16._20TBI_Fact_20Sheet_RCC_May_202014

OFFICE OF WOUNDED WARRIOR CARE POLICY | 200 Stovall Street | Room 11N01 | Alexandria, VA 22302 | [PHONE] 
Created by Wounded Warrior Care Policy for RCC Training purposes. 
00133-758 
Traumatic Brain Injury 
RCC Fact Sheet 
What is Traumatic Brain Injury?  
Traumatic brain injury (TBI) is a blow or jolt to the head that disrupts 
the function of the brain. It is important to know that not all blows or 
jolts to the head result in a TBI. The severity of the TBI is determined 
at the time of injury and may be classified as mild, moderate, severe 
or penetrating. 
Common causes of TBI in the military include blast exposures, 
bullets or fragments, falls, motor vehicle accidents, or other (blunt 
objects). Common physical symptoms in mild TBI (mTBI) are 
headache, dizziness, balance problems, nausea/vomiting, fatigue, 
visual disturbances, light sensitivity, and/or ringing in the ears. 
Cognitive deficits include slowed thinking, poor concentration, 
memory problems and/or difficulty finding words. Emotional 
symptoms include anxiety, depression, irritability or mood swings. 
Concussion is another word for a mild TBI. mTBI is not always 
obvious, and sometimes has a delayed presentation. It is the most 
common form of TBI in the military population. Moderate TBI often 
requires hospitalization with a transition to rehabilitation focused on 
return to duty or community reentry. Severe or penetrating TBI is an 
obvious injury that requires hospitalization and intensive rehabilitation 
and has potential for long-term care needs for the Service member. 
Education, support and advocacy across the continuum of care, 
recovery and spectrum of severity can help to mitigate negative 
outcomes and support positive functional outcomes for the Service 
member and family. 
How does this issue affect wounded warriors  
and their families? 
The effect of moderate to severe TBI can include changes in motor 
skills and balance, hearing, vision, speech, taste and smell, tremors 
and spasticity, fatigue and weakness, and seizures. Cognitive effects 
can include changes in memory, attention, concentration, processing, 
receptive and expressive language, executive functioning skills and 
self-perception. Personality and behavioral changes can include 
depression, difficulty with social skills, mood swings, emotional 
dyscontrol, inappropriate behavior, inability to inhibit remarks, 
inability to recognize social cues, problems with initiation, reduced 
self-esteem, and difficulty maintaining relationships or forming new 
relationships. All of these possible symptoms and changes can 
cause disruptions in school, work, and home environments often 
leading to marital and family separations, substance abuse, and 
engagement in risky behaviors resulting in judicial involvement. 
Families often become care-givers for their loved one with TBI and 
struggle with resources to address their needs. These physical, 
cognitive and personality/behavioral changes are of particular 
concern during periods of transition, such as moving from in-patient 
to out-patient status, returning to duty, etc. 
How can knowledge of this issue help Recovery  
Care Coordinators? 
Wounded warriors with TBI require identification, evaluation and 
support throughout the recovery process from injury to return to duty 
and/or reintegration into the community. Because of their access to 
the multi-disciplinary Recovery Team, Recovery Care Coordinators 
(RCCs) are well-positioned to support and connect the Service 
member to necessary care and resources. RCCs with knowledge of 
the effects of TBI can serve to identify Service members who may 
have sustained mTBI and connect them with the appropriate clinical 
care for TBI specific services. They can also support recovering 
Service members by providing increased contact during transitions 
from one level of care to the next, as this is when the Service 
member and families are most vulnerable. They can monitor missed 
medical, case management and/or support appointments; early 
discharge from medical care or case management due to behavioral 
problems; psychological or judicial involvement; anxiety; depression; 
irritability; mood swings; poor impulse control; substance abuse; 
marital and relationship problems; and trouble at work and provide 
early intervention and support services. 
Where can I find more information? 
DVBIC has a national network of programs providing subject 
matter experts on the continuum of care and recovery trajectory 
for TBI, educational resources and clinical care for recovering 
Service members, veterans and families dealing with TBI. As the 
Office of Responsibility for the surveillance of the incidence and 
prevalence of TBI in the DoD, DVBIC follows up with all 
symptomatic Service members and veterans with a diagnosis of 
TBI. More information can be accessed through the Web site at 
www.dvbic.org. TBI: A Guide for Family Caregivers of 
Service Members and Veterans is now available for caregivers 
of Service members with moderate to severe TBI.