Protecting Your Brain When Injury Strikes

Brain Injury
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As the weather warms, we are venturing outdoors increasingly, toward sports fields, bike paths and the open road. With our ever-increasing time spent outside and traveling comes greater risks of injury—particularly brain injury.

Each year, approximately 1.5 Million brain injuries occur in the United States. That is more than multiple sclerosis, spinal cord injuries, HIV/AIDS and breast cancer combined. Estimates run as high as 5.3 million Americans living with a disability resulting from a brain injury.

For 2020, the Centers for Disease Control and Prevention (CDC) reported 611 Traumatic Brain Injury (TBI) -related hospitalizations and 176 TBI-related deaths per day. Americans over the age of 75 years and older account for the highest percentage of hospitalizations (32%) and TBI-related deaths (28%). Men accounted for three times as many brain injuries as women.

The most common causes of brain injuries are falls, being in motor vehicle crashes, sports-related injuries and violence or assaults.  As we head outside, even with the best precautions, injuries do occur so we must know what to do when brain injury strikes.




The CDC defines a concussion as a TBI caused by a bump, blow or jolt to the head, or by a hit to the body that causes the head or brain to move rapidly back and forth.

These kinds of injuries cause the soft tissue of the brain to bounce inside the skull, physically damaging the brain as well as starting a cascade of substances to flood the brain, creating chemical changes as well. You do not have to lose consciousness to sustain a concussion. In fact, only about 10 percent of individuals who sustain brain injuries lose consciousness.

Most practitioners and researchers classify traumatic brain injury into three broad categories: mild, moderate or severe TBI, with concussions typically being classified as mild (mTBI). The word “concussion” comes from the Latin word “concutere,” which means “to shake violently.”

Non-traumatic brain injuries, often called “acquired brain injuries,” are those where the damage is not caused by an external force or blow. Commonly, these types of injuries are caused by blood flow being interrupted or cut off from a part of the brain, which can result in brain cells dying. Examples of an acquired brain injury are strokes, near-drowning and oxygen deprivation such as in an opioid overdose.

Since every brain is different and every brain injury is different, symptoms of a brain injury may be different as well. They typically show up soon after the injury, but can also manifest over hours or even days.

The most common symptoms of concussions are as follows:

  • Headache
  • Being bothered by light and noise
  • Dizziness or balance problems
  • Nausea or vomiting
  • Sleeping more or less than usual
  • Trouble with focus and memory
  • Feeling foggy or groggy, more emotional, slowed down or “just not right”




While anyone exhibiting these symptoms after a fall or blow to the head should seek medical attention, the CDC also identifies the following “danger signs” which should be addressed immediately by calling 9-1-1 or heading to the nearest emergency department:

  • Worsening headache that does not go away
  • Weakness, numbness, decreased coordination, convulsions or seizures
  • Repeated vomiting
  • Slurred speech or unusual behavior
  • One pupil (the black part in the middle of the eye) appears larger than the other
  • Trouble recognizing people or places, confusion, restlessness or agitation
  • Profound drowsiness, loss of consciousness or inability to wake up




Even mild brain injuries can result in a myriad of changes and disruptions to a person’s life. It takes time to heal from a brain injury including both mental and physical rest. Recent studies, however, suggest that too much rest can actually increase the recovery time. In some cases, there may be return of the affected activities. In others, the disability may be lifelong.

Expect your healthcare provider to possibly recommend occupational, physical or speech therapy. Depending on the injury, it could mean a stay in a rehab facility (inpatient) or seeking therapy in a rehab clinic (outpatient). Reengaging in pre-injury activities should be done slowly, over time and at the direction of your medical provider. You typically want to back off if symptoms reoccur or worsen.

During recovery, symptoms may include headaches or dizziness, as well as issues with thinking, sleeping, engaging in physical activities and relating to others. Many individuals with a mild TBI recover from the initial symptoms within six weeks. More severe brain injuries can create lifelong medical, cognitive and behavioral issues.

An active, physical, vigorous lifestyle is vital to long-term brain health. Changing seasons and reduced COVID-19 restrictions are the perfect invitation to “get out, get going, and reengage.” The Brain Injury Association of Maryland recommends, “If there is a helmet for your sport, wear it. You only have one brain, and you need to protect it.” However, knowing what to do if brain injury strikes can provide additional peace of mind as you go out to enjoy the great outdoors.

For more information on brain injury, concussion, stroke, treatments and recovery options, there are many valuable resources including the CDC, the American Stroke Association, the Brain Injury Association of America and the Brain Injury Association of Maryland.

Bryan Pugh is the executive director of the Brain Injury Association of Maryland which has been serving Maryland families living with brain injuries since 1983. For more information, visit or call 800.221.6443.

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