If your client recently sustained injury to head, neck, face, or body, or has been strangled, and is experiencing any of the red flag symptoms listed below, get medical help immediately - call 911 or get them to the nearest emergency department.
Signs and Symptoms
After a moderate or severe traumatic brain injury, a person can experience some of the same symptoms as experienced after a mild injury, in addition to the following:3
- Headache that gets worse/won't go away
- Persistent nausea/repeated vomiting
- Slurred speech
- Convulsions/seizures
- Inability to wake from sleep
- Enlargement of pupils (dark centre) in one or both eyes
- Numbness/tingling of the limbs
- Loss of coordination
- Increased confusion/restlessness/agitation
- Emotional changes (e.g., depression, anxiety, aggression, impulsivity)
- Personality changes
Red flag symptoms:1
- Neck pain
- Loss of consciousness, in and out of consciousness
- Confusion or irritability
- Severe or worsening headache
- Repeated vomiting
- Unusual changes in behaviour
- Seizures or convulsions
- Double vision
- Weakness/tingling/burning in limbs
Mild Traumatic Brain Injury/Concussion Signs and Symptoms:2
Physical:
- Headache
- Dizziness
- Nausea
- Vomiting
- Poor coordination
- Vision problems
- Fatigue
- Light sensitivity
- Noise sensitivity
Cognitive:
- Difficulty organizing thoughts
- Feeling slowed down
- Difficulty concentrating
- Difficulty remembering new information
Emotional:
- Irritability
- Sadness
- Heightened emotions
- Nervousness
- Anxiety
Sleep-related:
- Sleeping more/less than usual
- Trouble falling asleep
Strangulation Signs and Symptoms:4
Initial:
- Voice changes (e.g., hoarse, raspy voice, loss of voice)
- Pain when swallowing
- Bleeding from mouth/coughing up blood
- Abrasions, swelling, redness or bruises on the neck
- Ligature marks from rope, cord, fabric
- Swollen tongue
- Difficulty with concentration/attention/coordination/memory
- Difficulty using words, processing meaning of words
- Headache
- Light-headedness
- Dizziness
- Ear ringing
- Facial/eyelid drooping
- Breathing changes (e.g., hyperventilating)
- Sweating
- Visual disturbances
- Numbness/tingling
- Confusion
- Mental status changes (e.g., combativeness, agitation)
- Drowsiness
- Cyanosis (blue tint to skin due to low oxygen)
- Petechiae (small red spots) under the eyelids, around eyes/face/neck/scalp
- Bloody red eyes
- Limb jerking
- Seizures
- Loss of consciousness
- Coma
- Miscarriage if pregnant
- Involuntary urination/defecation
- Hormonal problems (e.g., neurogenic diabetes insipidus causing excessive thirst and urine production)
Long-term:
- Limb weakness
- Disturbed movement/balance/coordination (e.g., tremor, involuntary writhing, jerking)
- Spasticity/rigidity
- Cortical blindness (loss of vision in otherwise healthy eyes due to brain damage)
- Memory problems
- Disturbed speech and language functions
- Disturbed executive function (e.g., thinking, reasoning, making judgments, planning)
- Personality changes (e.g., irritability, impulsiveness, social conduct)
- Hormonal problems (e.g., muscle weakness, low blood pressure, inability to regulate body temperature)