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Traumatic Brain Injury

What is Traumatic Brain Injury (TBI)?

A traumatic brain injury occurs when a person’s brain is physically injured, usually by a sudden force. With military members, this is often the result of a concussive blast or explosion. It can also be caused by falls, motor vehicle accidents, assaults, or any sudden blow to the head.  Because the damage is internal, there may be no visible head wound.

Although TBI has been called the signature injury of the Global War on Terror, it is not a new condition, and it is not unique to those serving in the military. The Centers for Disease Control estimates that 1.4 million TBIs occur every year in the US, with about 6% resulting in long term disability. In prior conflicts, approximately 14% - 20% of surviving casualties had a TBI.

Are There Different Levels of TBI?

Yes. As the figures above suggest, there is a wide range in severity depending on the circumstances of the injury. Some people who experience a TBI can recover completely without medical intervention. On the other end of the scale, some people will have permanent and total disability. Any brain injury, whether mild, moderate, or severe, can temporarily or permanently diminish a person’s physical abilities, impair cognitive skills, and interfere with emotional and behavioral well being. Because of this, anyone who feels there is a possibility they may have a TBI should be seen by a doctor. 

What are the Symptoms of TBI?

Every brain injury is unique and symptoms can vary widely.  Damage to different parts of the brain will result in different symptoms.  TBI shares symptoms with other physical and mental health conditions, such as Posttraumatic Stress Disorder, which complicates diagnosis.  Below are some of the symptoms.  Having some of them, however, does not necessarily mean a person has TBI.  Only a doctor can definitively identify and diagnose a TBI.  

Common Symptoms Immediately After Injury

  • Being Dazed, confused, or "seeing stars"
  • Not remembering the injury
  • Losing consciousness (being knocked out)

Common Symptoms Later On

  • Persistent headache or neck pain
  • Sensitivity to light and noise
  • Loss of balance
  • Changes in sleep patterns
  • Feeling tired all the time, lacking energy
  • Ringing in the ears
  • Loss of sense of smell and taste
  • Slowness in thinking, acting, speaking or reading
  • Symptoms that may appear to be mental health conditions
    • Sudden mood changes for little or no reason
    • Difficulty managing relationships
    • Chronic anxiety, depression, apathy
  • Short term memory loss
  • Getting lost or easily confused
  • Having more trouble than usual with
    • Paying attention or concentrating
    • Organizing daily tasks
    • Making decisions

 How do I find out if I have TBI?

There are two steps to finding out if you have a traumatic brain injury.


The first step is screening to find out if you if you have experiences or symptoms that indicate you may have a TBI. This is a verbal logical test. The screener will ask a series of “Yes” or “No” questions, which usually takes about 5 minutes to complete. There are two possible outcomes of the screening: “I do not have TBI” or “I should be evaluated by a doctor to determine if I have TBI.” When you are referred to a doctor, it does not mean you have TBI. It only means that you are in a higher risk category for having TBI, and you should be examined by a doctor.

A variety of organizations provide TBI screening in Vermont.  You can go to any VA hospital or clinic. If you go to the White River Junction VA Medical Facility, you should be screened at their Polytrauma Support Clinic.  You can contact a member of the Vermont National Guard’s Veterans and Family Program, who have outreach specialists throughout the state and will help any veteran (not just guard veterans). You can also choose screening provided by community doctors and programs. To find out what is available in your area, you can contact the Brian Injury Association of Vermont, a non-profit organization helping Vermonters with TBI, or the State of Vermont Traumatic Brain Injury Program, which is part of the state Agency of Human Services.  They maintain a listing of all of the doctors and programs available in the state for people with TBI.

Medical Diagnosis by a Doctor

If you screen positive for TBI, we recommend you contact the White River Junction VA Medical Center’s Polytrauma Support Clinic. They will help you make arrangements to see a VA doctor to make a more definitive diagnosis. Again, if you would rather go see a doctor that is not affiliated with the VA or the military, you can get information from the Brain Injury Association and Traumatic Brain Injury Program. 

Who Should be Screened for TBI?

Veterans should be screened for TBI if they experienced any of the following during their service.

  • Close proximity to a blast or explosion (IED, RPG, Land Mine, Grenade, etc.)
  • Fragment wound or bullet wound above the shoulders
  • Vehicular accident or crash (including aircraft, tank, personnel carrier, etc.)
  • Fall
  • Blow to the head

I Already Know I have TBI, Who is Available to Help Me?

As you can see from above, there are a variety of programs in the state that can help you. If you have a diagnosis from a medical doctor that you have TBI, you should take advantage of whatever programs are best suited for your particular situation. Regardless of who you choose to provide care, veterans with a TBI should make contact with the VA Polytrauma Clinic and the Brain Injury Association of Vermont. That way they will stay informed of the resources available and will have a broader support network. Because every TBI is unique, there is no one-size-fits-all approach for treatment.

How can I Learn More About TBI?

In addition to the programs mentioned above, other resources are available to learn more. Here are two we’ve found helpful.

Defense and Veterans Brain Injury Center

The Defense and Veterans Brain Injury Center (DVBIC) serves active duty military, their dependents and veterans with TBI through medical care, clinical research initiatives and educational programs. They are a collaboration of the Department of Defense, the VA, and civilian partners. Their website has considerable information about TBI, to include TBI screening tools.

TBI Survival Guide

The TBI Survival Guide was put together by Ted Stachulski, a member of the Traumatic Brain Injury Program Advisory Board, a veteran, and a TBI survivor. This survival guide is a three-ringed binder that was catered specifically to the resources available here in Vermont and includes an 85 page guide filled with information that can help ease the burden of TBI survivors. To get a TBI Survival Guide, contact the Brain Injury Association.