When the Bruises Fade but the Brain Still Hurts: The Overlooked Link Between Domestic Violence and Brain Injury

When the Bruises Fade but the Brain Still Hurts: The Overlooked Link Between Domestic Violence and Brain Injury

When the Bruises Fade but the Brain Still Hurts: The Overlooked Link Between Domestic Violence and Brain Injury

Survivor-safe content · This article discusses domestic violence and head/neck injury. If you need help, the U.S. National Domestic Violence Hotline is 1-800-799-SAFE (7233) or thehotline.org.

Why this matters

Many survivors walk away from abuse believing they’re “just anxious,” “unfocused,” or “not themselves.” In reality, repeated head impacts, strangulation, and oxygen deprivation can injure the brain and nervous system. These injuries often go unrecognized because routine medical visits rarely screen for intimate partner violence (IPV) or IPV-related brain injury (sometimes called IPV-BI).[1–3]

How abuse can injure the brain

1) Strangulation and oxygen deprivation

Pressure to the neck can reduce or stop oxygen to the brain—even when there are no external marks. Brain effects can include memory changes, confusion, headaches, sleep issues, and emotional dysregulation. The risks increase with repeated events and loss/alteration of consciousness.[4,5,10]

2) Repetitive blows to the head

Survivors frequently report multiple head impacts over time. Cumulative injuries may not look like a single dramatic concussion, but together they can produce lasting symptoms that overlap with PTSD and depression, making diagnosis harder without targeted questions.[2,6,7,13,15]

What research shows

  • IPV-related brain injury is common and under-recognized; women are disproportionately affected.[1,6,7,13,15]
  • Neuroimaging and clinical studies report structural and functional brain changes in women exposed to IPV with head trauma/strangulation.[1,3]
  • Even decades after abuse, survivors show higher rates of TBI history and ongoing mental health conditions like depression, anxiety, sleep disorders, and PTSD.[8]

Common (often overlooked) symptoms

Note: symptoms vary; this is not a diagnostic list.

  • “Brain fog,” memory lapses, slowed processing, attention problems
  • Headache, dizziness, balance problems, light/noise sensitivity
  • Sleep disruption and chronic fatigue
  • Mood swings, anxiety, irritability, depression
  • Executive function challenges (planning, organizing, sequencing)

Because psychological trauma can produce similar symptoms, untreated brain injury may be missed unless providers ask directly about head/neck injury during abuse.[2,7,9]

What survivors can do (when it’s safe)

  • Mention head/neck events when seeking medical or mental health care.
  • Ask about neurocognitive screening or referral to neurology/neuropsychology.
  • Keep a simple symptom diary (headaches, sleep, memory, dizziness, triggers).
  • Work with trauma-informed clinicians who understand both TBI and PTSD—pacing, cognitive rest, and environmental adjustments often help.
  • Consider specialized programs; for example, the Domestic Violence Brain Injury Program at Barrow Neurological Institute focuses specifically on IPV-related brain injury.[9]

What providers and advocates can do

  • Add head/neck injury and strangulation questions to IPV screening.
  • Use trauma-informed exams and pacing; assume possible brain injury when symptoms overlap.
  • Coordinate referrals (medical, neuro, mental health, advocacy) and document histories carefully.
  • Train teams using emerging IPV-TBI toolkits and consensus recommendations.[1,7,13,15]

Bottom line

Domestic violence can leave injuries that are invisible but life-shaping. Recognizing the link between abuse and brain injury opens the door to better treatment, meaningful accommodations, and real healing. You are not broken—you are healing, and your brain wants to heal.

— 💛 —

Robbins Nest Alliance

Education, humor, and hope for caregivers and survivors.

RobbinsNestAlliance.com

References

  1. Colantonio A, et al. Brain Injury and Intimate Partner Violence. J Head Trauma Rehabil. 2022;37(1):E1–E6. Available at: journals.lww.com
  2. American Brain Foundation. Domestic Violence and Traumatic Brain Injury. 2023. americanbrainfoundation.org
  3. Karr JE, et al. Head Injury Due to Intimate Partner Violence. 2024. PMC10837033
  4. BIAA. Strangulation, Domestic Violence, and Brain Injury. biausa.org
  5. Jenkins ND, et al. Intimate partner violence, traumatic brain injury and long-term mental health outcomes in mid-life. BMJ Mental Health. 2025. PMC12161325
  6. American Brain Foundation. Traumatic Brain Injury (overview). Includes neck/head injury prevalence in IPV. americanbrainfoundation.org
  7. Costello K, et al. Update on Domestic Violence and Traumatic Brain Injury. 2022. PMC8773525
  8. The Guardian coverage of University of Glasgow/Drake IPV study (BMJ Mental Health), 2025. theguardian.com
  9. Barrow Neurological Institute. Domestic Violence Brain Injury Program. barrowneuro.org
  10. BIAA. Domestic Violence as a Cause of TBI. biausa.org
Back to blog