Brain injury – back to basics - Brain Injury Group

The human brain is a unique, complex organ that is the control centre for everything we think, feel and do. Unfortunately it can be damaged in any number of ways, which can lead to subtle or significant alterations to physical and cognitive abilities, behaviour and personality. Combine a complicated brain with different types and severity of injury, and it doesn’t take long to understand why it is impossible to predicting how well an individual might recover from a brain injury.

A brain injury not due to congenital or developmental disorders is referred to as an acquired brain injury (ABI). A traumatic brain injury (TBI) is the term used to describe damage caused from outside the brain, such as a blow to the head, though a brain injury could also be caused by a lack of oxygen to the brain at or since birth, an intracranial infection, a tumour or stroke.

Types of Traumatic Brain Injury (TBI)

Traumatic brain injury usually describes damage caused from outside the brain as a result of a blow to the head which might be caused by anything from a simple trip to a major road accident or assault. Again, there are different types of TBI including:

Concussion

A concussion is a minor or mild brain injury that can be caused by shaking, an impact to the head, or a sudden change in movement, like whiplash. Concussion can cause headaches, problems with concentration, memory loss and disorientation. It may be classed as a ‘mild’ injury, but it should still be treated seriously, especially if someone has suffered multiple concussions whether over a short or long period of time as it can have cumulative, long-term and permanent effects.
Contusion

A brain contusion is essentially a bruise of the brain tissue caused by the breaking and leaking of small blood vessels that can result in a build up of pressure resulting in swelling to the brain or poor oxygenation and other consequences. Any impact to the head can cause a brain contusion, with the damage occurring immediately under the site of the impact, on the opposite side of the brain when it slams into the skull, or in both areas.
Penetrating brain injury

Penetrating brain injury occurs when an external object or force actually penetrates the skull causing the object or fragments of the skull to make contact with the brain.
Anoxic brain injury

If the brain is starved of the oxygen it needs to operate properly even for just a few minutes, brain cells can quickly die resulting in brain injury. Anoxic brain injury occurs most often when blood flow to the brain is compromised, possibly the result of a heart attack or a serious trauma, or if the blood itself isn’t carrying enough oxygen such as in the event of suffocation or carbon monoxide poisoning.
Diffuse Axonal Injury

A diffuse axonal injury (DAI) is caused by the brain moving violently, causing tears in the connections of the brain to the spinal cord. Small or large, such tears can cause varying degrees of brain damage and can lead to permanent effects. At worst, they can be fatal.

Levels of severity for brain injury

As well as different types of injury, brain injuries are also classed as mild, moderate or severe. Each of the injuries mentioned above can be further complicated by the severity of the injury; the level of severity tends to be characterised by the likely effects.

A mild injury might result in a loss of consciousness for a few seconds or a few minutes – or not at all. Someone suffering concussion may appear to be confused or disoriented.
A moderate injury will probably result in loss of consciousness for several hours and confusion that lasts for weeks. The physical, cognitive and behavioural consequences of a moderate injury could last for months, or could be permanent.
A severe brain injury is life threatening. Permanent effects are pretty much guaranteed.

Symptoms and effects of brain injury

Similar symptoms could be presented in relation to any of the brain injuries described according to its severity. For example:

Lack of insight
Personality changes
Inappropriate behaviour
Poor perception, recognition and judgement
Lack of initiative
Fatigue
Physical disabilities
Slowed responses
Loss of physical sensations
Poor concentration
Poor planning and problem solving skills
Inability to understand and communicate
Poor memory
Slow or slurred speech
Overly talkative

Brain injury – the ‘hidden’ disability

Brain injury is often referred to as a ‘hidden’ disability because the effects of an accident involving the head – such as not being able to think straight, or being unable to comprehend information, or feeling anxious, irritable or depressed – are not as obvious to others although they are every bit as real as ‘visible’ physical disabilities and can have a negative impact on your life.

Recovery from a traumatic brain injury is possible and many people go on to lead fulfilling lives – though some will be different from the life they had before the injury. What is guaranteed is that recovery – particularly from moderate and severe injuries – will take time and patience.