The long-term effects of TBI can cause a person severe difficulties throughout their life.
But what are these effects, and are there any means of treating them?
In this article, we’ll be covering all the possible health conditions associated with a moderate to severe TBI so you can be prepared to face them when they arise.
We’ll also show you how to take a pro-active approach to managing these chronic effects and hopefully lessen their impact on your life.
So without further delay, let’s take a look at some of the long-term effects of TBI.
Long-Term Effects of TBI
The Institute of Medicine (IOM) reviewed all relevant studies of adult TBI survivors and identified several health conditions that frequently developed 6+ months after a person sustained a brain injury.
The institute identified several health conditions that frequently developed six months or more after a person sustained a brain injury.
They also found that whether or not a person experienced a certain effect was highly dependent on the location and severity of their injury.
So just because you’ve experienced a TBI does not mean you will necessarily experience all of the possible consequences associated with it.
With that, here are all of the long-term effects of TBI identified by the IOM.
1. Seizures and Epilepsy
Seizures typically occur after a penetrating TBI, such as a gunshot wound to the head.
They also usually follow a TBI that causes a hematoma, i.e. bleeding in the brain.
Seizures are caused by a sudden surge of electrical activity in the brain.
When you experience multiple seizures on a regular basis, this is considered epilepsy.
According to the IOM, about 5-10% of TBI patients will develop epilepsy after TBI.
Currently, the best treatment for seizures is anti-seizure medication. In severe cases, an implant that stimulates your nerves with electrical impulses can be attached to your neck.
2. Ocular and Visual-Motor Disturbances
This just refers to several different eye movement issues that typically follow a TBI. They usually occur in traumatic brain injuries that damage the cerebellum and brainstem. Some of these include:
- Blurred vision
- “Bouncing images” (oscillopsia)
- Dizziness and vertigo
- Problems with voluntary eye movement (ocular apraxia)
- Visual-spatial problems
These can also lead to posture and balance problems.
Ocular problems can usually be treated with corrective lenses. In more severe cases, gaze stabilization exercises and vestibular therapy can also be effective.
3. Cognitive Deficits
Traumatic brain injuries can cause several long-term cognitive issues, including:
- Executive dysfunction (problems with planning, organizing, and decision making)
- Attention and concentration issues
- Memory problems (short-term and long-term)
- Learning difficulties
- Problems with empathy and other social skills
Treating these deficits can be difficult, but it is possible to make improvements with consistent cognitive and behavioral therapy.
The best way to improve cognitive abilities is through repetitive cognitive rehabilitation exercises that engage different parts of the brain. This will help trigger neuroplasticity, your brain’s natural ability to rewire itself and create new neural pathways.
4. Post-Concussive Symptoms
Another common long-term effect of TBI is the persistent presence of post-concussive symptoms.
These symptoms include:
- Light sensitivity
- Memory loss
Following a good brain injury diet, staying hydrated, and exercising regularly can help relieve these symptoms. In severe cases, medication may be necessary.
According to the IOM report, psychiatric disorders, including psychotic breaks, are another possible, though rare, long-term effect of TBI.
Most episodes occur within the first five years after injury, though some have been known to occur after 20 years.
Some of the psychiatric disorders that can occur after a brain injury are:
- Auditory and visual hallucinations
- Paranoid or persecutory delusions
- Disorganized thoughts
- Anti-social behavior
Psychotic episodes are usually accompanied by other effects, such as mood swings and depression.
Treating these disorders will usually involve intensive psychotherapy and medication.
6. Personality Changes
One of the more distressing long-term effects of traumatic brain injury is the personality changes that can happen afterward.
This is all caused by damage to the right frontal lobe, which can affect a person’s emotions and inhibitions, causing them to behave more irrational and aggressive than normal.
It can also cause a person to experience severe mood swings, known as emotional lability.
These emotional problems after traumatic brain injury are difficult to treat, and some may even be permanent, but medication and psychotherapy can lessen their impact.
7. Endocrine Dysfunction
A traumatic brain injury can cause long-term issues with the endocrine system. The endocrine system is what regulates your hormones. It is made up of glands spread all throughout your body, with three of these glands located within your brain itself.
The glands that are inside your brain are the hypothalamus (the “control center” of the endocrine system), the pituitary, and the pineal glands. After a TBI, these glands can become damaged and lose their functions, which causes all kinds of negative symptoms.
The symptoms of endocrine dysfunction are very similar to the other symptoms of TBI, such as mood swings, fatigue, anxiety, and memory and concentration problems.
However, the root cause of these effects is not damage to the brain regions that control these functions, but a problem with your endocrine system. Therefore, treatment will have to be different.
Other symptoms of endocrine dysfunction include:
- Low muscle mass
- Diabetes insipidus
- Cold intolerance
- Low blood pressure
- Growth hormone deficiency
Endocrine dysfunction is frequently overlooked in TBI treatment, mainly because its symptoms overlap so much with other types of brain damage.
The problem is the methods used to treat other types of brain damage, like activating neuroplasticity to restore lost function, are pretty much ineffective against endocrine problems.
Treatment for endocrine dysfunction will mainly involve taking synthetic hormones to supplement or replace your natural hormones.
Secondary Long-Term Effects of TBI
There are also other effects of TBI that, while not necessarily directly caused by a brain injury, tend to follow it. That’s why they are sometimes referred to as secondary effects of TBI.
1. Neurological Disorders
Sadly, adults with a history of moderate to severe traumatic brain injury are 4 to 6 times more likely to develop Alzheimer’s or progressive dementia than those without a TBI.
People with multiple TBIs are at an even greater risk.
Other neurological disorders that can follow a brain injury are:
- Multiple Sclerosis (MS)
- Amyotrophic Lateral Sclerosis (ALS)
These disorders are rarer in TBI patients than dementia is, but there is still a significant connection.
Scientists are not sure why exactly there is a connection between brain injuries and these neurological disorders, but many think it has something to do with a protein abnormality that occurs after a TBI.
Not every person who experiences a TBI will develop a neurological disorder.
There is also no evidence that a single mild TBI will increase your risk of developing any of these conditions.
Currently, there is no verified treatment for dementia, but practicing cognitive exercises and keeping your mind active may help reduce your risk of developing it.
2. Depression, Unemployment, and Social Isolation
Because TBI is often an invisible disability, many people make harsh or unfair assumptions when they see a person acting strangely after their injury.
This is partly why depression, unemployment and social isolation are higher among TBI survivors than in the general population.
For example, an employer might assume their employee is acting lazy and losing focus when really it is their brain injury causing problems.
Fatigue also makes socializing too difficult for many people after a TBI, which can cause friends to drop away and lose touch.
Losing both your job and friends will invariably contribute to feelings of depression, and this starts a vicious cycle.
Depression makes it even harder than it already is to make friends or find a new job, and the continued lack of community only worsens the depression, etc.
This endless circle of unemployment, social isolation and depression also helps explain the tragic prevalence of suicide attempts among TBI survivors.
Pro-Active Ways to Manage the Long-Term Effects of TBI
Now that we’ve gotten all the bad news about out of the way, it’s time to turn to the good news.
And the good news is you can lessen your chances at developing these long-term effects by taking a pro-active approach in the early days of your recovery.
Here is our best advice for reducing the likelihood and severity of chronic TBI effects:
1. Stay Active
It is vital that you stay as physically and mentally active as possible after your TBI. Not only will you regain some of the abilities you lost, but it will also prevent some of the long-term effects of brain damage.
Low impact exercise like biking or swimming has numerous benefits for brain recovery, from reducing symptoms of depression to restoring cognitive functions.
You’ll want to be sure to exercise your mind too. Brain games like Sudoku, crossword puzzles and chess are especially great ways to keep your mental abilities sharp and prevent decline.
2. Be Open
Staying open with others about the difficulties you experience is key to maintaining relationships and preventing many of the problems that come with social isolation after TBI.
Most people really have no idea about the challenges you face every day, but once you tell them, they are very understanding.
Who knows, maybe they will choose a different activity that you all can enjoy. At the very least it helps prevent any misunderstandings that can lead to lost friendships.
Still, even when you have friendships, you can suffer from loneliness, especially if you feel like nobody fully understands what you are going through.
3. Find a TBI Support Group
When you find others who have experienced the same issues as you, it can come as a huge relief.
That’s why brain injury support groups are so important! They help prevent depression and feelings of isolation, and can motivate you to keep working on your recovery and achieve new goals. They can also give you helpful tips on how to make living with brain injury easier.
Even if you think support groups aren’t your thing, it’s still worth trying at least once.
If you’re interested in joining a TBI support group, but don’t know where to start, contact your state Brain Injury Association. They’ll be able to get you in touch with the right group near you.
Chronic Effects of TBI
Before we wrap this article up, we’ll close with a brief reminder:
No two traumatic brain injuries are exactly the same.
We know that reading about all the possible long-term effects of TBI can be overwhelming, but you most likely will not develop all the conditions mentioned here.
Our goal with this list was not to scare but rather to inform you of what you may experience.
The more informed you are, the more prepared you will be to take action that can improve your health!
By keeping active, staying open with others, and finding people who will support you with your recovery, you can greatly reduce your chances of developing these symptoms. And if they do still appear, their impact on you will be much smaller than if you do nothing.
It’s also very important to have regular check-ups with your doctor, even if it’s been years since your injury. This allows you to detect some of these conditions early and get the right interventions as soon as possible.
And with that, we hope this guide to the long-term effects of traumatic brain injury helps you to take the right steps towards your recovery.