Mild and moderate brain injuries: Know the symptoms during Brain Injury Awareness Month

It’s easy to associate brain injuries with major, life-altering events—a serious car accident, a bad fall, something that clearly requires hospitalization and emergency care. But not all brain injuries are so obvious. In reality, most occur in everyday life, whether someone bumps their head on the kitchen cabinet or gets hit a little too hard while playing a school sport. 

During Brain Injury Awareness Month, it’s important to know the signs of mild and moderate brain injuries, and when to seek medical attention.

According to Erol Veznedaroglu, MD, a neurosurgeon with Global Neurosciences Institute at St. Mary Medical Center, a few bumps to the head over a lifetime is normal and doesn’t always constitute a brain injury. Though some initial dizziness may be experienced, this should be temporary and dissipate within a few hours.

“It becomes an issue when symptoms are lingering over a week,” says Dr. Veznedaroglu.

Symptoms of a mild brain injury include:

• Headaches that don’t go away (especially for people who typically don’t experience them)
• Dizziness, lightheadedness and feeling disoriented
• Short-term memory loss and forgetfulness
• Changing sleep habits (increased or decreased sleep)
• General feeling of not being well

“Most people would feel better the next day. Maybe they’d just be a little sore at the impact site. But it’s serious when they’re waking up with a headache the next day that doesn’t go away, having difficulty concentrating, difficulty with screen time—new things that aren’t normal for that individual,” says Dr. Veznedaroglu.

When experiencing these symptoms, it’s easy to brush them off and assume they’ll improve with time—and without medical intervention. Sometimes, this is the case. With mild brain injuries, if a person has a slight headache but doesn’t lose consciousness after the impact, it will eventually get better. Still, it’s a good idea to get checked out by a provider.

“[With a mild brain injury,] there’s no long-lasting effects with the exception that it will last longer without medical attention,” says Dr. Veznedaroglu. “If you don’t identify it, you’re not able to help heal your brain, which is avoiding screen time on a computer, not being in situations where you’re multitasking. You’ll heal quicker.”

However, if the person blacks out for more than 30 minutes, doesn’t remember the event and experiences the onset of flu-like symptoms in the hours/days that follow, this is a potentially fatal moderate brain injury.

“You can hit your head and with certain types of bleeds in the brain where you have these symptoms, it gets worse and worse. The pressure in the head goes up to the point where it can be fatal,” says Dr. Veznedaroglu. “The biggest factor is lethargy—people that are tired. They’re just out of it, kind of like having the flu. You don’t have any energy level, you’re dozing off. You have nausea, vomiting. Go right to an emergency room.”

Brain injury patients will first undergo imaging, with a CAT scan able to determine if there’s bleeding or a contusion. If there’s not, and if there’s been no loss of consciousness, the patient can head home and meet with a specialist to better understand symptoms and how to manage them.

“The biggest factor is lethargy—people that are tired. They’re just out of it, kind of like having the flu. You don’t have any energy level, you’re dozing off. You have nausea, vomiting. Go right to an emergency room.” – Erol Veznedaroglu, MD

“Going back to work, exercising and trying to push through is the worst thing to do,” says Dr. Veznedaroglu. “The brain heals very slowly, which is a big stressor for some people. They feel like they don’t have control over that. But it’s important to take it easy.”

For moderate brain injuries, which show bleeding or swelling on the CAT scan, swift treatment is needed. Depending on the patient’s needs, this may involve managing oxygen and blood flow, prescribing anti-seizure medications to reduce brain swelling and a variety of therapies, including physical and speech.

While certain populations are at higher risk for mild or moderate brain injury, including older adults who are prone to falls and athletes, it can happen to anyone at any age. All it takes is a quick slip on an icy sidewalk or falling off a chair while reaching for something. Therefore, while brain injury isn’t 100 percent avoidable, long-term disability and death can be prevented by knowing the signs and not delaying a visit to the hospital.

“If any of the symptoms become evident after the fall or injury, see the doctor immediately,” says Dr. Veznedaroglu. “Remember to wear bicycle and motorcycle helmets. Use adequate protection during sports and just be aware—parents and players—that these sports do carry an increased risk of concussion.”

Global Neurosciences Institute at St. Mary Medical Center offers the full spectrum of patient care for conditions involving the brain, spine and nervous system. Visit the St. Mary Neuroscience Institute for more information.