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Polytrauma/TBI System of Care

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Understanding Traumatic Brain Injury


What is traumatic brain injury?

Traumatic brain injury (or TBI) is an injury to the head that affects the way the brain works. TBI can range from mild to severe.

What causes TBI?

TBI is caused by a sudden bump, blow, or jolt to the head or by a sharp object that pierces the brain. Not all head injuries cause TBI. TBI can happen during deployment, military training and civilian activities.

TBI can happen because of events like these:

  • A hard object such as a fist, club, or baseball bat strikes your head
  • Your head strikes a hard object, such as a car dashboard or the ground
  • An object such as a bullet pierces your skull
  • A nearby blast or explosion jolts your head (such as a bomb, grenade, improvised explosive device (IED), or firing certain weapons)

Who’s at risk for TBI?

TBI can happen to anyone. But certain groups of people have a higher risk. These groups include people who serve in the military.

These groups of people have a higher risk of TBI:

  • People ages 15 to 19
  • People ages 65 and older
  • People who use alcohol or drugs
  • Military service members, who may experience blasts or explosions

Men are at least 2 times as likely as women to have TBI.

Ask your health care team how you can lower your risk of TBI.

How severe can TBI be?

TBI can range from mild to severe. How severe your TBI is depends on these factors:

  • How long you remain unconscious after the injury
  • How long you remain confused or have memory loss after the injury
  • How responsive you are soon after the injury—for example, whether you can follow commands

A mild TBI happens when you’re confused or unconscious for a brief time. Mild TBI is also known as concussion.

A severe TBI happens when you lose consciousness for a longer amount of time or when an object pierces your brain.

What are some health conditions that are related to TBI?

TBI can cause changes in your ability to walk and perform everyday activities, as well as in your behavior and thinking skills. TBI can also lead to other health conditions like these:

  • Headaches
  • Mental health conditions (PTSD, depression, anxiety, or substance use)
  • Sleep problems
  • Difficulty remembering or paying attention;
  • Dizziness and imbalance

TBI can happen along with other injuries such as a broken bone, severe burn, or lost limb. When you have TBI and other related injuries or health problems, we call this “polytrauma.” Studies show that having 2 or more TBIs may increase the risk of conditions like Parkinson’s and Alzheimer’s Disease later in life.

How can I get care for TBI at VA?

If you think you have TBI, speak to your primary care provider or VA health care team. Or contact your local VA health facility. If you're not enrolled in VA health care, you can apply now. Learn how to apply for VA health care

Where will I go for care at VA?

We work to provide you with the right care at the right time and location for you. We provide your care at the VA facility closest to your home that has the expertise to manage your needs. If you need a high level of specialized care, you may need to travel to the VA facility that can provide that care. VA has a Polytrauma System of Care to treat and care for Veterans with TBI alone or in combination with other injuries and health conditions. This is a network of specialized programs and services located at most VA medical centers in the country.

How does VA treat TBI?

No matter what your symptoms are, treatments and resources are available. VA offers treatment options that are proven to be very effective. At VA, our experts across the country work together to provide all the care and support you need—from surgery to rehabilitation to mental health care. Depending on your health care needs, you can receive treatment at one of the specialized rehabilitation programs in the Polytrauma System of Care or seek treatment through your local VA facility or in-network community care provider.

Rehabilitation care in VA is provided by expert teams of doctors and therapists. They can develop a plan of care to meet your individual needs. Your care plan may include treatments like these:

  • Rehabilitation (such as physical, occupational, or speech-language therapy)
  • Learning strategies to cope with health, cognitive (thinking), and behavioral problems
  • Mental health counseling or other treatments
  • Assistive devices and technologies
  • Medical procedures and medicines
  • Surgery (may be needed in an emergency situation to minimize additional damage to brain tissues)