A traumatic brain injury can change how a person thinks, feels, communicates, sleeps, works, and interacts with family members. After a serious car or truck wreck, some brain injuries are immediately apparent. Others are subtle and may not become noticeable until hours or days later.
A person does not have to lose consciousness, strike the windshield, or suffer a skull fracture to sustain a traumatic brain injury. A forceful impact to the head or body can cause a TBI when the collision suddenly moves the head and brain.
If you are experiencing headaches, dizziness, memory problems, confusion, blurred vision, difficulty concentrating, mood changes, unusual fatigue, or disrupted sleep after a Dallas car or truck wreck, those symptoms should not be ignored.
What Is a Traumatic Brain Injury?
A traumatic brain injury, commonly called a TBI, is a brain injury caused by an outside force. It may result from a bump, blow, or jolt to the head or body or from an object that penetrates the skull.
A TBI can cause temporary or permanent problems with:
Memory
Concentration
Communication
Movement
Balance
Behavior
Emotional control
Sleep
Daily functioning
TBIs range from concussions to severe injuries involving brain bleeding, swelling, widespread nerve damage, permanent disability, or death. The Centers for Disease Control and Prevention identifies TBI as a major cause of death and disability in the United States.
Common types of traumatic brain injuries include:
Mild traumatic brain injury or concussion
Brain contusion or bruising
Intracranial hemorrhage or brain bleeding
Subdural hematoma
Epidural hematoma
Subarachnoid hemorrhage
Diffuse axonal injury
Penetrating brain injury
Skull fracture with associated brain trauma
A “mild” TBI is still a brain injury. The term generally describes the person’s initial presentation and does not necessarily predict how long the symptoms will last or how seriously the injury will affect daily life.
Researchers have recognized that traditional labels such as mild, moderate, and severe do not always accurately predict a patient’s long-term outcome. Some people initially classified as having a mild TBI continue to experience significant symptoms.
How Car and Truck Wrecks Cause Traumatic Brain Injuries
During a collision, the head and body may be thrown forward, backward, or sideways within a fraction of a second. Rapid acceleration, deceleration, and rotational movement can affect the brain even when the head does not directly strike an object.
Direct impact with the vehicle interior
A driver or passenger may strike their head against:
The steering wheel
Dashboard
Side window
Door frame
Headrest
Roof
Windshield
Airbag
Another part of the vehicle interior
A direct blow may cause a concussion, brain contusion, skull fracture, or bleeding within or around the brain.
Sudden acceleration and deceleration
In a rear-end, head-on, rollover, or side-impact wreck, the head may move violently even without striking the vehicle interior.
A sudden change in speed or direction can cause the brain to move inside the skull. A concussion can result in chemical changes within the brain and may stretch or damage brain cells.
Rotational forces
Side-impact crashes, rollovers, angled collisions, and multi-vehicle wrecks can also produce twisting forces.
When the head suddenly turns, the brain may rotate inside the skull. That rotational movement can place stress on the nerve fibers that allow different areas of the brain to communicate.
Multiple impacts in a chain-reaction wreck
A person may experience more than one violent movement during the same collision.
A driver may be:
Struck from behind
Pushed into the vehicle ahead
Spun into another traffic lane
Forced into a concrete barrier
Struck again by another vehicle
Each impact may cause a different change in the direction and speed of the head and brain.
Rear-Ended and Pushed Into the Vehicle Ahead
Imagine a driver stopped in traffic behind another vehicle. A pickup truck, delivery vehicle, or 18-wheeler crashes into the driver from behind and pushes the driver’s vehicle into the car directly ahead.
This is not one simple impact. The occupant may experience two separate and opposing collision forces within moments of each other.
When the vehicle is rear-ended, the seat suddenly pushes the occupant’s torso forward. The head, however, may initially lag behind because of inertia, causing the neck to extend backward before the head and neck move forward.
If the rear impact pushes the vehicle into the car ahead, the occupant experiences a second abrupt change in movement. During that front-end collision, the torso continues moving forward until it is suddenly restrained by the seat belt. The head may continue moving forward after the torso begins to slow, increasing the stress placed on the neck and head.
The experience can be compared to being tackled from behind and then immediately punched in the face.
The first collision violently drives the body forward from the rear. The second collision abruptly stops that forward movement from the front. These rapid changes in speed and direction can cause the head to move backward and forward and may cause the brain to move inside the skull.
The occupant may strike the headrest during the initial rear impact and then strike the steering wheel, airbag, side window, or another part of the vehicle during the second collision. However, a direct blow to the head is not required. A forceful jolt to the body may cause a traumatic brain injury.
After the wreck, the driver may experience:
Headaches
Dizziness
Nausea
Blurred vision
Sensitivity to light or sound
Memory problems
Confusion
Mental fogginess
Unusual fatigue
Irritability
Difficulty concentrating
Sleep disturbances
The driver may remain conscious throughout both impacts and still suffer a concussion or another traumatic brain injury.
Other Examples of TBIs From Motor Vehicle Wrecks
Rear-end collision without loss of consciousness
A driver is stopped at a red light when an SUV crashes into the rear of the vehicle. The driver’s head moves rapidly backward and forward.
The driver never blacks out and initially believes the injuries are limited to neck and back pain. Later that evening, the driver develops a severe headache, nausea, sensitivity to light, mental fogginess, and difficulty remembering conversations.
Those symptoms may be consistent with a concussion or mild TBI. Loss of consciousness is not required.
Side-impact wreck at an intersection
A pickup truck runs a red light and strikes the driver’s side of a passenger car. The impact throws the driver’s head sideways into the window or door pillar.
Emergency imaging may identify a brain contusion, skull fracture, or intracranial bleeding. The driver may experience confusion, vomiting, speech problems, weakness, worsening drowsiness, or loss of consciousness.
18-wheeler rear-end collision
A commercial truck driver fails to slow for stopped traffic and crashes into a smaller passenger vehicle.
The force of the collision may push the passenger vehicle into surrounding traffic, a barrier, or off the roadway. The occupant’s head and brain may be subjected to violent forward, backward, and rotational movement.
The occupant may suffer a concussion, brain bleed, brain contusion, skull fracture, or axonal injury.
Rollover wreck
During a rollover, an occupant may experience repeated impacts as the vehicle rotates.
The person’s head may strike the:
Roof
Window
Door pillar
Headrest
Dashboard
Ground
Loose objects inside the vehicle
Repeated trauma can cause brain bleeding, bruising, swelling, skull fractures, and other serious injuries.
Pedestrian or bicyclist struck by a vehicle
A pedestrian or bicyclist may suffer an initial impact from the vehicle followed by a second impact with the pavement.
Even when a bicyclist wears a helmet, the forces involved may cause a concussion, brain contusion, hemorrhage, skull fracture, or more serious brain injury.
Symptoms of a Traumatic Brain Injury After a Wreck
TBI symptoms vary from person to person. Some symptoms begin immediately, while others may not appear until hours or days after the collision.
Symptoms can affect how a person feels, thinks, acts, and sleeps. They may also change during recovery.
Physical symptoms
Physical symptoms may include:
Headaches or pressure in the head
Headaches that continue to worsen
Dizziness or vertigo
Nausea
Vomiting
Blurred vision
Double vision
Sensitivity to light
Sensitivity to noise
Ringing in the ears
Balance problems
Poor coordination
Fatigue
Weakness
Numbness or tingling
Seizures
Slurred speech
Loss of consciousness
Unusual drowsiness
Difficulty waking up
Blood or clear fluid draining from the nose or ears
Cognitive symptoms
A traumatic brain injury may interfere with the ability to think, learn, remember, and process information.
Cognitive symptoms may include:
Confusion
Feeling mentally foggy
Difficulty concentrating
Short-term memory loss
Forgetting recent conversations
Repeating questions
Slowed thinking
Trouble following instructions
Difficulty reading
Trouble understanding information
Difficulty finding the right words
Problems making decisions
Reduced ability to multitask
Problems organizing daily activities
Getting lost in familiar places
Forgetting appointments or responsibilities
Published medical literature describes headaches, blurred vision, dizziness, sleep problems, subjective memory problems, poor concentration, slowed information processing, irritability, depression, and anxiety among the symptoms that may follow a mild TBI.
Emotional and behavioral symptoms
Family members may notice emotional or personality changes before the injured person recognizes them.
Possible symptoms include:
Irritability
Anxiety
Depression
Unusual anger
Emotional outbursts
Frequent crying
Loss of motivation
Impulsiveness
Agitation
Social withdrawal
Feeling overwhelmed
Reduced tolerance for stress
Personality changes
Loss of interest in normal activities
Injured in an Accident?
Free consultation. Tell us what happened and learn what options may be available.
Sleep-related symptoms
A person with a TBI may experience:
Difficulty falling asleep
Difficulty remaining asleep
Sleeping more than usual
Sleeping less than usual
Daytime drowsiness
Nightmares
An irregular sleep schedule
Waking without feeling rested
Vision and balance symptoms
A brain injury may affect vision, balance, eye movement, and spatial orientation.
Symptoms may include:
Blurred or double vision
Difficulty reading
Eye strain
Trouble focusing
Dizziness when moving the head
Motion sensitivity
Feeling unsteady
Difficulty walking in crowded places
Nausea while riding in a vehicle
Difficulty tolerating computer or phone screens
When Should You Go to the Emergency Room?
Seek immediate emergency medical attention after a wreck if you or a loved one experiences:
A worsening or severe headache
Repeated vomiting
A seizure
Increasing confusion
Unusual agitation or restlessness
Slurred speech
Weakness or numbness
Unequal pupils
Double vision
Loss of coordination
Inability to recognize people or places
Difficulty staying awake
Inability to wake up
Loss of consciousness
Clear fluid or blood from the nose or ears
A significant change in behavior
Any rapidly worsening neurological symptom
Call 911 when the symptoms suggest a medical emergency. Do not drive yourself if you are confused, dizzy, extremely drowsy, or experiencing serious vision problems.
Older adults, people taking anticoagulants or other blood-thinning medications, and people with bleeding disorders should be especially cautious after head trauma.
Can You Have a Brain Injury Without Hitting Your Head?
Yes.
A TBI can result from a forceful jolt to the body that causes the head and brain to move rapidly. A person does not necessarily have to strike the steering wheel, window, dashboard, or another surface.
During a collision, the torso may be restrained by the seat belt while the head continues moving. This can expose the brain to acceleration, deceleration, and rotational forces.
A person should not dismiss headaches, dizziness, memory problems, confusion, or other neurological symptoms merely because there was no visible head wound or remembered head impact.
Can You Have a Concussion Without Losing Consciousness?
Yes. Loss of consciousness is not required for a concussion or mild traumatic brain injury.
A person may remain awake throughout the wreck but later experience:
Confusion
Memory gaps
Headaches
Dizziness
Light sensitivity
Noise sensitivity
Difficulty concentrating
Irritability
Fatigue
Sleep disturbances
Some people remember the collision but cannot remember the moments immediately before or after it. Others may appear outwardly normal at the scene while experiencing confusion, altered awareness, or post-traumatic amnesia.
Can TBI Symptoms Be Delayed?
Yes. Some symptoms appear immediately, while others may not develop or become noticeable until hours or days after the collision.
Adrenaline, stress, shock, pain medication, and other injuries may make neurological symptoms difficult to recognize at the scene.
A person may initially focus on neck, back, shoulder, knee, or leg pain. Later, the person may begin to notice:
Headaches
Memory problems
Mental fogginess
Dizziness
Vision problems
Sleep disturbances
Personality changes
Difficulty concentrating
Delayed symptoms should still be reported to a healthcare provider and documented in the medical record.
How Are Traumatic Brain Injuries Diagnosed?
There is no single test that identifies every traumatic brain injury.
Doctors may consider:
The history of the collision
The forces involved
The number and direction of impacts
Reported symptoms
Witness observations
Neurological findings
Cognitive testing
Clinical observations
Imaging studies
Laboratory testing, when appropriate
Medical history and description of the wreck
A healthcare provider may ask:
Did you hit your head?
Did you lose consciousness?
Were you dazed or confused?
Do you have a memory gap surrounding the wreck?
Did anyone observe unusual behavior?
Have you vomited?
Are your symptoms improving or worsening?
Are you taking blood thinners?
Have you had a previous concussion or brain injury?
Did an airbag deploy?
Was your vehicle pushed into another vehicle?
Did you experience more than one impact?
Describe every physical, cognitive, emotional, visual, balance-related, and sleep-related symptom you have noticed.
Neurological examination
A neurological examination may evaluate:
Alertness
Orientation
Speech
Pupillary response
Eye movement
Strength
Sensation
Reflexes
Coordination
Balance
Walking
Memory
Attention
Ability to follow commands
Glasgow Coma Scale
Emergency personnel and physicians may use the Glasgow Coma Scale to evaluate eye opening, verbal responses, and motor responses.
The scale helps providers assess a person’s level of consciousness. However, someone may receive a relatively high Glasgow Coma Scale score and still have a mild TBI.
CT scan
A computed tomography scan, commonly called a CT scan, is often used in emergency settings to look for acute structural injuries such as:
Brain bleeding
Skull fractures
Brain swelling
Hematomas
Brain contusions
A normal CT scan does not necessarily rule out a concussion or every type of traumatic brain injury.
The CDC explains that a brain scan is not ordinarily required to identify a mild TBI or concussion. A CT scan may instead be used when a patient is at risk of brain bleeding. A person may still have a mild TBI even when the injury does not appear on imaging.
MRI
Magnetic resonance imaging may provide more detailed images of brain tissue.
A physician may order an MRI when:
Symptoms continue
Neurological findings are concerning
A patient’s condition worsens
Doctors suspect an injury not adequately shown on an initial CT scan
Whether an MRI is appropriate depends on the person’s symptoms, medical history, examination, and circumstances.
Cognitive and neuropsychological testing
Neuropsychological or neurocognitive testing may evaluate:
Memory
Learning
Concentration
Attention
Processing speed
Problem-solving
Language
Executive functioning
Emotional functioning
These evaluations may be helpful when an injured person continues experiencing difficulty at work, school, or home despite having normal structural imaging.
Balance, vestibular, and vision testing
A TBI may affect the systems responsible for balance, eye movement, spatial orientation, and visual processing.
Healthcare providers may evaluate:
Gait and balance
Eye tracking
Visual convergence
Depth perception
Motion sensitivity
Dizziness triggered by movement
Vestibular functioning
Blood-based brain injury testing
In some clinical settings, physicians may use blood tests that measure proteins associated with brain injury.
FDA-authorized TBI blood tests may measure proteins such as GFAP and UCH-L1. These tests are used with clinical information to help determine whether certain adult patients with suspected mild TBI may need a CT scan. They do not replace a medical examination or independently diagnose every concussion.
Why a Normal CT Scan Does Not Necessarily Rule Out a Concussion
Emergency CT imaging is primarily designed to identify acute structural problems such as significant bleeding, fractures, or swelling.
A concussion and certain microscopic or functional injuries may not appear on a routine CT scan. A person may therefore be discharged from the emergency room with a normal CT result but continue experiencing:
Headaches
Memory problems
Dizziness
Brain fog
Light sensitivity
Noise sensitivity
Sleep disruption
Emotional changes
Difficulty working
Difficulty driving
Trouble performing household responsibilities
A normal CT result does not mean that the patient is imagining the symptoms or that no brain injury occurred. The CDC expressly recognizes that a person may have a mild TBI or concussion even when it does not appear on testing.
Continuing symptoms may require follow-up with an appropriate provider, such as a:
Primary care physician
Neurologist
Neurosurgeon
Neuropsychologist
Concussion specialist
Physical medicine and rehabilitation physician
Physical therapist
Occupational therapist
Speech-language pathologist
Vestibular therapist
Vision specialist
What Is Post-Concussion Syndrome?
Post-concussion syndrome generally refers to concussion-related symptoms that continue beyond the expected initial recovery period.
Symptoms may include:
Persistent headaches
Dizziness
Fatigue
Memory difficulties
Poor concentration
Sleep problems
Anxiety
Depression
Irritability
Sensitivity to light or sound
Vision problems
Reduced tolerance for physical or mental activity
The duration and severity of symptoms vary. Some people improve within a relatively brief period, while others experience symptoms for months or longer.
The National Institute of Neurological Disorders and Stroke explains that post-concussion symptoms may last for weeks, months, or more than a year in some cases.
Persistent symptoms should be evaluated rather than dismissed. Providers may also consider whether neck injuries, migraines, medication side effects, sleep disorders, vestibular problems, vision problems, psychological distress, or other conditions are contributing to the symptoms.
How a Brain Injury Can Affect Daily Life
A traumatic brain injury can interfere with nearly every part of a person’s life.
An injured person may struggle to:
Return to work
Follow conversations
Remember instructions
Read or review documents
Use a computer
Drive safely
Manage appointments
Pay bills
Care for children
Prepare meals
Complete household tasks
Control emotions
Maintain relationships
Participate in social activities
Tolerate bright lights
Tolerate noisy environments
Shop in crowded stores
Complete several tasks at once
A person may look physically normal while struggling with headaches, memory loss, emotional changes, slowed thinking, and overwhelming fatigue.
Documenting TBI Symptoms After a Wreck
Documentation can help healthcare providers understand how symptoms are developing. It may also become important in an insurance claim or personal injury case.
Consider keeping a daily symptom journal that records:
Headache frequency and severity
Dizziness
Nausea
Memory problems
Confusion
Sleep disturbances
Vision problems
Light or sound sensitivity
Missed work
Difficulty completing normal tasks
Medication use
Medical appointments
Changes noticed by family members
Be truthful and specific.
Instead of writing, “My memory is bad,” document specific incidents such as:
Forgetting an appointment
Leaving the stove on
Repeating the same question
Missing a familiar highway exit
Forgetting why you entered a room
Being unable to remember work instructions
Losing track of a conversation
Forgetting to pay a bill
Family members can also document emotional, behavioral, and functional changes they observe.
Evidence That May Matter in a TBI Claim
A traumatic brain injury claim may require evidence connecting the injury to the collision and showing how it has affected the victim.
Important evidence may include:
Ambulance records
Emergency room records
CT and MRI images
Neurology records
Neuropsychological testing
Concussion clinic records
Physical therapy records
Occupational therapy records
Speech therapy records
Vestibular therapy records
Prescription history
Photographs of visible injuries
Vehicle damage photographs
Crash reports
Witness statements
Employment records
School records
Statements from family members
Video showing behavioral or functional changes
Medical and rehabilitation opinions
In a truck wreck case, additional evidence may include:
Electronic control module data
Event data recorder information
Dash-camera footage
Driver qualification records
Hours-of-service logs
Electronic logging device data
Inspection records
Maintenance records
Cargo records
Cellphone evidence
Dispatch communications
Company safety policies
Prior safety violations
Trucking companies and insurance carriers may begin investigating immediately. Electronic information can be overwritten, vehicles can be repaired, video can be erased, and records may become difficult to obtain unless preservation efforts begin promptly.
Compensation for a Traumatic Brain Injury After a Texas Wreck
When another driver, trucking company, commercial carrier, employer, or other party causes a collision, the injured person may be entitled to pursue compensation for damages such as:
Emergency medical expenses
Hospital expenses
Diagnostic imaging
Neurological care
Neuropsychological testing
Rehabilitation
Physical therapy
Occupational therapy
Speech therapy
Vestibular therapy
Counseling
Prescription medication
Lost wages
Loss of earning capacity
Physical pain
Mental anguish
Physical impairment
Disfigurement
Future medical care
Loss of household services
The potential value of a TBI claim depends on the medical evidence, duration of symptoms, functional limitations, future prognosis, responsibility for the wreck, available insurance coverage, and the ways the injury has changed the victim’s life.
Speak With a Dallas Traumatic Brain Injury Lawyer
Traumatic brain injury claims are frequently disputed because many symptoms cannot be seen on an X-ray, CT scan, or photograph.
An insurance company may argue that:
The victim never lost consciousness
The victim did not directly hit their head
The CT scan was normal
The symptoms were reported too late
The symptoms are unrelated to the collision
The victim should have recovered sooner
The victim returned to work
The vehicle damage does not look serious enough
Those arguments do not necessarily tell the complete medical story.
The Wooley Law Firm investigates serious car and truck wrecks throughout Dallas and North Texas. We work to preserve collision evidence, obtain medical documentation, evaluate available insurance coverage, and hold negligent drivers and commercial companies accountable.
If you or a family member is experiencing possible traumatic brain injury symptoms after a collision, seek appropriate medical care. Then contact The Wooley Law Firm at 214-699-6524 for a free consultation with a Dallas car accident lawyer.
You don’t pay unless we win.
Frequently Asked Questions About Traumatic Brain Injuries
Can being rear-ended and pushed into another vehicle cause a TBI?
Yes. The initial rear impact may push the occupant’s torso forward while the head initially lags behind. The secondary front impact then abruptly slows the vehicle and the torso while the head continues moving.
The experience may be compared to being tackled from behind and then immediately punched in the face. These rapid changes in speed and direction can place substantial stress on the head and neck and may cause the brain to move inside the skull.
Can a rear-end collision cause a brain injury without head impact?
Yes. A forceful jolt to the body can cause the head and brain to move rapidly even when the person does not strike the steering wheel, window, dashboard, or another surface.
Do I have a concussion if I did not black out?
Possibly. Loss of consciousness is not required for a concussion. A person may experience headaches, confusion, memory problems, dizziness, sensitivity to light, sleep problems, or difficulty concentrating without blacking out.
Can a CT scan be normal when someone has a concussion?
Yes. CT scans are commonly used to identify acute structural problems such as bleeding or skull fractures. A person may have a concussion or mild TBI even when a CT scan does not show an acute abnormality.
How long after a wreck can TBI symptoms appear?
Some symptoms appear immediately, while others may develop or become noticeable hours or days later. New or worsening symptoms should be reported to a healthcare provider.
What doctor treats a traumatic brain injury?
Depending on the symptoms and severity, treatment may involve an emergency physician, neurologist, neurosurgeon, neuropsychologist, concussion specialist, rehabilitation physician, physical therapist, occupational therapist, speech therapist, vestibular therapist, or another healthcare provider.
Should I tell my doctor about memory and mood changes?
Yes. Report cognitive, emotional, behavioral, sleep-related, visual, and physical symptoms. These details may help the provider determine whether additional evaluation or treatment is appropriate.
What if my family notices changes that I do not?
Family members may notice changes in memory, behavior, personality, judgment, or emotional control before the injured person recognizes them. Ask them to document specific examples and share relevant observations with the healthcare provider.
Can I pursue compensation if my brain injury does not appear on imaging?
Potentially. Imaging is only one part of the evidence. A diagnosis may also be supported by the collision history, mechanism of injury, reported symptoms, neurological examinations, cognitive testing, treatment records, witness observations, and medical opinions.
Medical Studies and TBI Resources
Readers seeking additional medical information and research may review:
National Institute of Neurological Disorders and Stroke: Traumatic Brain Injury
National Library of Medicine: Neurocognitive and Psychiatric Symptoms Following Mild TBI
National Library of Medicine: Mild TBI and Motor Vehicle Crashes
This article is for general informational purposes and is not medical advice. Seek immediate medical attention for serious, worsening, or emergency symptoms.
Topics
Share This Article
Andrew J. Wooley
Personal Injury Attorney
Andrew J. Wooley is a dedicated personal injury attorney based in Dallas, Texas. He focuses on helping accident victims recover fair compensation for their injuries. With a commitment to personalized service, Andrew works directly with each client to understand their unique situation and fight for their rights.
Related Local News
Recent related coverage
