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Secondary Effects of Traumatic Brain Injury: What to Expect

doctor explaining side effects of traumatic brain injury

Depending on the location and severity of one’s traumatic brain injury (TBI), individuals may experience a wide variety of secondary effects. Because no two brain injuries are exactly the same, each person experiences TBI and its effects differently. To help you understand what to expect following a TBI, this article will go over the most common secondary effects.

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Understanding Secondary Effects of Traumatic Brain Injury

Secondary effects of TBI refer to conditions that result from the initial brain injury. Some complications may not develop until several months later while others will be present immediately.

Fortunately, many of these effects and conditions are treatable, especially if you can catch them early. That’s why it’s essential for you, family members, and friends to know potential complications that may arise after a TBI and keep an eye out for early signs of them. Below, we’ll discuss the various secondary effects that may occur after TBI.

Physical Effects of a Traumatic Brain Injury

The primary motor cortex controls most intentional physical movements. Therefore, some of the most common effects of traumatic brain injury affecting this area are mobility impairments and specific movement disorders.

Motor impairments after TBI occur because motor signals from the brain cannot reach the muscles. As a result, individuals may not be able to control the contraction and relaxation of their muscles or coordinate their movements.

Some of these mobility-related complications of traumatic brain injury include:

Hemiplegia / hemiparesis

Two of the most common secondary effects of TBI are hemiplegia and hemiparesis. Hemiplegia describes paralysis on one side (left or right) of the body while hemiparesis describes weakness on one side of the body. The more severe the TBI, the more severe the loss of motor control.


Spasticity refers to involuntary muscle contractions caused by the disrupted transmission of signals from the brain to the muscles after TBI. Individuals with spasticity often experience stiff movements and limited range of motion.


There may be times when spasticity progresses into contractures. Contractures occur when muscle fibers consistently remain contracted. This causes a fixed tightening across the associated joint(s), which can significantly limit one’s range of motion and functional abilities.

Foot drop

Foot drop occurs when motor signals from the brain cannot reach the muscles that allow you to lift your foot. As a result, individuals with foot drop may drag their feet, which makes it difficult to walk and increases your risk of falling.

Balance problems

Balance problems may occur as a result of weakness/paralysis or damage to the cerebellum (the part of your brain primarily responsible for regulating balance functions). Because individuals with balance problems have an increased risk of falling, a therapist may recommend using assistive mobility devices such as a walker or cane for extra support.


Tremors refer to involuntary shaking, often caused by damage to the cerebellum. Individuals with tremors may struggle to perform tasks that require fine motor skills such as writing and feeding.


Dystonia is a movement disorder characterized by involuntary muscle contractions. As a result, individuals with dystonia often demonstrate repetitive twitching or twisting motions. Dystonia is most commonly associated with damage to the basal ganglia.


About 30% of traumatic brain injury survivors experience headaches in the first year after injury. They can be caused by inflammation, muscle tension, and nerve damage.


Fatigue often occurs after traumatic brain injuries because the brain is using most of its energy to recover. However, fatigue can also be caused by sleep complications, medications, depression, and endocrine problems. Excessive tiredness throughout the day can significantly affect your mood, concentration, and physical activity levels.


Dysphagia describes difficulties swallowing due to impaired motor control over the muscles in the mouth and throat. Individuals with dysphagia may experience coughing, drooling, and a weak voice. In severe cases, they may need to use a feeding tube to ensure proper nutrition.

Cognitive Effects of Brain Injury

traumatic brain injury survivor dealing with cognitive secondary effects

There are multiple possible cognitive effects of brain injury. These most often occur after a frontal lobe injury, which affects a person’s ability to process information. Additionally, a TBI can affect our perceptual-cognitive skills.

and significantly affect the way individuals interpret the surrounding environment. As a result, they can affect one’s relationships, career, and overall recovery. Fortunately, with the right interventions (which will be explained later in this article), individuals often learn how to overcome cognitive and perceptual changes.

The following are the most common cognitive and perceptual effects of traumatic brain injury:


Amnesia often occurs after an individual awakens from a coma. It’s characterized by the inability to form or recall memories. As a result, individuals with amnesia often experience confusion as they struggle to recognize familiar places, people, and objects.


Aphasia is characterized by difficulties producing or understanding speech and language. Additionally, it can affect your reading and writing skills as well. Aphasia after TBI is associated with damage to the left hemisphere, which is where the language center of the brain resides.


Agnosia is a rare condition that affects an individual’s ability to recognize familiar objects, people, or sounds due to difficulties processing sensory information. For example, individuals may not be able to recognize a person by looking at them because of visual processing impairments; however, they may still be able to recognize them by hearing their voice.

Reduced Concentration

Reduced concentration may occur as a result of damage to the lateral intraparietal cortex, prefrontal cortex, visual cortex, thalamus, or midbrain. It can make it difficult to complete everyday tasks, hold conversations, and stay focused on your rehabilitation.

Low Motivation

Low motivation after brain injury is often associated with damage to the frontal lobe. The frontal lobe plays a major role in planning, decision-making, and multi-tasking. Therefore, when these functions are impaired, individuals may appear to have low motivation.


Perseveration is a thinking disorder that causes a person to persistently repeat words, phrases, or gestures. It can also involve the inability to shift goals or tasks. Perseveration is caused by damage to the area of the brain responsible for regulating awareness and inhibition. As a result, it becomes challenging for individuals to understand when to stop and move on to their next thought.


Anosognosia is a condition characterized by a lack of insight. As a result, individuals may not recognize that they have a TBI despite significant evidence that they do. This can interfere with recovery because it becomes difficult to get the individual to participate in rehabilitative therapies.

Lack of empathy

Lack of empathy after TBI makes it challenging for individuals to see things from the perspective of others and understand how they feel. As a result, individuals with lack of empathy may come off as self-centered.

Impaired Social Skills

Impaired social skills may occur for a variety of reasons after TBI. For example, a TBI can affect one’s insight and awareness, making it difficult for them to hold onto a conversation. Likewise, some TBIs can cause impulsive outbursts, causing individuals to blurt inappropriate things.

Emotional Effects of Traumatic Brain Injury

Traumatic brain injuries can also cause individuals to experience emotional changes. Some of these are a result of direct damage to the emotional center of the brain. Others are caused by indirect changes following brain injury.

Adjusting to life after TBI can be overwhelming and stressful, which can cause individuals to feel a wide range of emotions. Generally, emotional effects caused by indirect changes to the brain’s emotional centers are most severe immediately following the injury. As time passes and individuals learn more effective ways to cope and adjust, emotional sensitivity often stabilizes.

Below are a few of the most common emotional effects of brain injury:

Pseudobulbar Affect

Pseudobulbar affect describes extreme mood swings after brain injury. Individuals with pseudobulbar affect (also known as emotional lability) struggle with emotional expression, which often results in emotional outbursts.

Flat Affect

Flat affect is characterized by a lack of emotional expressiveness. Individuals with this flat affect may demonstrate monotone speaking, minimal changes in facial expression, and neutral body language.


Whether it is from the TBI itself or difficulties learning to cope with the effects of a TBI, depression may develop. This can influence your relationships with others, self-care, and motivation to participate in rehabilitation.


Anxiety disorders such as panic disorders, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder may develop after TBI. They can be caused by the emotional and psychological burdens of dealing with a serious disability, as well as physical changes in the brain.


It’s suggested that about 30% of individuals experience aggression after TBI. Aggressive behavior is commonly associated with difficulties regulating reasoning, problem-solving, and impulse control. This can cause individuals to act irrationally and struggle to hold back their emotions.

Sensory Effects of Traumatic Brain Injury

Lastly, traumatic brain injury can cause a variety of sensory-perceptual changes. These typically occur after damage to the parietal and temporal lobes.

Often, there’s nothing wrong with the eyes, mouth, nose, skin, or ears themselves. Rather, sensory-perceptual changes are caused by the brain’s inability to process information sent from these parts of the body. This alters how sensory input is perceived. Treatment may involve training the brain to better process the information through repetitive stimulation or learning adaptive tactics to compensate for lost senses.

The following are the most common sensory perceptual effects of brain injury:


Numbness after TBI is most commonly associated with damage to the somatosensory cortex, which is the area of the brain primarily responsible for processing sensory stimuli such as textures and temperatures. When this area of the brain is affected, individuals may experience tactile impairments such as numbness or tingling.

Hearing Loss

Hearing loss may occur after TBI due to damage to the ear itself or parts of the brain responsible for processing auditory stimuli such as the parietal and temporal lobes.

Vision Problems

Vision problems such as blurred vision, double vision, eye pain, light sensitivity, and visual field loss may occur after a TBI. Consequently, vision problems can cause dizziness, headaches, confusion, and difficulties interacting with your surroundings.


Anosmia refers to loss of the sense of smell. It’s associated with damage to areas of the brain that regulate your sense of smell such as the orbitofrontal cortex, insula, and piriform cortex.

Now that you’ve learned the various secondary effects of a TBI, let’s discuss treatment.

Treatment of TBI Secondary Effects

tbi survivor working on treatment for secondary effects

Because every individual experiences traumatic brain injury and its secondary effects differently, a personalized approach to treatment is essential. By working with a team of medical specialists you can learn how to better manage your specific complications.

To treat secondary effects of TBI, individuals may work with various healthcare professionals, including:

  • physical therapists
  • occupational therapists
  • speech-language pathologists
  • psychotherapists
  • neurologists

Therapists will focus on engaging your brain’s natural healing mechanism (neuroplasticity) to repair lost neural connections and restore as much function as possible.

Consistently practicing any skill affected by TBI helps reinforce demand for those functions. For example, if you want to improve your speech, you must consistently practice speech therapy exercises. Likewise, if you want to improve your memory, you should practice activities that test your memory. Task-specific training is essential for promoting adaptive changes in the brain.

Ultimately, there is no universal treatment for TBI or its secondary effects. Rather, each secondary effect must be addressed separately.

Understanding Secondary Effects of TBI

TBI is a serious medical condition that can cause life-changing secondary effects. Fortunately, many of these secondary effects can be effectively managed and improved.

We hope this guide to the most common effects of traumatic brain injury empowers you to overcome the obstacles you may face after your injury.

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