Our poor characters. How many times must we whack them in the head?
I get lots of questions about amnesia and head trauma in fictional scenarios. Now, before you think it's cliché to have characters suffer from traumatic brain injury, or TBI, let's review some facts.
According to the CDC (Centers for Disease Control), TBI is a major, worldwide cause of disability and death. In the U.S., 1.7 million people sustain a TBI per year.
The causes include motor vehicle accidents, falls, being struck/striking head against something, and assaults.
And the groups most at risk? Ages 0-4, 15-19, and over 65.
So for many of us writing YA, this isn't a completely random, pull-an-injury-out-of-a-hat situation at all.
So on to our question! This week, Melody asks:
If hit with a blunt object (in my case, a gun) that knocked them out, how long would be a reasonable amount of time for someone (a teenager) to be unconscious, and, most importantly, how would they feel when they woke up? And is there any way to have a concussion and not lose memory?
Great question, Melody. She's already read my earlier posts on head trauma (getting shot in the head) and types of amnesia after head trauma.
First of all, let's define TBI vs. concussion. This is a little confusing. Mild concussion may be considered a type of TBI, where there is clear neurologic impairment at some point in time (confusion, amnesia, difficulty concentrating or feeling slowed down). Being unconscious isn't necessary for the definition of concussion, FYI.
Mild TBI is defined as a person who, 30 minutes after the trauma, knows who they are and where they are; can open their eyes spontaneously; and obeys commands.
In mild TBI/concussion, most people won't lose consciousness. If they do, it's for less than a minute. If Melody need her character to be unconscious for longer, the character would have to pay the price by having more issues with amnesia and other symptoms, and it would have to be clear that the hit to the head was quite severe.
Many people with mild TBI/concussion may have a loss of memory surrounding the incident. Even without losing consciousness, it's common for the sufferer to repeat questions over an over again ("What happened? How did I get here?"). However, that may not last for long. However, the longer the person stays unconscious from the trauma, the larger the period of time they might suffer from amnesia.
How would they feel when they woke up? Here's a run down of some common symptoms:
- pain or swelling (the goose egg!) in the area of the injury; possibly broken skin over the scalp and a good bit of bleeding (scalps have a rich blood supply)
- dizziness and/or vertigo
- stumbling; possibly unable to walk a straight line
- nausea and vomiting
- emotions out of proportion to situation
- slurred speech
- inability to concentrate
- vacant staring
- slowed or delayed speech