Symptoms, side effects, and related deficits fall into four major groups: Cognitive, Perceptual, Physical, and Behavioral/Emotional. Keep in mind that, because of the uniqueness of each injury, some survivors may or many not fact or exhibit some or all of the symptoms. The number of symptoms does not reflect on the impact that the injury will have on the survivors, either. A survivor of a head injury may only have one symptom from it, but that one symptom can loom so large or be so bad as to take over that person's whole life, causing a domino effect of other side effects, behaviors, and symptoms (including depression and frustration). The following list of symptoms is by no means complete or comprehensive, but only meant as an overview of the most common symptoms:

1. COGNITIVE SYMPTOMS:
   • Difficulty in processing information (decreased speed, accuracy, and consistency). -- This is rather like a computer. If some files are damaged, the information is not gone. It is still there, but you have to find a different way to access it. The ability to process information is not gone, a survivor just has to find new ways and techniques to process it.
   • Shortened attention span.

   • Inability or difficulty in understanding abstract concepts.

   • Impaired decision-making ability.

   • Impaired judgment.

   • Inability or difficulty in shifting mental tasks or following multi-step directions. This makes it hard for a survivor to process the steps of organization, as in organizing study materials for example or doing chores in order of importance. It is hard for them to prioritize things in levels. To them, sometimes, either everything seems urgent; or, conversely, nothing seems very important at all.

   • Memory loss or impairment

   • Language deficits (difficulty in expressing thoughts and understanding others, inappropriate word selection, word-finding difficulties, remembering names, etc.

2. PERCEPTUAL SYMPTOMS:
   • Changes in vision, hearing, or sense of touch.

   • Loss of sense of time and space or spatial disorientation, difficulties with hand/eye coordination (and, believe it or not, video games and 3-dimensional computer games may help retrain the brain to regain at least some of this).

   • Disorders of smell and taste.

   • Altered sense of balance.

   • Increased or decreased pain sensitivity. (They can also have both of these in different parts of the body, such as increased pain sensitivity in the head and decreased pain sensitivity in the feet and hands).

3. PHYSICAL SYMPTOMS:
   • Persistent headache.

   • Extreme mental and/or physical fatigue.

   • Disorders of movement -- gaiting, ataxia, spasticity, and tremors

   • Seizure activity (traumatic epilepsy)

   • Impaired small motor control

   • Photosensitivity (sensitivity to light)

   • Sleep disorders

   • Paralysis

   • Speech that is not clear due to poor control of the muscles in the lips, tongue, and jaw and/or poor breathing patterns

4. BEHAVIORAL/EMOTIONAL SYMPTOMS:
   • Irritability and Impatience

   • Reduced tolerance for Stress

   • Lack of initiative, apathy

   • Dependence (failure to assume responsibility for one's actions)

   • Denial of disability.

   • Lack of inhibition (may result in aggression, cursing, and inappropriate sexual behavior).

   • Inflexibility.

   • Flattened or heightened emotional responses/reactions.

Each injury is different and unique to the survivor just as all survivors have different capacities for recognizing and compensating for the symptoms they exhibit. Much depends on getting the correct diagnosis and treatment and insuring that good support systems are in place for the survivor and for the ENTIRE family. Support systems that are normally available for every student and parent (for example) such as school systems may have to become educated in order to be able to continue to be a valid support system for the students who are TBI survivors and their parents. Changes and improvement continue although sometimes they are so slight they are hard to notice. It does not just happen overnight. Some of the deficits may remain for a lifetime while others may improve to the point that they are not a major factor in day-to-day living any more.

NO! TBI/ABI has many levels of intensity. It is possible that someone can acquire a brain injury without loss of consciousness or external bruising or tangible confirmation such as CAT scans, skull x-rays, EEG's, etc.) Individuals who are survivors of even mild brain injuries may continue to experience and suffer from a wide variety of symptoms that can have life-changing implications. However, each injury is different and unique for each person.

NO! A mild brain injury can have the same devastating effects that a moderate or severe injury can have. The key point is location. Most survivors of mild brain injury don't lose consciousness and may only be in the emergency room for a short time before being sent home without ever knowing that they have been injured. For many of them, the survivor and their family/friends will begin noticing changes in them... sometimes very subtle changes and sometimes very obvious changes. Since they were not diagnosed with a brain injury in the emergency room, and since they did not ever lose consciousness, far too many of them will never receive the help that they need. Only now are the impacts of mild brain injury being understood, identified, and treated. Even the impacts of severe brain injuries have not been recognized for much longer than that. Most typically, mild brain injuries are received in car accidents where the brain is "sloshed" around in the skull by the collision.

In the most mild of cases, the brain still gets bruised in much the same way your leg might get bruised if you bump into a coffee table. However, the head and the brain are pretty resilient; and it can usually handle that injury without much effort. Sometimes people can get a really tremendous blow on the head, and it will not have any external effect. Again, much depends on the location of the injury and the brain's ability to compensate.

NO! Estimates place the annual occurrence of Acquired Brain Injury or Traumatic Brain Injury at 2 million. That is two million people every year! Tasks shared are tasks lightened. PLEASE take advantage of the people and orginizations waiting and willing to help you. Become an advocate for your survivor or for yourself. Educate the educators if you must. Join a support group. Start a support group. People who live in wheelchairs, their friends, and their families have had to fight for their rights to have handicapped access to public places, schools, libraries, restaurants, stores, special parking spots, etc. People who are hearing impaired have had to fight for their rights to have TDD access to libraries, major companies such as phones and utilities, even the phones in their own homes sometimes. If you want to change things, you have to challenge the way things are, educate the people who can do the most good, and fight for what you as a survivor or you as a family member of your survivor need.

Brain injury is traumatic .... physically, mentally, and emotionally. It is hard on the person who has sustained the injury, and it is hard on the family and friends of that person. It usually occurs quickly and without warning and finds everyone scared, confused, overwhelmed, and in a state of shock.

Just as the definition of TBI/ABI varies, so does the information that is passed on to the survivor and their family. It can either be too much information or too little information. It can be only the good information or only the bad information. There might be times when you are so tired that you don't think you can go another step. Fatigue may hit you all at once. You will find yourself caught up in many different emotions. You might feel that all hope is gone, but do not ever give up!

Brain injury requires that someone without prior knowledge or only vague knowledge quickly become informed and aware of what is happening now and what might happen in the future. It requires that lines of communication be put into place and then used to their maximum, advocating for the survivor until he/she is able to assist with that responsibility or take it over completely. If a survivor is your child, this may only be until the child becomes an adult; or it may be for the rest of the child's life, depending upon the extent and severity of the injuries.

If you are the survivor, there will be times when you are so frustrated, so angry, so depressed, so confused, that you will want to give up. Please don't! Reach out and find a peer group of survivors and let them help you. You will find that you are not "going crazy" in spite of what it sometimes seems like.

Recovery and changes will occur long after you were told they would stop. A great deal will depend on the desire of the survivor to improve, but "desire" alone won't do it. Never feel that this injury would go away if the survivor really wanted it to. It will take work and lots of it on everyone's part to help the survivor recover to the best of their ability.