The relative risk of post-traumatic seizures increases with the severity of<unk> . A CT of the head years after a<unk>  showing an empty space where the damage occurred marked by the arrow. Improvement of neurological function usually occurs for two or more years after the trauma. For many years it was believed that recovery was fastest during the first six months, but there is no evidence to support this. It may be related to services commonly being withdrawn after this period, rather than any physiological limitation to further progress. Children recover better in the immediate time frame and improve for longer periods. Complications are distinct medical problems that may arise as a result of the<unk> . The results of<unk>  vary widely in type and duration; they include physical, cognitive, emotional, and behavioral complications.<unk>  can cause prolonged or permanent effects on consciousness, such as coma,<unk>  death, persistent vegetative state (in which patients are unable to achieve a state of alertness to interact with their surroundings), and minimally conscious state (in which patients show minimal signs of being aware of self or environment). Lying still for long periods can cause complications including pressure sores, pneumonia or other infections, progressive multiple organ failure, and deep venous thrombosis, which can cause pulmonary embolism. Infections that can follow skull fractures and penetrating<unk> es include meningitis and abscesses. Complications involving the blood vessels include vasospasm, in which vessels constrict and restrict blood flow, the formation of aneurysms, in which the side of a vessel weakens and balloons out, and stroke. Movement disorders that may develop after<unk>  include tremor, ataxia (uncoordinated muscle movements), spasticity (muscle contractions are overactive), myoclonus (shock-like contractions of muscles), and loss of movement range and control (in particular with a loss of movement repertoire). The risk of post-traumatic seizures increases with severity of trauma (image at right) and is particularly elevated with certain types of<unk>  trauma such as cerebral contusions or hematomas. People with early seizures, those occurring within a week of<unk> , have an increased risk of post-traumatic epilepsy (recurrent seizures occurring more than a week after the initial trauma). People may lose or experience altered vision, hearing, or smell. Hormonal disturbances may occur secondary to hypopituitarism, occurring immediately or years after<unk>  in 10 to 15% of<unk>  patients. Development of diabetes insipidus or an electrolyte abnormality acutely after<unk>  indicate need for endocrinologic work up. Signs and symptoms of hypopituitarism may develop and be screened for in adults with moderate<unk>  and in mild<unk>  with imaging abnormalities. Children with moderate to severe head<unk>  may also develop hypopituitarism. Screening should take place 3 to 6 months, and 12 months after<unk> , but problems may occur more remotely. Cognitive deficits that can follow<unk>  include impaired attention; disrupted insight, judgement, and thought; reduced processing speed; distractibility; and deficits in executive functions such as abstract reasoning, planning, problem-solving, and multitasking. Memory loss, the most common cognitive impairment among head-injured people, occurs in 20–79% of people with closed head trauma, depending on severity. People who have suffered<unk>  may also have difficulty with understanding or producing spoken or written language, or with more subtle aspects of communication such as body language. Post-concussion syndrome, a set of lasting symptoms experienced after mild<unk> , can include physical, cognitive, emotional and behavioral problems such as headaches, dizziness, difficulty concentrating, and depression. Multiple<unk> s may have a cumulative effect. A young person who receives a second concussion before symptoms from another one have healed may be at risk for developing a very rare but deadly condition called second-impact syndrome, in which the<unk>  swells catastrophically after even a mild blow, with debilitating or deadly results. About one in five career boxers is affected by chronic<unk>  (CTBI), which causes cognitive, behavioral, and physical impairments. Dementia pugilistica, the severe form of CTBI, affects primarily career boxers years after a boxing career. It commonly manifests as dementia, memory problems, and parkinsonism (tremors and lack of coordination).<unk>  may cause emotional, social, or behavioral problems and changes in personality. These may include emotional instability, depression, anxiety, hypomania, mania, apathy, irritability, problems with social judgment, and impaired conversational skills.<unk>  appears to predispose survivors to psychiatric disorders including obsessive compulsive disorder, substance abuse, dysthymia, clinical depression, bipolar disorder, and anxiety disorders. In patients who have depression after<unk> , suicidal ideation is not uncommon; the suicide rate among these persons is increased 2- to 3-fold. Social and behavioral symptoms that can follow<unk>  include disinhibition, inability to control anger, impulsiveness, lack of initiative, inappropriate sexual activity, asociality and social withdrawal, and changes in personality.<unk>  also has a substantial impact on the functioning of family systems Caregiving family members and<unk>  survivors often significantly alter their familial roles and responsibilities following<unk> , creating significant change and strain on a family system. Typical challenges identified by families recovering from<unk>  include: frustration and impatience with one another, loss of former lives and relationships, difficulty setting reasonable goals, inability to effectively solve problems as a family, increased level of stress and household tension, changes in emotional dynamics, and overwhelming desire to return to pre-injury status. In addition, families may exhibit less effective functioning in areas including coping, problem solving and communication. Psychoeducation and counseling models have been demonstrated to be effective in minimizing family disruption.
Traumatic brain injury
Alcohol intoxication
Pediatric concussion
Epidural hematoma
Acquired brain injury
Abnormal posturing  Abnormal posturing  1
Penetrating head injury
Cerebral edema  Cerebral edema  1