Common Problems in Mild, Moderate, and Severe TBI

traumatic brain injury

When thinking of the term traumatic brain injury (TBI), often what comes to mind is someone who has had a catastrophic incident that has resulted in a skull fracture, brain hemorrhage, or other very serious consequence of head trauma. People may imagine the cause of such injuries come from events like a bad auto accident, a combat injury, a snowboarder falling head-first into the lip of a half-pipe, or a bicycle racer losing control on a steep descent and crashing at high speed.

While all these scenarios are possible, the cause of most TBIs is far less dramatic, but can still disrupt brain function and result in numerous symptoms and lasting cognitive problems or mental health issues.


According to the CDC, there are approximately 2.5 million emergency room visits each year for TBIs; however, we know that many head injuries are never reported.

So often, people hit their head—”get their bell rung”—and don’t think much about it afterward, unless they have some symptoms. Even though someone doesn’t crack their skull or is wearing a helmet, it does not mean the brain didn’t get hurt. Here’s why:

The brain is very soft, like the texture of soft butter. It sits inside a very hard skull which is designed to protect it. BUT when you hit your head, something hits you in the head, or your head gets jerked really hard (such as whiplash), the force can cause your brain to slam into the inside of the skull, which has boney ridges that help keep the brain in place. The force against your brain from any kind of impact can cause shearing of the axons (the connecting fibers that let cells communicate) and disrupt normal function in the brain. The brain can also get “bruised” (a contusion), it can bleed, or it can develop blood clots which are potentially fatal.

As amazing and powerful as our brains are, they are also very delicate.

The force against your brain from any kind of impact can cause shearing of the axons (the connecting fibers that let cells communicate) and other problems that disrupt normal function in the brain. Click To Tweet


Depending on the severity of a brain injury, a person may have a few symptoms—or many—and have them in varying degrees. Traumatic brain injuries are classified into 3 levels: mild, moderate, and severe based on:

  • If and how long there was a loss of consciousness
  • The duration of amnesia or any memory problems related to the event
  • Score on the Glasgow Coma Scale which assesses any visual, movement, and speech problems from the event

1. Severe TBI

With severe traumatic brain injuries, there is significant damage to the brain and most people must be hospitalized for a period of time. Severe TBIs can result in damage to any number of important areas of function, such as motor coordination, speech, cognition, vision, and capacity for self-care. Many patients will undergo extensive rehabilitation to help regain—or at least improve—functions that were diminished or lost due to the injury. Some brain damage may be permanent.

2. Moderate TBI

With moderate TBI, symptoms can appear almost immediately or within a few days of the injury. As with severe TBI, moderate head trauma can cause impairment in important functions too, but to a lesser degree. These patients can also struggle with symptoms such as headaches, nausea, vision or speech problems, sensitivity to light and sound, cognitive changes, and mood problems, among others. Some may fully recover from their symptoms, but some people may not.

3. Mild TBI

This type of brain injury is what we often refer to as a concussion and accounts for the vast majority of TBIs. There are many causes, including motor vehicle accidents; sports such as football, soccer, hockey—even cheerleading; recreational activities; falls; and assaults.

With a concussion, a person may develop symptoms right away or after a few days or weeks. Common symptoms include:

  • Confusion or disorientation
  • Headaches
  • Nausea/vomiting
  • Tinnitus (ringing in the ear)
  • Dizziness and fatigue
  • Brain fog
  • Memory problems
  • Difficulty with concentration
  • Moodiness
  • Sleep issues
  • Balance problems

Although the symptoms of mild TBI are not as debilitating as those with moderate or severe brain injuries, they can still cause a wide range of impairments and interfere with psychosocial functioning. For instance, a person may suddenly struggle to do their job or schoolwork or become uncharacteristically irritable and fatigued. With rest and following the doctor’s orders, many people appear to recover well from a mild TBI, even though there may be some long-lasting or permanent changes inside the brain.

Remember, the brain is very soft, and the skull is very hard!


The term “mild TBI” is deceiving, and it causes many people to overlook the potential long-term consequences of concussions and repeated concussions. A study published in JAMA Neurology in February 2021 examined the frequency of repeated head impacts of Division 1 college football players. The research found that players had an average of 415 impacts to their heads each season! Interestingly, most of these occurred during practice and preseason training. This is very concerning because of the growing research about the long-term consequences of repetitive trauma to the brain.

Left untreated, even mild TBI/concussions can increase the risk of mental health issues, such as depression, anxiety, PTSD, aggression and behavior problems, dementia, and even suicide.

Left untreated, even mild TBI/concussions can increase the risk of mental health issues, such as depression, anxiety, PTSD, aggression and behavior problems, dementia and even suicide. Click To Tweet


Even if your TBI was a while ago, there are things you can do to make it better. Choosing healthy lifestyle changes to take care of your brain now can make all the difference in the world.

Here are 5 easy tips to help you get started:

  1. Eat a brain-healthy diet with lots of greens and fresh produce, high-quality protein, and low-glycemic carbs.
  2. Exercise regularly to help boost blood flow to your brain.
  3. Manage your stress with meditation/prayer or yoga.
  4. Exercise your brain by learning new things and doing online brain games.
  5. Help your brain with hyperbaric oxygen therapy (HBOT), a non-invasive treatment that uses pure oxygen to speed the healing process.

Taking good care of your brain is the most important thing you can do to live a better life after a TBI/concussion.

TBIs and concussions can’t wait. At Amen Clinics, brain scans reveal that 40% of patients have suffered a mild TBI—although many of them don’t remember it—that contributes to their cognitive or psychiatric symptoms. We have developed a proven, science-backed, integrative Concussion Rescue Program to help heal your brain and overcome your symptoms. During these uncertain times, your cognitive and mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.

At Amen Clinics, we’re here for you. And as an essential medical practice, our clinics are open to serve you. For more information about our Concussion Rescue Program, speak to a specialist today at 888-288-9834 or visit our contact page here.


  1. This is completely consistent with what is explained in the”Mild Traumatic Brain Injury Workbook” by Douglas Mason, which I’m finding very helpful. I’m PTSD and post concussion syndrome and my boyfriend recently had a minor stroke, and everything in Dr. Amon’s books and blogs is helpful and consistent with what is helping us.

    Comment by Sharyn DiGeronimo — March 6, 2021 @ 10:41 AM

  2. I suffer from tinnitus and though I have read many thing yours shed some welcome knowledge on it
    Thank you

    Comment by james bennett — March 8, 2021 @ 6:13 AM

  3. I recently suffered a “mild” TBI and am still suffering almost 60 days later with memory and balance issues. I look forward to your articles and I read and listen to your books for guidance. Thank you.

    Comment by LAUREL WERNER — March 8, 2021 @ 8:40 AM

  4. After surviving a TBI I was confronted with an ill-informed and incompetent medical system. I appreciate your efforts to raise awareness. I enjoyed your article very much.

    Comment by Beatrice Coleman — March 8, 2021 @ 12:59 PM

  5. How does a forceps birth factor into TBI? I have several dents on the left side of my head (the one on the top is 3 Inches long and an inch wide that I can fit my index finger into, caused by a failed forceps birth (I was eventually born by emerg c-section while my mother was under general anesthesia). I have several mental issues that never have made sense…

    Comment by Tracey — March 9, 2021 @ 7:25 PM

  6. Hi! My 21 year old grandson was in terrible car accident March 8th of last year. Just now 1 year. He was passenger of car. A truck tried to beat red light and turned in front of car Nick was a passenger in. The car hit a pole on Nicks side. Took firemen 2.3 hours to cut him out o car with Jaws o Life. He suffered a TBI. Plus his right leg was smashed. The femur bone was missing 3 inches. And, both bones in right lower leg was broken. both ankles bilaterly.
    He was in coma for one week. He was alone cause of Covid. He had brain surgery. He had a blood clot. So he has metal and screws in head. And rods, pins, plates and screws in legs. When someone has metal in head can you even look at his brain? He was in hospital for cpl months, wheel chair for three months. He wore air casts for months. He has been back to hospital many times for surgery in legs. Hemotomas and several infections.
    The boy driving car didn’t have insurance. Nicks bill is over 3 million dollars now.
    He has hardened from all the pain. They gave him Tylenol with codeine.
    His personality has hardened. He needs to be able to get his brain working better. Can you help him. Thanks in advance!

    Comment by Pamela Lewis — March 10, 2021 @ 1:08 PM

  7. Hello Pamela, thank you for reaching out. We’d be happy to contact you directly with more information regarding scheduling an appointment at one of our clinics. We look forward to speaking with you soon.

    Comment by Amen Clinics — March 10, 2021 @ 3:18 PM

  8. I really appreciate finding your column. I am so frustrated with my medical doctors! I had a closed head injury don’t know exactly what happened, but it really hurt. I have had what I beleive was a CSF leak, but they don’t listen, keep blaming my high blood pressure for everything like that’s all they know about . Can you help me….maybe I explain it wrong.

    Comment by Rita Seay — March 11, 2021 @ 7:21 PM

  9. Hello Rita, thank you for reaching out. For more information about brain SPECT imaging and the consultations and evaluations we offer, please contact our Care Coordinators:

    Comment by Amen Clinics — March 12, 2021 @ 12:20 PM

  10. Want to learn more. This was very informative and more helpful than what I learned from a neurologist. Very concerned .

    Comment by Miriam Mayer, PhD — March 12, 2021 @ 5:09 PM

  11. Hi: I live in Canada and have been following your site since seeing you on Dr. Phil a year or so ago. I am now 73 years old. In 2017 I was (misdiagnosed) with Type 2 Diabetes. I controlled it with low-carb/exercise. Then in 2019 I had a severe DKA episode and ended up in hospital for 4.5 days and was diagnosed with Type 2 Diabetes. I had bariatric surgery 40 years ago, but didn’t know most of the side effects it would produce. I’ve had trauma (head injuries/physical, mental, etc. abuse) since childhood. And, to top it off, I fell in 2018 and hit the back of my head on the pavement. I was shaking a bit, but felt otherwise ok. The next morning my right arm was going crazy so I drove to the ER. Very fortunate for me a neurologist from Halifax happened to be there doing clinics. Since the ER doctor/nurse had never seen an arm doing weird things from a fall, they called him. He came to see me and said I was having focal seizures from the part of my brain that got hurt. He took a video of my seizures. I think he may be using it in his medical classes that he teaches at a University. I had a burning sensation on the right side of my head and then my arm went crazy. I had a grade 3 concussion and a brain bleed. So, now I’m on anti-seizure meds for the rest of my life. Very occasionally, if I lift my arm above my head I get small tremors. I sometimes feel out of balance/dizzy, especially if I get up quickly (moreso than ever before). I have depression/anxiety (for a long time) and am on meds for that. Sometimes I don’t think they work because when I have an anxiety attack I have uncontrollable rage. I have been taking Vit K/D, Fish Oil and need to take more Magnesium. My anxiety attacks seem to have lessened since taking the vitamins suggested by Dr. Amen. I also bought two of Dr. Amen’s books and find them very informative. Am I doing enough to help whatever my poor brain is experiencing? Any tips/advice would be greatly appreciated.

    Comment by Lynn Ellis — March 15, 2021 @ 7:21 AM

  12. Had a subdural bleed summer of 2017 of unknown cause. Was left with some deficits. Light sensitivity, unable to read for any length of time,motion sensitivity, feeling weird at times, low blood pressure, sleep problems, floating feeling, feeling off, medication sensitivity. Been seen at Mayo Clinic and they feel that this is all somatic and to live with. Any stress makes it worse. The only medication that seems to work is Valium at a 0.5 that I take every three weeks or so. My long term disability stopped since all my scans and EEG are all normal. Any recommendations?

    Comment by Barbara A Weaver — March 17, 2021 @ 6:23 AM

  13. My service member suffered a moderate TBI and severe leg injuries in an accident In Afghanistan. It’s be 10 years now and her executive functions are someway impaired. She works but at times is slow processing things. I’ve overheard her boss shouting at her b/c she obviously did get directions right the first time. This behavior bothers me as she was in the hospital and rehab for three years and I took care of her 24/7. How can I address this issue with an employer as her self esteem goes down everytime he demeans her? Any suggestions would be appreciated. Thank you.

    Comment by Paulette Mason — March 17, 2021 @ 6:45 AM

  14. Hello Barbara, thank you for reaching out and sharing your brain health journey. We’d be happy to contact you directly with information on how Amen Clinics can assist. Thank you.

    Comment by Amen Clinics — March 17, 2021 @ 12:27 PM

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