Diagnosis of Brain Injury: FAQs

Getting a Diagnosis of Brain Injury is Essential

By DeAnna Frye, Ph.D.

What does diagnosis of traumatic brain injury mean?

Traumatic brain injury (TBI) occurs when a sudden physical assault on the head causes damage to the brain.  The head does not have to be struck directly for the brain to be injured.  The damage can be focal which means it is confined to one area of the brain, or it can be diffuse and involve more than one area of the brain.  TBI can result from a closed head injury or a penetrating head injury.

Symptoms indicating a TBI diagnosis may include headache, nausea, confusion or other cognitive problems, a change in personality, depression, irritability, and other emotional and behavioral problems.  Some people may have seizures as a result of a TBI.

What are the types of head injury?

A closed head injury occurs when the head suddenly and violently hits an object, but the object does not break through the skull. 

A penetrating head injury occurs when an object pierces the skull and enters the brain tissue.

A concussion is a jarring injury to the brain.  A person who has a concussion may not pass out or may lose consciousness only very briefly. The person may feel dazed and may lose vision or balance for a while after the injury.

A skull fracture is when the skull cracks.  Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury.  A depressed skull fracture occurs when pieces of the broken skull press into the tissue of the brain. 

Shaken baby syndrome is a severe form of head injury that occurs when a baby is shaken

Can blood collect in the brain?

A brain contusion is a bruise of the brain.  This means there is some bleeding in the brain, that may cause the brain to swell.  A contusion can also occur in response to shaking the brain within the confines of the skull, an injury called “countrecoup.”

A hematoma is bleeding in the brain that collects and clots.  A hematoma may not be apparent for a day or even as long as several weeks.  So it’s important to tell your doctor if someone with a head injury feels or acts oddly.

Damage to a major blood vessel within the head can cause a hematoma, or heavy bleeding into or around the brain.  The severity of a TBI can range from a mild concussion to the extremes of coma or even death.  A coma  is a profound or deep state of unconsciousness.

What is the difference between a traumatic brain injury (TBI) and an acquired brain injury (ABI)?

A traumatic brain injury is the result of an injury to the brain by an external physical force that may produce a change in consciousness and results in impairment of cognitive abilities, physical functioning or changes in personality/behavior.  Types of TBI include diffuse axonal injury, concussion, contusion and coup-contrecoup injury.  This kind of injury can occur from car crashes, falls, sports injuries, or physical violence.

An acquired brain injury is an injury to the brain that occurs after birth and is due to a change in neuronal activity, usually as the result of another medical condition.  Examples of ABI include anoxia, which is an injury that occurs when the brain does not receive any oxygen, or hypoxia, when the brain receives some, but not enough oxygen.  Causes of ABI can include heart attacks, aneurysms, near drowning, choking, electrical shock or airway obstruction.

What is “Second Impact Syndrome?”

Second impact syndrome is also known as recurrent traumatic brain injury and can occur when an individual has a second brain injury before the first injury has healed.  The second injury can occur days or weeks after the first one and is more likely to cause swelling of the brain and widespread damage.  Individuals experiencing second impact syndrome need to seek emergency medical treatment immediately as death can occur rapidly following the second injury.  This is why it is important that anyone recovering from a brain injury take all possible precautions to avoid further injuries until all of their symptoms from the first injury have resolved.  This includes all types of brain injuries, even concussions.

Dr DeAnna Frye has a B.S. in Psychology, M.S. in Counseling Psychology, Ph.D. in Counseling Psychology. She is currently employed by Neurology Neuroscience Associates of Akron. Her special interests are psychotherapy and counseling to patients with neurological disorders with special expertise in brain injury. She is a founding member and the current co-chair of the Summit County Traumatic Brain Injury Collaborative located in Akron, Ohio.

Recommendations for more information:

Brain Injury: It is a Journey

By Flora Hammond, M.D. and Tami Guerrier, B.S.

This brain injury book for families explains consequences of traumatic brain injury and gives strategies for coping with changes in the survivor’s physical abilities, memory, attention, thinking and emotions.


Understanding the Effects of Concussion, Blast and Brain InjuriesUnderstanding the Effects of Concussion, Blast and Brain Injuries

Blast injury, PTSD and brain injury guide for families and caregivers on the consequences of concussion in veterans. Used by many VA Hospitals and Army Medical Facilities.



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4 responses to “Diagnosis of Brain Injury: FAQs”

  1. Dear Shelley,
    No it does not result in a traumatic or acquired brain injury. You wil find a helpful article on ECT – electroconvulsive therapy – on Wikipedia at

    Best wishes,
    Marilyn Lash

  2. Shelley says:

    Does/can ECT cause a TBI or abi?

  3. Dodie says:

    I am an acquired brain injury survivor. Many non-invasive medical procedures have been tried but all have failed to give a “picture” of the brain injury that I have had for 15 years, which was exponentially increased in nature by two minor car accidents 8 years ago. It is a living hell to be a survivor or such an injury because you look & sound the same as ever–I believe that this is actually part of my defence mechanisms that help me hide my “invisible disability”. Therefore, others, including many close Family Members & Friends, as well as many Medical Practitioners, deny you your validation without that aforementioned “picture”.
    Is there anyone out there who can help me, Please?

  4. Hello, I must say this is a good article. Such clever writing is rare these days. Informed comment like this has to be applauded. I’ll certainly be looking in on this blog again soon.

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