What is Traumatic Brain Injury?

Traumatic brain injury (TBI) is an injury to the brain that is caused by external physical force.

Penetrating injuries are caused when a foreign object (such as a knife or bullet) pierces the skull and enters the brain, damaging those parts of the brain that lie along the path that the object travels into the brain. This type of injury causes focal damage, limited to a specific part of the brain.

Closed head injuries occur when there is a blow to the head that does not fracture the skull, or when the head is severely shaken. Closed head injuries can cause both localized damage and diffuse or widespread damage, due to stretching, tearing and swelling of brain tissue, as well as bleeding. Swelling and bleeding can continue to damage the brain and worsen the injury for hours or days after it originally occurs.

Anoxia – loss of oxygen to the brain, as from attempted drowning or strangulation – can also damage brain cells.

A victim of domestic violence may suffer from a TBI without knowing it. This can happen when:

She has no severe trauma or obvious symptoms at first. Mild or subtle injuries can lead to cognitive symptoms later on, and often no one connects them to the assault.
She does not lose consciousness. People with mild TBI often do not lose consciousness, yet still have injury-related difficulties.
She does not receive medical care, which may happen because:
- Her abusive partner refuses to let her seek care.
- She has no independent access to money and cannot afford care.
- She is afraid that she will have to disclose the abuse if she goes to the hospital, and is not ready to do that.
She gets medical care, but the provider does not ask about domestic violence, or thinks her symptoms are only psychological.

What Do Professionals Need to Know?