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Concussions and Traumatic Brain Injuries (TBI)

Advanced Care for All Forms of Brain Trauma

A traumatic brain injury (TBI) is an injury that causes sudden brain damage. A TBI can result from a car accident, fall, sports injury [link to] or another sudden blow to the head or body. Concussions are one of the most common forms of TBI.

To reduce your risk for long-term effects from your TBI, it’s important that you receive an accurate diagnosis and fast, effective treatment. That’s what you can expect from our team of professionals at Baystate Health. We provide both adult and pediatric neurology care for people with TBIs.

TBI Symptoms

If you or a loved one has experienced a TBI, you may notice some symptoms right after the injury, while other symptoms may not appear until days or even weeks afterward. Some of the symptoms to watch for include:

  • Changes in senses, including blurred vision or ringing ears
  • Clear fluid draining from the nose or ears
  • Confusion
  • Dizziness or trouble with balance
  • Drowsiness or fatigue
  • Headaches
  • Loss of consciousness
  • Mood changes
  • Nausea or vomiting
  • Seizures
  • Slurred speech
  • Trouble sleeping and/or trouble waking from sleep
  • Trouble speaking
  • Trouble with memory or concentration

These symptoms may appear a bit different in children. If your child has experienced a blow to the head or body that could result in a TBI, watch for these warning signs:

  • Changes in eating habits
  • Changes in mood, such as increased irritability or feeling especially sad or depressed
  • Changes in sleep patterns
  • Lack of interest in toys, usual activities, etc.
  • Trouble paying attention

Concussion Symptoms

It’s possible to have a concussion and not realize it. If you or a loved one has any of the following symptoms, you should request a concussion evaluation:

  • Balance problems
  • Blurred or double vision
  • Clumsiness that wasn’t present before an injury
  • Confusion, memory problems or trouble concentrating
  • Sensitivity to light or noise
  • Headaches or a feeling of pressure in the head
  • Nausea or vomiting
  • New or increased feelings of sadness, anxiety or irritability
  • Feeling sluggish, hazy, foggy or groggy
  • Trouble following instructions after an injury

Your primary care doctor or sports team trainer can manage most concussions successfully. However, if your symptoms don’t go away within a week of your injury, you may need a referral to our specialists.

TBI Evaluation and Diagnosis

It’s important for a medical professional to evaluate you right away if you’ve been injured in a way that means you’re at risk for a TBI. When you come to us for help, depending on where you go and what type of injury you have, you may see one of our:

We’ll ask questions about your injury and how it happened. You may need imaging tests, such as a CT (computed tomography) scan or an MRI (magnetic resonance imaging) scan so we can see the extent of your TBI. You may also need neuropsychological testing so we can find out whether your TBI has affected your memory or cognitive (thinking) ability.

Baseline Testing Before Concussions in Sports

Baseline tests let us measure your normal cognitive abilities before a concussion. Because athletes, especially those in contact or collision sports such as football, are at higher risk for concussions, we recommend baseline tests for any athletes 10 and older who are in a contact or collision sport. You or your child should have a baseline test before contact drills, as concussions can happen during practices.

We use the ImPACT™ test, which is the same test many college and professional sports leagues use. The test takes about 30 minutes. The results can let team trainers and us better understand the extent of the injury if you or your child ever experiences a concussion.

TBI Treatment

Many mild TBIs improve on their own with observation and rest. If you have a moderate or severe TBI, you may need to stay with us in the hospital. We’ll work with you on a customized treatment plan based on your symptoms and needs.

Your treatment plan may include medications to reduce your risk of blood clots, seizures or other risks of TBIs. Depending on your injury, you may need surgery to treat bleeding or blood clots in the brain, as well as any possible skull fractures.

You may need rehabilitation therapy as part of your recovery. Rehabilitation therapy can help you improve your ability to perform your regular activities after a serious TBI. Based on your symptoms and needs, your doctor may recommend one or more of the following types of rehabilitation:

  • Occupational therapy: This can help you be better able to manage everyday tasks, such as getting dressed or bathing
  • Physical therapy: This can help you improve your coordination and balance after a TBI
  • Speech therapy: This can help address any issues you may have with speaking after a TBI

Concussion Treatment

Depending on the severity of the concussion, you or your child may need to stay in the hospital with us overnight for observation. You may be able to recover at home after a mild concussion if a loved one can check on you.

You should not return to your sport or other physical activities for 24 to 72 hours after the injury to make sure your symptoms don’t get worse. Try to rest during this time, and avoid activities like watching TV, reading or using your smartphone. These can make your symptoms worse and slow your recovery.

If your symptoms don’t improve on their own in a few weeks, you should talk to your primary care doctor or contact us for an appointment. You may be at risk for post-concussion syndrome, which is when the symptoms of a concussion last longer than they normally should.

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