It is difficult to predict with any accuracy what long-term effects TBI will have on the patient. Effects may not become evident until well after the initial injury. This is due to the fact that, initially, the brain swells. It takes time for this swelling to subside, so that it becomes difficult for medical personnel to determine if damage is due to the initial assault or is a permanent, lingering effect.

Health issues related to TBI can cause long-term effects on physical, cognitive, language, speech, and psychological aspects of the patient’s life.

Physical Aspects

In a formal study of over 300 patients with TBI conducted by the Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury, it was found that TBI patients (especially women) were more likely than healthy subjects to experience:

a thyroid condition

headache

sleep disturbances

loss of urinary control

frequent colds

arthritic symptoms

changes in weight

changes in skin and hair

changes in body temperature

frequent sinus infections

Although the authors found that patients with TBI were more likely to suffer from these symptoms, they stressed that patients with TBI should not assume that these symptoms are part of the normal consequence of TBI. Patients suffering from any of these symptoms should discuss their symptoms with a physician, and diagnosis and treatment should be aggressively sought. Other studies have shown that people with moderate to severe TBI are about twice as likely to die prematurely in comparison to people without TBI.

Cognitive Impairment

Cognitive impairment can affect the patient’s ability to concentrate for various periods of time. Patients may have difficulty organizing their thoughts and may become easily confused and forgetful. They may have difficulty learning new things. Some patients may have difficulty inferring the meaning of people’s actions, which may cause them to experience difficulties in social situations. Some patients may also say or do inappropriate things in social situations. Additionally, they may have difficulty in solving problems, making decisions, and planning. Judgment may also be affected.

Language Impairment

Following a TBI, patients may have difficulty finding the right words to use and forming proper sentences. They may give faulty descriptions and explanations. They may also have great trouble interpreting sarcasm, jokes, and figures of speech. When they have difficulty communicating, they may become angry and frustrated and might attempt to place the blame for their difficulty in communication on others. Reading and writing may be very hard for the patient following TBI, and they may also find it very difficult to perform mathematical calculations.

Speech

Speech may be slow, halting, slurred, and hard to understand. This is termed Dysphagia. , or difficulty swallowing, is also common in TBI. Apraxia occurs when the patient has difficulty saying words correctly in a consistent way.

Psychological Aspects

Many patients with TBI suffer from depression. It is perfectly understandable that patients with TBI may become depressed when so many things that once came easily to them no longer do. Recovery from TBI can be a process of taking two steps forward and one step back. Often a patient will be seen to plateau, with no noticeable improvement for a period of time. This can be very frustrating for the patient and their family. The loss of their former life and self can be devastating for the patient, who is often quite aware that they are not the same person they were prior to TBI. All of these factors may contribute to the depression that many patients with TBI experience. Depression may cause these patients to use alcohol or drugs to mitigate these feelings. Alcohol and drug use may have a further depressant effect.

Children and TBI

Children may experience social and behavioural problems following TBI. Parents may notice the following:

• Social immaturity-patients may revert to behaviour of an earlier age
• Memory problems
• Decline in social skills-patients may need to be taught social skills that they had already mastered before the injury.
• Difficulty controlling their temper, actions, and feelings
• Restlessness
• Hitting others
• Swearing
• Difficulty following directions
• Signs and symptoms of depression

Patients who suffer a TBI will need ongoing support to address lingering physical effects, as well as new problems that may occur as a direct or indirect result of their injury. They will also need support to cope with cognitive, behavioural, and psychological problems. Support may come from their family physician, a neurologist, a psychiatrist or psychologist, a speech therapist, an occupational therapist, and family members.

Family members should not be forgotten, as they will likely require support and education to help them to cope with changes in behaviour and cognition of their loved one.