Understanding the Hidden Injury

Domestic Violence and intimate partner violence (IPV) can have lasting effects that extend far beyond visible injuries. Many survivors experience blows to the head, face, or neck, or episodes of strangulation that may result in a traumatic brain injury (TBI) or other acquired brain injury.

Brain Injuries related to abuse often go undiagnosed because symptoms can be mistaken for stress, anxiety, depression, post-traumatic stress disorder (PTSD), or the emotional effects of trauma. As a result, survivors may struggle for months or years without realizing that a brain injury may be contributing to their challenges.

Recognizing the signs of the brain injury is an important step toward receiving appropriate support, treatment, and accommodations.

What is a Traumatic Brain Injury?

A traumatic brain injury (TBI) occurs when a bump, blow, jolt, or penetrating injury disrupts normal brain function. In situations involving domestic or intimate partner violence, brain injuries can result from:
  • Being hit in the head, face, or neck
  • Being pushed and falling
  • Having the head slammed into an object
  • Shaken violently
  • Experiencing strangulation or choking 
  • Loss of oxygen to the brain
Even if a survivor never lost consciousness, a brain injury may still have occurred.

Common Signs and Symptoms

Symptoms may appear immediately after an injury or develop over time.

Physical Symptoms

  • Headaches
  • Dizziness
  • Balance problems
  • Nausea
  • Fatigue
  • Vision changes
  • Sensitivity to light or noise

Cognitive Symptoms

  • Memory difficulties
  • Trouble concentrating
  • Confusion
  • Difficulty finding words
  • Slower thinking
  • Difficulty organizing tasks

Emotional Symptoms

  • Anxiety
  • Depression
  • Irritability
  • Mood swings
  • Emotional overwhelm
  • Increase stress

Sleep-Related Symptoms

  • Difficulty falling asleep
  • Sleeping more than usual
  • Feeling tired despite adequate rest 

The Hidden Impact of Strangulation

Strangulation is one of the most serious yet frequently overlooked causes of brain injury in domestic violence situations.

When oxygen flow to the brain is interrupted, even briefly, an acquired brain injury can occur. Many survivors do not have visible marks or bruising, making these injuries difficult to recognize.

If you have experienced strangulation, choking, or pressure to your neck, it is important to seek medical attention and discuss possible brain injury symptoms with a healthcare professional.

Why Brain Injury Awareness Matters

A brain injury can affect nearly every aspect of daily life, including:
  • Employment
  • Education
  • Relationships
  • Emotional well-being
  • Independence
  • Communication
  • Decision-making
For survivors of intimate partner violence, the effects of a brain injury may also makes it more difficult to recognize abuse, develop and carry out a safety plan, access resources, or navigate legal, medical, and support systems. Challenges with memory, attention, processing information, or decision-making can create additional barriers to leaving an abusive situation or maintaining long-term safety.

Without proper Identification and support, survivors may face barriers to recovery and accessing services they need. Understanding the connection between intimate partner violence and brain injury helps survivors, families, advocates, healthcare providers, and community partners provide more informed, compassionate, and effective support.

Resources for Survivors

If you are experiencing domestic violence or need support, help is available. Survivors of abuse, including those who may have sustained a brain injury, often benefit from resources that provide information on safety, planning, advocacy, legal assistance, healthcare, housing, and emotional support.

Maryland Health Care Coalition Against Domestic Violence

Referred to as the Health Resource Center on Domestic Violence. We encourage you to visit the Health Resource Center on Domestic Violence's Resources for Survivors page for information and services designed to support survivors at every stage of their journey.

​Visit: https://healthanddv.org/resources-for-survivors/

Ohio Domestic Violence Network

The Ohio Violence Network (ODVN) created the Center on Partner-inflicted Brain Injury to increase awareness of brain injuries caused by intimate partner violence, including traumatic brain injuries and brain injuries resulting from strangulation or oxygen deprivation. The Center offers educational materials, survivor resources, safety planning information, and tools for advocates and healthcare professionals to better identify and support survivors living with brain injury.

Center on Partner-Inflicted Brain Injury:
https://www.odvn.org/brain-injury/

National Domestic Violence Hotline

Call: 800-799-SAFE (7233)
Text: START to 88788

Maryland Resources 

For Maryland domestic violence resources, visit: www.mnadv.org/

For Healthcare Providers and Advocates

Healthcare professionals. domestic violence advocates, social workers, attorneys, and community partners play a critical role in identifying possible brain injuries among survivors.

Consider Screening for brain injury when individuals report:
  • Repeated blows to the head
  • Falls resulting from abuse
  • Strangulation or choking
  • Persistent cognitive difficulties 
  • Memory concerns
  • Changes in behavior or emotional regulation
Early recognition and referral can improve outcomes and help survivors access appropriate care and support.

You Are Not Alone

Recovery from both trauma and brain injury is possible. Understanding the connection between domestic violence and brain injury is possible. Understanding the connection between domestic violence and brain injury is an important step toward healing, support, and hope. If you believe you may have experienced a brain injury as a result of domestic or intimate partner violence, reach out to a healthcare provider, advocate, or BIAMD for guidance and support. 

References

Brain Injury Association of America. (n.d.). Domestic violence and brain injury. Retrieved June 11, 2026, from https://biausa.org/tbims-abstracts/domestic
Brain Injury Association of Virginia. (2020). Traumatic brain injury and domestic violence: Facts for providers.https://www.biav.net/wp-content/uploads/2022/01/DV-04-Traumatic-Brain-Injury-and-Domestic-Violence-Facts-for-Providers-BIAV-2020.1105.pdf
Brain Injury Association of South Carolina. (n.d.). Intimate partner violence and brain injury.https://www.biaofsc.com/ipv-and-brain-injury
Centers for Disease Control and Prevention. (2024). Traumatic brain injury & concussion. Retrieved June 11, 2026, from https://www.cdc.gov/traumatic-brain-injury/index.html
Maryland Health Care Coalition Against Domestic Violence. (n.d.). Resources for survivors.https://healthanddv.org/resources-for-survivors/
Ohio Domestic Violence Network. (n.d.). The Center on Partner-Inflicted Brain Injury.https://www.odvn.org/brain-injury/