Quick answer. A brain injury can cause a range of physical effects. Headache is one of the most common, and dizziness and balance problems affect many people, often from inner-ear (vestibular), vision or brain-related causes. There can also be sensitivity to light and noise, vision changes, changes in smell and taste, and disturbed sleep, and some people develop seizures. Most of these are managed with the right therapies – physiotherapy and vestibular therapy for balance, good sleep habits, and treatment guided by a doctor. Certain signs after a head injury – including a first seizure or a sudden severe headache – are emergencies: call 995.
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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
Headaches after brain injury
Headache is one of the most common symptoms after a brain injury, sometimes called post-traumatic headache, and it can persist or recur for a long time. There are different types: tension-type headache, felt as a tight or squeezing pain on both sides; migraine, often throbbing and one-sided, sometimes with nausea or sensitivity to light; cervicogenic headache, coming from an injured neck and worse on neck movement; and rebound or medication-overuse headache, caused by using painkillers too often. Common triggers include poor sleep, dehydration, stress and caffeine. Identifying the type and triggers, and avoiding overusing painkillers, is central to managing headaches well.
Dizziness and balance
Dizziness and balance problems are common in recovery and can have several causes. These include inner-ear (vestibular) problems, including a spinning sensation; injury affecting the balance centres of the brain; vision problems such as double vision or difficulty judging depth; drops in blood pressure on standing; and side-effects of some medications. Most people walk independently again within a few months, though full recovery of balance can take months to years. Physiotherapists and vestibular therapists are especially helpful here, using specific exercises and, for certain kinds of positional dizziness, repositioning techniques. Getting balance problems assessed helps both recovery and safety, as they raise the risk of falls.
Sensory changes
A brain injury can change the senses. Sensitivity to light and noise is common, and can make busy, bright environments overwhelming and tiring. Vision may change, and some people notice changes in their sense of smell and taste. These sensory changes can affect daily life in ways others may not appreciate, from struggling in a noisy shopping centre to finding food less enjoyable. Managing them often involves practical adjustments – sunglasses, quieter environments, regular breaks – alongside assessment by the relevant specialist, such as an optometrist or ophthalmologist for vision. Recognising sensory sensitivity as a real effect helps others understand why certain environments are difficult.
Sleep disturbance
Sleep problems are very common after a brain injury, including difficulty falling or staying asleep, daytime sleepiness, and sometimes sleep apnoea. They can be driven by a disrupted body clock, pain, low mood, medication, and caffeine or alcohol. Poor sleep worsens fatigue, concentration and mood, so improving it can help several other problems at once. Good sleep habits are the first-line approach – a regular schedule, a wind-down routine, limiting daytime naps, and being careful with caffeine and alcohol – and a doctor can review any medications that might be interfering with sleep. Persistent sleep problems are worth raising, as they are often treatable.
Seizures after brain injury
Some people develop seizures after a brain injury, sometimes called post-traumatic epilepsy, though most people who have a brain injury never have a seizure, and the majority of those who do respond well to treatment. Seizures are managed by a doctor, who may prescribe medication where appropriate. If seizures are a risk, there are important safety points around driving, swimming, working at heights and alcohol, and your doctor will advise on these. Understanding that seizures are a recognised but not inevitable complication, and one that can usually be treated, helps put this risk in perspective while taking it seriously.
Seizure first aid
It helps to know basic seizure first aid. If someone has a seizure, protect them from injury by cushioning their head and moving hazards away, do not put anything in their mouth, and once the movements have stopped, gently turn them onto their side. Stay with them and reassure them as they recover. Call 995 if the seizure lasts more than a few minutes, if one seizure follows another without recovery in between, if the person is injured, or if they do not come round properly afterwards. A first-ever seizure after a head injury should always be treated as an emergency and assessed urgently.
How these are managed
These physical effects are managed by the right members of the care team, with treatments framed as options a doctor may consider rather than something to self-manage. Physiotherapists and vestibular therapists help with balance and dizziness; optometry or ophthalmology helps with vision; sleep hygiene, with a medication review by a doctor, addresses sleep; and headaches are managed by identifying the type and triggers and avoiding painkiller overuse. Where medication is needed – for headaches, seizures or other problems – it is prescribed and monitored by a doctor. In Singapore, the National Neuroscience Institute and the Tan Tock Seng Hospital Rehabilitation Centre provide this specialist care.
When to seek urgent help
Certain signs are emergencies. After a head injury, call 995 or go to A&E for a severe or rapidly worsening headache, repeated vomiting, a seizure or fit, weakness or numbness, slurred speech, confusion, drowsiness or being unable to stay awake, clear fluid from the nose or ears, or unequal pupils. A first-ever seizure, or a sudden severe “thunderclap” headache, or a headache that is rapidly getting worse, all mean urgent care. Do not drive yourself to hospital after a head injury. These red flags always take priority over the general management above, so when in doubt, seek emergency help.
Related brain injury topics
- Life after a traumatic brain injury
- Understanding brain injury & recovery
- Concussion & mild traumatic brain injury
- Recovering from concussion
- Cognitive changes
- Fatigue after a brain injury
- Emotional & behavioural changes
- Returning to work, study & driving
- Caring for someone with a brain injury
- Head injury first aid
- Neurologists in Singapore
Sources
- Headway – Physical effects of brain injury: headway.org.uk
- MSKTC – Headaches after traumatic brain injury: msktc.org
- MSKTC – Balance problems after traumatic brain injury: msktc.org
- MSKTC – Sleep and traumatic brain injury: msktc.org
- MSKTC – Seizures after traumatic brain injury: msktc.org