Memory and Traumatic Brain Injury

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Memory After Moderate to Severe TBI

A TBI can damage the parts of the brain that you use to learn and remember. As a result, memory problems after TBI are very common. But, people with TBI can develop strategies to manage these memory problems.

What Kinds of Memory Are Affected by TBI?

There are many types of memory. TBI affects some types more than others.

Memories for New Versus Old Information

After TBI, memory for things that happened long ago may be better than memory for things that happened recently. For example, you will likely be able to remember special moments with your family before the TBI, but you may have difficulty remembering what you had for breakfast. This is partly because your brain already made the memories from before the TBI, while the making of new memories is disrupted by the TBI. This can occur if you are having problems with attention, as paying attention to what you want to remember is necessary to make memories.

Here are some problems with recent memories that are common after TBI:

• Forgetting the important details from a conversation.
• Forgetting where you left things, like your cell phone or keys.
• Feeling unsure of what you did or said this morning, yesterday, or last week. This can lead you to do things too many times or to ask the same questions more than once.
• Losing track of time or feeling unsure of what day it is.
• Being unable to retrace a route you took earlier in the day or week
• Forgetting all or part of what you read in a book or saw in a movie.

Although TBI affects new memories more than old ones, after TBI, people sometimes have trouble retrieving the correct information when they need it. For example, you may recognize someone but not remember their name when you see them and then remember it later.

Prospective Memory

Prospective memory is “remembering to remember” plans, commitments, and things you need to do in the future. It’s like holding on to information in your mind so that it is ready when you need to use it. Here are some prospective memory problems that are common after TBI:

• Forgetting to keep appointments
• Telling someone that you will call or visit them at a certain time and then forgetting to do so
• Forgetting what you meant to do, like going into a room and forgetting why
• Forgetting to pick up your children or other family members at a certain time
• Forgetting to take medicine at the right time

Procedural Memory

Procedural memory is stored memory for how to perform a task or a certain sequence of movements. Examples of procedural memory include how to load and start a washing machine, how to ride a bike, and how to tie your shoes. TBI does not usually affect this type of memory. Also, if you need to learn a new procedure after your TBI, practicing it repeatedly can make it more likely that you will remember it.

Memory of the TBI

People with moderate to severe TBI may not remember anything about their TBI (for example, what caused it). The best way to learn about your injury is to ask family, friends, or medical personnel about it.

What Can You Do to Help Your Memory?

Healthy lifestyle habits (e.g., getting enough sleep, exercising regularly, eating healthy food, and managing stress) can have a positive impact on memory ability. Although practicing the use of your memory via games or memory exercises may be fun, research has shown that using compensatory strategies is the best way to improve memory functioning.

Compensatory strategies can help you find new ways to do things to “work around” the difficulties you have with learning and remembering due to your TBI. For example, you can use your smartphone or a paper notepad to help you remember grocery lists, addresses, appointments, and “to-do” lists. The use of such strategies is common in today’s world.

Having memory problems after TBI may make it hard for you to learn and remember to use these memory strategies. Memory strategies work best when they are designed to meet your needs in your everyday environment. Individual or group cognitive rehabilitation can help you learn what strategies are best for you and how to use them. It may be helpful to ask a family member or friend to remind you to use your strategies when you first start using them. Over time, using the strategies may become a habit, and you can use them on your own.

Some people worry that using compensatory memory strategies will hurt their ability to remember things, but that is not true. In fact, compensatory strategies improve everyday functioning.

Here are some tips to make the best use of compensatory strategies to help work around memory difficulties:

• Take your time and be careful, consistent, and organized with your strategies.
• Get rid of distractions before starting on something that you want to remember.
• Ask people to talk slower or repeat what they say to make sure that you understand it.
• Give yourself extra time to practice, repeat, and rehearse information that you need to remember.
• Use an organizer, notebook, cell phone calendar, or “app” to keep track of important information, such as deadlines, meetings, and telephone numbers.
• Use “smart devices” like smartphones and smart speakers as (1) alarms to do things on time, (2) reminders to get things done, and (3) schedulers to make and keep track of appointments.
• Keep all items that you need to take with you when you go out (e.g., your wallet, keys, and phone) in a “memory station”—like a table by the door or a special section of the counter.
• Use a pill box to keep track of and take your medicines at the right time.
• Use checklists to keep track of the things you have to do. Check off each thing on the list after you do it. For example, make a checklist of bills that you need to pay every month and when each one is due. Then, check off each bill when you pay it so that you know you paid it.

Other Supports

Memory problems can make it especially difficult for people with moderate to severe TBI to succeed in school or to perform well in jobs that require a lot of learning and memory. College students can contact the Disability Support Services office at their school to get help with note-taking and other services to support their learning and memory. State-based Vocational Rehabilitation services may be able to provide additional help to college students and supply job coaching or counseling to those who need memory support for work.

Summary

Memory problems are common after a moderate to severe TBI. By using research-based strategies regularly, people with TBI can learn how to work around memory problems and improve everyday memory functioning.

Resources

• Cognitive Problems After Traumatic Brain Injury: https://msktc.org/tbi/factsheets/cognitive-problems-after-traumatic-brain-injury
• How Can I Locate Brain Injury Supports and Resources in My State? https://www.biausa.org/brain-injury/about-brain-injury/nbiic/how-can-i-locate-brain-injury-supports-and-resources-in-my-state

Authorship

Memory and Moderate to Severe Traumatic Brain Injury was originally developed by Tessa Hart, PhD, and Angelle Sander, PhD, in collaboration with the Model Systems Knowledge Translation Center (MSKTC). This factsheet was revised in 2025 by Therese M. O’Neil-Pirozzi, ScD, Angelle Sander, PhD, and Robin Hanks, PhD, in collaboration with the MSKTC.

Source: The content in this factsheet is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Traumatic Brain Injury Model System (TBIMS) centers, funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, as well as experts from the Polytrauma Rehabilitation Centers (PRCs), with funding from the U.S. Department of Veterans Affairs. The content of the factsheet has also been reviewed by individuals with TBI and/or their family members.

Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this factsheet were originally developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DP0012, 90DP0037, 90RT5007, 90DP0028, and 90DP0060) and were updated under an NIDILRR grant (90DPTB0027 and 90DPKT0009). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the federal government.

Recommended citation: O’Neil-Pirozzi, T. M., Sander, A., & Hanks, R. (2025). Memory and moderate to severe traumatic brain injury. Model Systems Knowledge Translation Center (MSKTC). https://msktc.org/tbi/factsheets/memory-and-traumatic-brain-injury

Copyright © 2025 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.