Brain Injury and Intimate Partner Violence: What the Research Shows

Traumatic brain injury is most commonly discussed in the context of sports and military service. Those conversations matter and they have changed how we diagnose and treat brain injuries in those populations. But there is a third population that the research has largely overlooked until very recently: women who sustain brain injuries at the hands of an intimate partner.

The numbers are not fringe statistics. They represent one of the largest unaddressed public health crises related to brain injury in the world.

How Common Is TBI in Intimate Partner Violence Survivors?

Research published in the Journal of Family Violence by Campbell and colleagues estimated that between 75 and 92 percent of women who experience intimate partner violence sustain at least one traumatic brain injury. A separate study by Valera and Kucyi, published in Brain Imaging and Behavior, documented structural brain changes in IPV survivors consistent with repeated head trauma.

These are not minor injuries. The mechanisms include direct blows to the head and face, being slammed into walls or floors, and strangulation. Each of these causes measurable neurological damage.

Strangulation Is a Brain Injury Mechanism

Non-fatal strangulation is one of the most dangerous and least understood injury mechanisms in intimate partner violence. When blood flow to the brain is interrupted, even briefly, the result can be hypoxic brain injury: damage caused by oxygen deprivation rather than direct impact. Survivors of strangulation may experience memory problems, headaches, difficulty concentrating, and mood changes that begin days or weeks after the event and that are neurological in origin.

Because strangulation often leaves no visible marks, it is frequently undocumented in medical records. The brain injury it causes is almost never identified.

Why These Injuries Go Undiagnosed

Three overlapping factors explain why TBI is so rarely diagnosed in IPV survivors.

First, access barriers. Survivors often cannot seek care safely or consistently while in an abusive relationship. Even when they can, medical appointments happen under conditions of fear, surveillance, or time pressure that make full disclosure impossible.

Second, clinical blind spots. When survivors do seek care, they typically report symptoms without connecting them to head trauma. Headaches, sleep problems, memory difficulties, and depression are the presenting complaints. Clinicians who are not trained to ask about IPV do not ask, and the brain injury is never identified.

Third, the research gap. CTE research has historically focused on populations that researchers had consistent access to: male athletes and male veterans. Brain banks were built around those groups. The first published case of CTE in a woman with a history of intimate partner violence appeared in the literature in 1990. As of 2025, Mount Sinai's Brain Injury Research Center is conducting the largest brain autopsy study of female IPV decedents in history. The science is only now beginning to reflect the full scope of who brain injury affects.

The Polytrauma Clinical Triad

Women who experience IPV-related TBI commonly develop a pattern that researchers call the polytrauma clinical triad. The three components are:

These three conditions overlap, reinforce one another, and together produce a clinical picture that is frequently misread as a psychiatric disorder alone. A 2025 study from the University of Kentucky documented this triad in detail and called for systematic TBI screening as part of standard care for IPV survivors.

Common symptoms in this population include headaches, disrupted sleep, problems with memory and sustained attention, executive dysfunction, mood instability, anxiety, depression, sensitivity to light and sound, balance problems, and fatigue. Survivors are often diagnosed with anxiety, depression, or PTSD, all of which may be accurate. The problem is that the underlying brain injury driving many of those symptoms is rarely identified, and without that identification, treatment remains incomplete.

What the Newer Research Is Showing

A 2025 study from the PREVENT Dementia cohort in the United Kingdom, published in BMJ Mental Health, examined 632 participants and found that 14 percent reported a history of IPV-related physical abuse. Depression in midlife is already recognized as a risk factor for dementia. IPV-related TBI may be contributing to long-term neurodegenerative outcomes that researchers are only beginning to quantify.

This is not a prediction. It is an emerging area of investigation with enough preliminary evidence to warrant serious clinical attention now, not after a generation of autopsy data has accumulated.

What This Means Clinically and Practically

For survivors who have left an abusive relationship and are experiencing persistent headaches, memory difficulties, mood symptoms, or disrupted sleep, the appropriate clinical step is to ask their physician specifically about traumatic brain injury screening. Naming the mechanism matters. "I was hit in the head repeatedly" or "I was strangled" gives a clinician the information they need to order the right evaluation. "I have been feeling depressed and forgetful" often does not.

The Brain Injury Association of America maintains state affiliate resources that can connect survivors to specialists. A list of state affiliates is available at biausa.org.

Why Robbins Nest Alliance Covers This

Our mission is peer-reviewed brain injury education for the families and caregivers doing this work in real time. That mission does not have a demographic qualifier. Brain injury affects veterans, athletes, and people living inside abusive relationships. The research on all three populations deserves the same rigor and the same public platform.

CTE research took decades to reach the level of public awareness it now has. IPV-related TBI is at an earlier stage in that same process. Survivors in this population often cannot search for information themselves, and the people around them frequently do not know what they are looking at. Education is the first intervention.

If this article is useful to you, sharing it with someone who works with survivors, in healthcare, advocacy, shelter services, or legal aid, is one of the most direct ways to extend its reach.