Post-traumatic amnesia

Post-traumatic amnesia (PTA) is the time after a period of unconsciousness when the injured person is conscious and awake, but is behaving or talking in a bizarre or uncharacteristic manner.

The person has no continuous memory of day-to-day events, and recent events may be equally affected, so that they are unable to remember what happened a few hours or even a few minutes ago. To complicate the issue, PTA can sometimes occur without the person having been unconscious beforehand.

The behaviour exhibited during PTA can be very distressing for family and friends to see.

Post-traumatic amnesia symptoms

The most obvious symptom is the loss of memory for the present time. The person may recognise family and friends but be unable to process the fact that they are in hospital or have had an injury of some kind.

Other symptoms of PTA include:

  • Confusion, agitation, distress and anxiety
  • Uncharacteristic behaviours such as violence, aggression, swearing, shouting, disinhibition
  • Inability to recognise familiar people
  • Tendency to wander
  • In some cases people may be very quiet, docil, loving and friendly

What can be done about post-traumatic amnesia?

PTA is a stage of recovery that the person goes through after the injury and, while it is very distressing for family and friends and may present a management problem for hospital staff, it is important to remember that this is a phase that will pass.

Try to stay as calm as possible. Seeing other people distressed and not being able to understand the reason may add to the confusion and distress the injured person is feeling.

The brain is struggling to cope with the injury, and too much stimulation should be avoided. It is therefore helpful to ensure a peaceful and quiet environment.

Reduce the risk of harm. This may mean having someone sat with the person at all times, particularly if they are likely to wander off or try to get out of bed. During the day, a rota of familiar faces may be useful, perhaps with an assigned nurse at night. Discuss the situation with the hospital staff.

The person may ask the same things over and over again, which can be very wearing. They may persist with a delusion, but it is best not to correct them or try to force them to remember. This will only make everyone more agitated. Gradually, the person will hold on to more information and begin to make sense of the world around them, such as where they are, why they are in hospital, and the month and year.

Remember that the person is not in control of their actions and cannot be held responsible for what they do or say. It may be of some comfort to the family to realise that the person who is injured is likely to have little memory of this time, or that it may be experienced as a bad dream.

Be sure to take time out for yourself or to share the visiting and supervision with others. Being tired adds to already stretched emotions and it is vital to look after yourself.

How long will post-traumatic amnesia last?

PTA may last for a few minutes, hours, days, weeks or even, in rare cases, months.

Certain types of medication have been used to try to improve the condition, with varying degrees of success. Sadly, there is usually no way of knowing exactly how long it will last.

What are the long-term effects of post-traumatic amnesia?

PTA itself does not have any adverse effects, unless the person’s behaviour causes them to injure themselves. However, the duration of PTA, along with length of time in coma, is often a good indicator of the severity of the brain injury and its likely long-term effects.

People who experience PTA for more than 24 hours are likely to have sustained a severe brain injury and to experience long-term complications, whereas PTA of less than 1 hour is likely to indicate a minor brain injury. These are rough guidelines and the long-term effects will only become apparent when the PTA has passed.

Visit our Injury severity page to find out how the length of time in PTA indicates the severity of a person's brain injury.