeding in the brain.
• Diuretics: To reduce fluid buildup and intracranial pressure in some cases.
• Stimulants: To improve alertness and attention in some individuals experiencing fatigue.
• Antidepressants and Anti-anxiety Medications: To treat depression, anxiety, and emotional lability that can occur after TBI.

Severe TBI Treatment

Immediate treatment for severe TBI is focused on life-saving measures and preventing further brain damage. Priorities include:

• Emergency Resuscitation: Ensuring airway, breathing, and circulation (ABCs) are stable.
• Stabilization: Stabilizing the spinal cord, heart, lung, and other vital organ functions.
• Oxygenation and Ventilation: Ensuring adequate oxygen delivery to the brain and lungs.
• Blood Pressure Control: Maintaining stable blood pressure to ensure adequate blood flow to the brain.
• Prevention of Secondary Injury: Strategies to minimize secondary brain damage.
• Monitoring: Continuous monitoring of intracranial pressure (ICP), blood flow to the brain, brain temperature, and oxygen supply.

Surgery may be necessary for severe TBI to:

• Relieve Intracranial Pressure: Craniectomy (removing a portion of the skull) may be needed to create space for brain swelling and reduce ICP.
• Remove Hematomas: Surgical evacuation of hematomas (blood clots) to relieve pressure on the brain.
• Remove Debris and Dead Tissue: Debridement to remove bone fragments, foreign objects, or necrotic brain tissue.
• Repair Skull Fractures: Surgical repair of significant skull fractures.

During hospitalization for severe TBI, patients are monitored for complications like infections (pneumonia is common) and deep vein thrombosis (DVT), which can occur due to prolonged immobility.

Rehabilitation for Severe TBI

Once medically stable, individuals with severe TBI often require intensive rehabilitation to maximize recovery and functional independence. Rehabilitation is typically provided in specialized rehabilitation centers and involves a multidisciplinary team, including:

• Neurologists and physiatrists (rehabilitation physicians)
• Rehabilitation nurses
• Clinical psychologists and neuropsychologists
• Nutritionists
• Physical therapists (PT)
• Occupational therapists (OT)
• Speech-language pathologists (SLP)
• Vocational therapists
• Respiratory therapists

Rehabilitation programs are tailored to the individual’s specific needs and deficits and aim to improve:

• Physical Function: Motor skills, strength, balance, coordination, mobility, and activities of daily living (ADLs).
• Cognitive Function: Memory, attention, executive functions, problem-solving, and information processing.
• Communication Skills: Speech, language comprehension, and communication strategies.
• Emotional and Behavioral Issues: Managing emotional lability, depression, anxiety, irritability, and behavioral problems.
• Vocational Rehabilitation: Assisting with return to work or school, or finding meaningful activities.

Cognitive Rehabilitation Therapy (CRT): CRT is a key component of TBI rehabilitation, focusing on retraining cognitive skills through individualized programs. CRT helps individuals learn strategies to cope with persistent memory, thinking, and problem-solving difficulties.

What are the Latest Updates on Traumatic Brain Injury Research?

The National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health (NIH), is a leading institute supporting and conducting extensive research on TBI, along with other NIH institutes.

NINDS-funded research encompasses a wide range of areas, including:

• Understanding TBI Mechanisms: Research to better understand the complex biological processes involved in TBI and its long-term consequences.
• Improving Diagnosis and Outcomes: Studies aimed at developing more accurate and earlier diagnostic tools and improving outcomes for individuals with TBI.
• Developing Potential Therapies: Research to identify and develop new treatments and therapies to promote brain repair and recovery after TBI.
• Neuroplasticity: Exploring ways to harness the brain’s natural ability to reorganize and repair itself after injury (neuroplasticity) to enhance recovery.
• CTE and TES: Refining diagnostic criteria for Chronic Traumatic Encephalopathy (CTE) and Traumatic Encephalopathy Syndrome (TES), a related condition.
• Biomarkers for TBI: Supporting the development and validation of clinically useful biomarkers (biological indicators) for TBI through the Translational Outcomes Project in Neurotrauma (TOP-NT) consortium. Biomarkers could aid in diagnosis, prognosis, and treatment monitoring.
• Biomarkers for CTE: Identifying biomarkers to enable the diagnosis of CTE in living individuals, rather than only post-mortem.

Clinical Research

NINDS co-leads the Strategies to Innovate EmeRgENcy Care Clinical Trials (SIREN) network, which supports clinical trials in neurological emergencies, including TBI. Current TBI trials within SIREN include BOOST3 (Brain Oxygen Optimization in Severe TBI), comparing different methods of monitoring brain tissue oxygen levels to optimize treatment for severe TBI.

The NINDS-funded Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) project, recently completed, was a large observational study of adults and children with TBI of all severity levels. TRACK-TBI has created a valuable TBI database and resources to improve diagnostic methods and outcome assessment after TBI. Researchers are now extending TRACK-TBI to further investigate risk factors, biomarkers, and long-term outcomes in TBI.

The NINDS Common Data Elements (CDE) project promotes data sharing and standardization in TBI research by developing common data collection standards for TBI studies. This facilitates collaboration and data pooling across different research groups.

Scientific Collaboration in TBI Research

NINDS and the European Commission collaborate through the International Initiative for TBI Research (InTBIR) to improve TBI diagnosis and evaluate the effectiveness of different care approaches for both children and adults.

NIH and the Department of Defense jointly lead the Federal Interagency TBI Research (FITBIR) database, a large repository of data from TBI observational studies and other research.

NIH and the FDA are collaborating with the Department of Defense-led TBI Endpoints Development (TED) program to improve the design of clinical trials for TBI treatments, aiming to accelerate the development of effective therapies.

NINDS also works with the Department of Defense, Department of Health and Human Services, Veterans Affairs, and Education to coordinate TBI research relevant to military personnel. The National Research Action Plan (NRAP) is a related initiative focused on improving prevention, diagnosis, and treatment of TBI and co-occurring conditions like PTSD in veterans and their families.

Recognizing the need for more precise and evidence-based TBI classification beyond the traditional “mild,” “moderate,” and “severe” categories, NINDS convened the TBI Classification and Nomenclature Workshop in January 2024 to advance TBI classification systems.

Information about NIH-funded TBI research projects can be found through NIH RePORTER (http://projectreporter.nih.gov/), a searchable database of NIH and other federal agency-supported research projects. RePORTER also provides links to publications and other resources related to these projects.

Learn About Clinical Trials

Clinical trials are essential for advancing our understanding of TBI and developing better treatments. They offer opportunities for patients to access new and innovative treatment approaches.

Search Clinical Trials

How Can I or My Loved One Help Improve Care for People with Traumatic Brain Injury?

Participating in clinical research is a valuable way to contribute to improving care for people with TBI. Clinical trials help researchers learn more about TBI and related conditions, potentially leading to better diagnostic tools, treatments, and prevention strategies.

Clinical research studies need participants of all types—healthy individuals and those with illnesses or diseases, and people of all ages, sexes, races, and ethnicities—to ensure that research results are broadly applicable and that treatments are safe and effective for everyone.

For more information about participating in clinical research, visit NIH Clinical Research Trials and You. To find clinical trials specifically for TBI, visit Clinicaltrials.gov.

Another important way to support TBI research is through brain tissue donation. Donating brain tissue after death is crucial for advancing our understanding of brain function and neurological disorders. The NIH NeuroBioBank coordinates a network of brain banks across the U.S. to facilitate the collection and distribution of post-mortem brain tissue to qualified researchers. For information on brain donation, visit Consider Donating Your Brain for Neurological Disease Research.

Where Can I Find More Information About Traumatic Brain Injury (TBI)?

Valuable information and support resources for TBI are available from the following organizations:

Brain Injury Association of America
Phone: 703-761-0750 or 800-444-6443

Brain Injury Resource Center
Phone: 206-621-8558

Brain Trauma Foundation
Phone: 212-772-0608

Defense and Veterans Brain Injury Center
Phone: 800-870-9244

National Library of Medicine
Phone: 301-594-5983 or 888-346-3656

National Rehabilitation Information Center
Phone: 800-346-2742

ThinkFirst
Phone: 630-961-1400 or 800-844-6556

Uniformed Services University of the Health Sciences (USUHS)

U.S. Centers for Disease Control and Prevention (CDC) – Heads Up to Concussion
Phone: 800-232-4636 or 888-232-6348

U.S. Centers for Disease Control and Prevention (CDC) – TBI & Concussion