CEMM Virtual Library

Moderate to Severe TBI

Potential Effects of Moderate to Severe TBI

The long-term symptoms of TBI can be divided into several categories, including physical changes, cognitive effects, sensory effects, perceptual effects, social/emotional changes and others. You’ll find a partial list of these symptoms and effects below. Keep in mind that the symptoms and effects will vary greatly from one patient to another, depending on the severity of the TBI.


Physical changes:

  • Sleep disorders
  • Loss of stamina
  • Appetite changes
  • Physical paralysis/spasticity
  • Chronic pain
  • Control of bowel and bladder
  • Seizures
  • Difficulty regulating body temperature
  • Hormonal challenges


Cognitive difficulties relating to:

  • Attention
  • Concentration
  • Distractibility
  • Memory
  • Speed of processing
  • Confusion
  • Perseveration, the abnormal persistent repetition of a word gesture or act.
  • Impulsiveness
  • Language Processing
  • Executive functions, which are involved in brain processes, such as planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions and inhibiting inappropriate actions, and selecting relevant sensory information.

Speech and Language

Speech and language effects:

  • Receptive Aphasia — which involves difficulty understanding the spoken word
  • Expressive Aphasia — in which the patient knows what he wishes to say but is unable to get the words out. In some cases, the patient is able to perceive and comprehend both spoken and written language, but is unable to repeat what he sees or hears.
  • Slurred speech
  • Speaking very fast or very slow
  • Problems reading
  • Problems writing


Sensory difficulties relating to the interpretation of:

  • Touch
  • Temperature
  • Movement
  • Limb position
  • Fine discrimination

Perceptual effects:

  • Difficulty integrating and understanding information gained through the five senses


  • Partial or total loss of vision
  • Weakness of eye muscles and double vision (diplopia)
  • Blurred vision
  • Problems judging distance
  • Involuntary eye movements (nystagmus)
  • Intolerance of light (photophobia)


  • Decrease or loss of hearing
  • Ringing in the ears (tinnitus)
  • Increased sensitivity to sounds


  • Loss or diminished sense of smell (anosmia)


  • Loss or diminished sense of taste


Social-emotional effects:

  • Dependent behaviors
  • Fluctuating emotions
  • Lack of motivation
  • Irritability
  • Aggression
  • Depression
  • Lack of inhibition
  • Denial/lack of awareness

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