If this is an emergency, call 911. Go to an emergency department or call 911 right away for a headache that keeps getting worse, repeated vomiting, a seizure, new weakness or numbness, slurred speech, unusual confusion or sleepiness, one pupil larger than the other, or if someone cannot be woken. These can happen even long after an injury. This article is general education, not medical advice, and it does not create a doctor-patient relationship.
The short answer
Many people still have problems long after a traumatic brain injury (TBI). In a large US study of people with mild TBI seen at Level I trauma centers, 53% reported at least some injury-related limitation in daily life a year later, compared with 38% of people with orthopedic injuries (Nelson et al., 2019). Experts now describe TBI, for many people, as a chronic health condition, and function can improve or decline for up to two decades after injury (Wilson et al., 2017). If you are months or years out and still struggling, a second opinion can review the diagnosis, look for treatable problems that may have been missed, and help you plan next steps with your own doctors.
Reported any injury-related limitation 1 year after injury
Why problems can last or appear later
"TBI" describes an injury, not a single condition. For mild TBI, the 2021 VA/DoD guideline has a dedicated section on managing symptoms that persist beyond the first week.
Things worth checking include:
- Depression and anxiety. In a Seattle study of 559 adults hospitalized with complicated-mild to severe TBI, 53% had major depression at some point in the first year. Only 44% of them received an antidepressant or counseling (Bombardier et al., 2010).
- Sleep problems. A review of 21 studies found that about 50% of people had some form of sleep disturbance after TBI, and 25-29% had a diagnosed sleep disorder such as insomnia or sleep apnea (Mathias and Alvaro, 2012).
- Hormone problems from the pituitary gland. A 2007 review of 19 studies found reduced pituitary function in about 27.5% of people in the chronic phase after TBI, more often after severe injury. People with this problem had poorer quality of life, and the review calls it a serious but treatable complication (Schneider et al., 2007).
- Seizures. In a population study of 4,541 people, seizure risk was about 17 times the expected rate after severe TBI. After mild TBI the risk was only slightly raised, and not raised beyond five years (Annegers et al., 1998).
Common problems after TBI (separate studies, different groups)
Over the longer term, TBI is also a risk factor for epilepsy, stroke and neurodegenerative disease (Wilson et al., 2017). This is a matter of raised risk across groups of people. It does not mean any one person will develop these conditions.
People with more severe injuries often face lasting challenges. In a US study of adults who needed inpatient rehabilitation after TBI, 57% were moderately or severely disabled at 5 years, and 39% had declined from the level they had reached 1 to 2 years after injury (Corrigan et al., 2014). Decline is not the only path. Some people keep improving for years (Wilson et al., 2017).
Five years after inpatient TBI rehabilitation: change from the 1-2 year level
When to seek a second opinion
Consider asking for a second opinion if any of these apply:
- You are months or years out and still have symptoms that affect work, school or relationships.
- Things are getting worse rather than better, or new symptoms have appeared.
- Nobody has checked for depression, sleep problems or pituitary hormone problems.
- You have spells, blackouts or unexplained episodes.
- Your care ended after the first months, and no one has reviewed your situation since.
- Different clinicians have told you different things.
- You are considering an expensive or unproven treatment and want an independent view of the evidence.
New or sudden symptoms, such as a seizure, worsening headache, weakness or confusion, are not a reason for a second opinion. They are a reason to call 911.
What a second opinion can and can't do
It can:
- Review your records, imaging and timeline with fresh eyes, even if the injury was long ago.
- Tell you whether the working explanation fits the evidence, or whether other causes deserve a look.
- Suggest questions, tests or specialist referrals to discuss with your treating doctors.
- Explain what the research does and does not show about options you are considering.
It can't:
- Replace your treating physicians or provide ongoing care, prescriptions or emergency care.
- Guarantee a new diagnosis, a different answer or any particular outcome.
- Replace a hands-on examination or formal neuropsychological testing.
- Settle legal, disability or insurance disputes. A medical second opinion is not a forensic or legal evaluation.
How a second opinion works
- Register interestJoin the waitlist. Bookings are not yet open.
- Send records securelyReports, imaging and notes by secure email or fax. Nothing through the website.
- Physician reviewDr. Hadanny reviews your records and the relevant evidence before the visit.
- Video visitA secure video consultation while you are in Florida, New York or Arizona.
- Written opinionA written summary for you to share with your own doctors, who continue your care.
What to prepare
Older records can be hard to find. Gather what you can:
- A short timeline: date and cause of injury, how long you were unconscious or confused (if known), and how things have changed since. Keep it factual and brief.
- Emergency department, hospital and rehabilitation discharge summaries.
- Imaging reports (CT, MRI), and where possible the images themselves through a secure image-sharing link or on disc.
- Notes from neurology, neurosurgery, rehabilitation medicine, therapy and any neuropsychological testing.
- Any blood test results for hormone levels, and any EEG reports.
- A current list of medications and supplements.
- Three to five focused questions, written down.
How records are sent: Records are sent through a secure, encrypted channel or by secure fax, using instructions we provide after enrollment. Please never send medical records or health details by regular email, web forms or social media.
Frequently asked questions
Is it too late to get help years after a TBI? Not necessarily. Function after TBI can change for many years, and some contributing problems, such as depression, sleep disorders and hormone deficiencies, are treatable at any stage.
My scans were normal back then. Does that mean my brain is fine? Not necessarily. Many people with mild TBI have normal routine CT scans and still report problems a year later. A normal scan is reassuring about some serious problems, but it does not explain ongoing symptoms.
Who is this service for? Adults located in Florida, New York or Arizona at the time of the video visit.
Will you treat me afterward? A second opinion is a consultation. The written summary is meant to be shared with your own doctors, who continue your care.
References
- Nelson LD, Temkin NR, Dikmen S, et al; TRACK-TBI Investigators. Recovery after mild traumatic brain injury in patients presenting to US Level I trauma centers: a Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study. JAMA Neurol. 2019;76(9):1049-1059. doi:10.1001/jamaneurol.2019.1313. https://pubmed.ncbi.nlm.nih.gov/31157856/
- Wilson L, Stewart W, Dams-O'Connor K, et al. The chronic and evolving neurological consequences of traumatic brain injury. Lancet Neurol. 2017;16(10):813-825. doi:10.1016/S1474-4422(17)30279-X. https://pubmed.ncbi.nlm.nih.gov/28920887/
- Bombardier CH, Fann JR, Temkin NR, Esselman PC, Barber J, Dikmen SS. Rates of major depressive disorder and clinical outcomes following traumatic brain injury. JAMA. 2010;303(19):1938-1945. doi:10.1001/jama.2010.599. https://pubmed.ncbi.nlm.nih.gov/20483970/
- Mathias JL, Alvaro PK. Prevalence of sleep disturbances, disorders, and problems following traumatic brain injury: a meta-analysis. Sleep Med. 2012;13(7):898-905. doi:10.1016/j.sleep.2012.04.006. https://pubmed.ncbi.nlm.nih.gov/22705246/
- Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007;298(12):1429-1438. doi:10.1001/jama.298.12.1429. https://pubmed.ncbi.nlm.nih.gov/17895459/
- Annegers JF, Hauser WA, Coan SP, Rocca WA. A population-based study of seizures after traumatic brain injuries. N Engl J Med. 1998;338(1):20-24. doi:10.1056/NEJM199801013380104. https://pubmed.ncbi.nlm.nih.gov/9414327/
- Corrigan JD, Cuthbert JP, Harrison-Felix C, et al. US population estimates of health and social outcomes 5 years after rehabilitation for traumatic brain injury. J Head Trauma Rehabil. 2014;29(6):E1-E9. doi:10.1097/HTR.0000000000000020. https://pubmed.ncbi.nlm.nih.gov/24495919/
- US Department of Veterans Affairs / Department of Defense. VA/DoD Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury (mTBI). 2021. https://www.healthquality.va.gov/guidelines/Rehab/mtbi/ (background: includes a module on managing symptoms that persist beyond 7 days after mild TBI)
Reviewer note: refs 1-7 were verified against PubMed records (authors, title, journal, year, volume, pages; every number quoted is in the abstract) on 2026-11-13. Ref 8 was verified on the VA page; it is listed as background and no specific recommendation is quoted from it.
Video second opinions are not yet open for booking. If you would like to hear when they open, you can join the waitlist. We only ask for your name, email and state. Please don't include any health information.
This article is for general education and is not medical advice. Reading it does not create a doctor-patient relationship. If this is an emergency, call 911.