Invisible wound, visible effects: TBIs need medical help – and the sooner, the better.

Traumatic brain injuries can happen anywhere. Regardless of how or when, all TBIs need medical attention, experts warn. (Photo courtesy of Walter Reed National Military Medical Center)


From falling on a slippery sidewalk to being exposed to an explosive blast, traumatic brain injuries can happen to anyone, anywhere. While these injuries may be invisible to the eye, they require the time and attention of a visible injury. Regardless of where, when, or how these injuries happen, one thing is for sure: All TBIs need medical attention.

Dr. Katharine Stout, clinical affairs director and a physical therapist at the Defense and Veterans Brain Injury Center, said resting and waiting to see if symptoms go away on their own can have a negative impact on neurological recovery – even for mild brain injuries. “The one thing we absolutely know about recovery is the earlier you’re seen and get into treatment, the better your long term recovery is,” said Stout. “It’s also important to remember that no traumatic brain injury is the same, so the recovery process for one person could be completely different from another.” Comparing recovery processes can be detrimental to the patient because it can foster unrealistic expectations.

A mild TBI, sometimes referred to as a concussion, can be caused by a blow or jolt to the brain. According to the Centers for Disease Control and Prevention, symptoms may include headache, dizziness, memory problems, irritability, trouble sleeping or concentrating, or sensitivity to light or noise. Treatment for a mild TBI may require only a few weeks of symptom management. Individuals with a severe or penetrating TBI, which can cause behavioral, functional, or psychological changes, most likely face a longer recovery. At the National Intrepid Center of Excellence, or NICoE, the interdisciplinary approach to treatment involves a team of specialists. Patients may meet with a psychiatrist, physical therapist, occupational therapist, neuropsychologist, or speech and language pathologist, depending on the severity of the TBI. Patients work with their providers to come up with a plan that fits their needs.

Treven Pickett, department chief of research at the NICoE, said that while the rehabilitation and recovery process can be challenging for both patient and family members, the process also provides an opportunity to grow.

“After a TBI, lives can change,” said Pickett. Minor changes and lifestyle adjustments may occur following milder injuries, while family members can become full-time caregivers in more severe cases.

Because of this crucial role in supporting the rehabilitation and recovery process for a TBI patient, Pickett said family members need to take care of themselves as well during that time. In addition to various outpatient services and patient-focused assessments, the NICoE offers family-centered services, such as psychotherapy and family counseling, to help family members improve coping skills and communication. The NICoE, a directorate of Walter Reed National Military Medical Center in Bethesda, also supports and coordinates with Intrepid Spirit Centers located across the country.

Dr. Scott Livingston, education director at DVBIC, said traumatic brain injuries do not have the same stigma as other mental health conditions like depression, but he still sees some patients hesitant to report symptoms and seek treatment. However, many advancements have been made in the way these injuries are discussed, researched, and treated, he stressed. Getting assessed and seeking treatment are the first steps to recovery for a TBI, but sticking with rehabilitation is critical to achieve the best outcomes and quality of life. Patients may reach plateaus in their recovery, but they’re encouraged to keep going, said Livingston. Whether they stall in progress when it comes to their mobile, cognitive, or communication abilities, improvements are always possible, he added.

“We try to encourage all service members, veterans, family members, and caregivers that seeking help is not a sign of weakness,” said Livingston. “It’s actually a good show of strength that you have the courage to report your symptoms and get evaluated and treated.”

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