Traumatic Brain Injury
What is a Traumatic Brain Injury?
A traumatic brain injury (TBI) is an injury to the brain or skull caused by force, such as a strike or impact, and the damage can disturb the function of the brain. Not every head injury causes a traumatic brain injury. A TBI can range from a mild injury to severe. Severe cases can result in unconsciousness or amnesia after the injury. TBI symptoms may not appear until days or weeks following the injury. Serious traumatic brain injuries need emergency treatment.
Causes of Traumatic Brain Injuries
Can occur when the head:
- is violently shaken by external force (e.g., severe whiplash, shaken baby syndrome)
- hits a stationary object (e.g., falls, hits a windshield in a car crash)
- is hit (e.g., by impact from a ball)
- is penetrated (e.g., gunshot wound)
Types of Brain Injuries
Concussions
Most TBIs are concussions or other forms of mild TBI. A concussion is a type of brain injury caused by a bump, blow, or jolt to the head that changes the way the brain normally works. They can also occur from a blow to the body that causes the head to move rapidly back and forth.
Acquired Brain Injury
An acquired brain injury (ABI) occurs after birth and is caused by a stroke, lack of oxygen to the brain (known as hypoxia), which can happen in cases of near drowning, choking, and smoke inhalation.
Shaken Baby Syndrome
Shaken Baby Syndrome is a form of abuse. When anyone shakes a baby or young child, their brain and body are seriously injured. Some children can even die. It takes only a few seconds of shaking to cause permanent damage. When a baby or young child is violently shaken, their head rolls back and forth causing their brain to hit the skull.
Signs and Symptoms of a TBI
The signs and symptoms can be either subtle or obvious depending on the severity of the injury. Seek medical attention if you or someone is experiencing any of the following:
- Headaches or neck pain that do not go away
- Difficulty remembering, concentrating, or making decisions
- Slurred speech, and slowness in thinking, speaking, acting, or reading
- Getting lost or easily confused
- Feeling tired all of the time, having no energy or motivation
- Mood changes (feeling sad or angry for no reason)
- Changes in sleep patterns (sleeping a lot more or having a hard time sleeping)
- One pupil larger than the other
- Convulsions or seizures
- Light-headedness, dizziness, or loss of balance
- Nausea repeated vomiting
- Increased sensitivity to lights, sounds, or distractions
- Blurred vision or eyes that tire easily
- Loss of sense of smell or taste
- Ringing in the ears
- Loss of consciousness
Children with a brain injury can have the same signs and symptoms as adults.
It is often harder for children to communicate how they feel. A health care provider will be able to decide how serious the injury is. If the child was playing a sport while their head was injured, do not let them return to play until they have been medically cleared. Athletes who return to play too soon are at a greater risk for having a second traumatic brain injury.
Call their health care provider if a blow to the head occurred and you notice any of the above symptoms or any of the following:
- Will not stop crying or cannot be consoled
- Will not eat or nurse
- Changes in the way the child plays
- Changes in performance at school
- Changes in the way the child plays
- Changes in performance at school
- Lack of interest in favorite toys or activities
- Loss of new skills, such as toilet training
- Loss of balance or unsteady walking
Who is at Risk?
Children
In children, the most severe TBIs occur from motor vehicle traffic-related crashes. Using an age-appropriate car or booster seat, or a seat belt, and riding in the backseat until age 13 to reduce these risks. Also, following the rules of the road and being a safe pedestrian and bicyclist will also help reduce risk of injury. Children also are at a great risk of a TBI due to a fall. Making sure the home is safe by using gates at the top of stairs, safety locks on windows, and practicing safe play even on playgrounds are some ways to reduce the risk of falls. In addition, secure firearms to avoid unintentional firearm injuries.
Children's Sports
Every year, thousands of New York children 19 and younger are treated at hospitals for a sports-related TBI. Concussions can happen in any sport, but most often occur in contact sports, such as football, rugby, or ice hockey. These sports require the use of proper safety equipment on the body and/or rules to participate safely.
Older Adults
In New York State, falls a leading cause of unintentional injury deaths for those 45 years and older. Adults 65 years and older have the highest rate of TBI deaths.
Victims of Violence
Victims of violence who have been hit in the face or head, fallen and hit their head, been shaken severely, strangled, or choked are at risk for a TBI. Heads Up! is a resource for anyone who may be a victim of violence and experiencing TBI symptoms.
Veterans
TBIs are a significant health issue that affects service members and veterans.
TBI and Long-term Health
A traumatic brain injury can cause a wide range of functional changes affecting thinking, sensation, language, or emotions. They can also cause epilepsy and increase the risk for conditions such as Alzheimer's disease, Parkinson's disease, and other brain disorders that become more common with age. Repeated mild TBIs taking place over months or years can result in lasting physical and mental changes. Those that occur within a short period of time, such as hours, days, or even weeks, can be fatal.
Recovery
Medical care and evaluation after a brain injury is sometimes a long process. Staying connected with your healthcare provider during recovery, remaining patient, and listening to your body are important. Ignoring symptoms and returning to regular daily activities or sports too soon can make the symptoms worse. Parents and guardians need to take an active role in their child's recovery.
Brain Injury Grand Rounds Webinar Series
Join the New York State Department of Health, the New York Office of Mental Health, and the New York State Office of Addiction Support and Services for a webinar training series designed to strengthen providers' skills in recognizing brain injury, delivering effective interventions, and engaging individuals with complex co-occurring needs.
Brain Injury Grand Rounds Flyer (PDF)
Brain Injury 101: Understanding & Identifying Brain Injury via WebEx
Tuesday, March 31, 2026
10 a.m. to 11 a.m.
This session offers a practical foundation in Acquired Brain Injury, including concussions, other Traumatic Brain Injuries (TBI), and hypoxic events. Learn how these often-underrecognized injuries can shape behavior, cognition, and recovery, particularly with behavioral health or substance use challenges. Through real-world case examples, participants will learn to identify possible indicators of brain injury even without a formal diagnosis. They will also gain insight into how brain injuries are assessed and confirmed in clinical practice.Brain Injury Grand Rounds Flyer 3.31.2026 (PDF)
Continuing Medical Education and Continuing Education Credits
This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the New York State Office of Mental Health's Bureau of Psychiatric Services & Research Institute Support and the New York State Department of Health. The Bureau of Psychiatric Services & Research Institute Support is accredited by MSSNY to provide continuing medical education for physicians.
The Bureau of Psychiatric Services & Research Institute Support designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Bureau of Psychiatric Services & Research Institute Support relies upon planners and faculty participants to provide educational information that is objective and free of bias. In this spirit, and in accordance with the Bureau of Psychiatric Services & Research Institute Support & MSSNY guidelines, all speakers & planners must follow guidelines. They must disclose financial relationships with ineligible companies whose products, devices, or services may be discussed in the CME content or may be perceived as a real or apparent conflict of interest. Any discussion of investigational or unlabeled use of a product will be identified.
The planners and presenters for this educational activity do not have any financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing health care products used by or on patients.
This activity has been submitted to VTL Center for Professional Development for approval to award contact hours. VTL Center for Professional Development is accredited as an approver of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
The New York State Office of Mental Health (OMH) is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0227. Licensed Master Social Workers (LMSWs) and Licensed Clinical Social Workers (LCSWs) who attend this class in its entirety will receive one contact hour toward renewal of their social work license.
OMH is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0122. Licensed Psychologists who attend this class in its entirety will receive 1 contact hour toward renewal of their license.
This course is approved for CASAC/CPP/CPS renewal clock hours.
Brain Injury Treatment: Psychopharmacology & Medical Interventions via WebEx
Tuesday, April 21, 2026
10 a.m. to 11 a.m.
This session explores the neurobehavioral and psychiatric symptoms that often complicate brain injury recovery. These include cognitive changes, impulse control issues, emotional dysregulation, post-traumatic stress, suicidality, and new or worsening substance use. Learn about medication considerations specific to brain injury, including agents to avoid, which may support stabilization, and how brain injury can alter an individual's response to psychiatric and addiction treatments.Brain Injury Grand Rounds Flyer 4.21.2026 (PDF)
Continuing Medical Education and Continuing Education Credits
This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the New York State Office of Mental Health's Bureau of Psychiatric Services & Research Institute Support and the New York State Department of Health. The Bureau of Psychiatric Services & Research Institute Support is accredited by MSSNY to provide continuing medical education for physicians.
The Bureau of Psychiatric Services & Research Institute Support designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Bureau of Psychiatric Services & Research Institute Support relies upon planners and faculty participants to provide educational information that is objective and free of bias. In this spirit & in accordance with the Bureau of Psychiatric Services & Research Institute Support & MSSNY guidelines, all speakers & planners must follow guidelines. They must disclose financial relationships with ineligible companies whose products, devices, or services may be discussed in the CME content or may be perceived as a real or apparent conflict of interest. Any discussion of investigational or unlabeled use of a product will be identified.
The planners and presenters for this educational activity do not have any financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing health care products used by or on patients.
This activity has been submitted to VTL Center for Professional Development for approval to award contact hours. VTL Center for Professional Development is accredited as an approver of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
The New York State Office of Mental Health (OMH) is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0227. Licensed Master Social Workers (LMSWs) and Licensed Clinical Social Workers (LCSWs) who attend this class in its entirety will receive one contact hour toward renewal of their social work license.
OMH is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0122. Licensed Psychologists who attend this class in its entirety will receive one 1 contact hour toward renewal of their license.
This course is approved for CASAC/CPP/CPS renewal clock hours.
Brain Injury: Practical Strategies for Engagement via WebEx
Tuesday, May 19, 2026
10 a.m. to 11 a.m.
This session examines barriers often preventing individuals with brain injury from fully engaging in behavioral health and addiction services. Practical strategies to improve access and participation will be provided, including communication techniques supporting clients with cognitive challenges. Learn approaches to reduce confusion and overwhelm by shaping environments, as well as ways to adapt therapy, groups, and case management so that care is genuinely informed by the needs of people living with brain injury.Brain Injury Grand Rounds Flyer 5.19.2026 (PDF)
Continuing Medical Education and Continuing Education Credits
This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the New York State Office of Mental Health's Bureau of Psychiatric Services & Research Institute Support and the New York State Department of Health. The Bureau of Psychiatric Services & Research Institute Support is accredited by MSSNY to provide continuing medical education for physicians.
The Bureau of Psychiatric Services & Research Institute Support designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Bureau of Psychiatric Services & Research Institute Support relies upon planners and faculty participants to provide educational information that is objective and free of bias. In this spirit, and in accordance with the Bureau of Psychiatric Services & Research Institute Support & MSSNY guidelines, all speakers & planners must follow guidelines. They must disclose financial relationships with ineligible companies whose products, devices, or services may be discussed in the CME content or may be perceived as a real or apparent conflict of interest. Any discussion of investigational or unlabeled use of a product will be identified.
The planners and presenters for this educational activity do not have any financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients.
This activity has been submitted to VTL Center for Professional Development for approval to award contact hours. VTL Center for Professional Development is accredited as an approver of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
The State of New York Office of Mental Health (OMH) is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0227. Licensed Master Social Workers (LMSWs) and Licensed Clinical Social Workers (LCSWs) who attend this class in its entirety will receive one contact hour toward renewal of their social work license.
OMH is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0122. Licensed Psychologists who attend this class in its entirety will receive 1 contact hour toward renewal of their license.
This course is approved for CASAC/CPP/CPS renewal clock hours.
