Complications

     There are many neurological, cognitive (thinking), and behavioral consequences of mild traumatic brain injury (MTBI) as a result of concussion (a blow to the head). Most of these complications are evident during the first few days or months after the injury. They can occur singly or in combination in any one patient, and they can change in severity and their presentation over time. These complications can include:

Neurological

• Dizziness
• Headache
• Blurred or double vision
• Sensitivity to bright light
• Sleep disturbances
• Fatigue
• Lethargy

Cognitive

• Poor concentration
• Memory loss
• Trouble thinking

Behavioral

• Irritability
• Anxiety
• Depression
• Verbal and physical aggression
• Difficulty in new learning
• Limited self-awareness
• Impulsivity
• Mood disorders
• Personality changes

Recovery

     The most rapid recovery occurs in the first 6 months following the injury, usually without specific treatment. Many patients experience greatly improved or complete recovery within the first year following the injury. In these cases, the neurological, cognitive, and behavioral complications are symptoms of postconcussion syndrome, and not of brain damage. (However, some patients who have suffered MTBI can experience persistent complications, which may lead to a functional disability.)

     Following are some recommendations for coping with the neurological, cognitive, and behavioral complications of postconcussion syndrome in MTBI:

1. Rest and Relax - After leaving the hospital, relax for at least one week at home and get as much sleep as you can. Then gradually increase your activity during the second week following discharge. Do not ignore your symptoms or worry about them. They are a normal part of recovery.

2. Concentration - When you experience difficulty concentrating, take a break and relax for 15 to 30 minutes, reduce distractions, and try to do only one thing at a time. If you still have problems, shorten your work day, class schedule, or daily routine.

3. Irritability - When you become irritable, it may be because you are tired or overworked. Adjust your schedule and get more rest. If this does not help, try to figure out why you are angry and what you can do to change the way you think about things to prevent getting angry in the future.

4. Fatigue - Fatigue is a normal consequence of head injury. Avoid becoming fatigued by scheduling rest breaks or daily naps, but if you do, rest and resume your activity level gradually. However, fatigue may also be caused by a TBI-related visual problem, so you may want to check this with your physician

5. Depression - Depression is normal when unpleasant things, such as a brain injury, happen. To treat depression, plan to do something enjoyable for yourself every day. Make a specific plan, look forward to it, and stick to it. Avoid thinking negative thoughts, or stop a depressing thought if and when it occurs.

6. Memory Problems
   • If you cannot remember the accident well, the part of the brain that stores memory was probably bruised. As the bruise heals, your memory will improve over time.
   • If you can remember the accident, then your brain was probably not bruised, and memory problems are due to poor concentration and fatigue. In this case, getting enough rest and preventing fatigue will help treat your memory problems, or, writing things down or using a pocket tape recorder will help you cope with temporary memory problems.

7. Headaches - Headaches are also a normal part of the recovery process. Headaches are commonly caused by stress or tension, and frequently cause irritability and concentrationproblems following a brain injury. If you have tension headaches, relaxing your muscles can help. However, because headaches have many causes, such as a TBI-related visual problem, you should discuss your headaches with your physician.

8. Anxiety - Anxiety is frequently caused by worrying about your symptoms and/or problems caused by your injury. If you understand that your symptoms are a normal part of your recovery, get enough rest, resume your responsibilities gradually, and stop yourself from thinking anxious thoughts, this will decrease your anxiety.

9. Trouble Thinking - This can be a side effect of the symptoms, such as concentration problems, being tired, headaches, and anxiety, and an indication that you are doing too much, too soon.

10. Dizziness, Visual Problems, and Light Sensitivity - These problems should be checked by your physician, who may prescribe medication or eyeglasses. However, it has been found that the less patients worry about these symptoms, the faster they may go away.

     Additional information from the National Center for Injury Prevention and Control is available by clicking on Facts about Brain Injury and Where to Get Help.