An acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma. The injury causes a change in the brain’s neuronal activity, which affects the physical integrity, metabolic activity, or functional ability of nerve cells in the brain. There are two types of acquired brain injuries, traumatic and non-traumatic.
What is a traumatic brain injury?
A traumatic brain injury (TBI) occurs when a sudden, external, physical assault damages the brain. Traumatic impact injuries can be defined as closed (or non-penetrating) or open (penetrating). It is one of the most common causes of disability and death in adults. TBI is a broad term that describes a vast array of injuries that happen to the brain. The damage can be focal (confined to one area of the brain) or diffuse (happens in more than one area of the brain). The severity of a brain injury can range from a mild concussion to a coma or even death.
A non-traumatic brain injury causes damage to the brain through internal factors.
Causes of traumatic brain injuries:
- Injuries
- Falls
- Trauma (i.e. physical violence)
- And more
Causes of non traumatic brain injuries:
- Stroke
- Seizure
- Lack of oxygen
- And more
Types of disorders of consciousness
Vegetative State | An individual is unaware, but begins to have sleep and wake cycles. They have normal digestion, breathing, and heart rates, and they may open his or her eyes. The individual may occasionally respond to stimuli.
Persistent Vegetative State | Doctors consider a person to be in a persistent vegetative state one year after traumatic brain injury or three to six months after the brain receives little to no oxygen.
Persistent Vegetative State | Doctors consider a person to be in a persistent vegetative state one year after traumatic brain injury or three to six months after the brain receives little to no oxygen.
Locked-in Syndrome | An individual can only move his or her eyes but is conscious and able to think. The person may use eye movements and blinking to communicate and operate environmental controls.
Minimally Conscious State | An individual shows slight but definite self-awareness or awareness of their environment. They may inconsistently speak short phrases or words, respond to simple commands, may make “yes or no” gestures or verbalizations (sometimes incorrectly), follow people with their eyes, grasp or hold objects, and show appropriate emotional responses, such as smiling or crying. An individual is considered out of a minimally conscious state if he or she can communicate consistently (at least “yes” and “no”) or can use common objects.
Brain Death | Not alive because all brain functions no longer work. Physicians refer to the Uniform Determination of Death Act (UDDA) to make the determination of brain death. Brain death is not reversible.
What are the different types of TBI?
Brain injury may happen in one of two ways:
- A closed brain injuries happen when there is a nonpenetrating injury to the brain with no break in the skull. A closed brain injury is caused by a rapid forward or backward movement and shaking of the brain inside the skull that results in injury (harm, wound, trauma, damage) to the brain tissue and blood vessels. Closed brain injuries are usually caused by car accidents, falls, and increasingly, in sports. This can also be caused by shaken baby syndrome.
- A penetrating brain injury, or an open head injury, can happen when there is a break in the skull.
What is primary and secondary brain injury?
Primary brain injury refers to the sudden and profound injury to the brain at the time of impact. This happens at the time of the car accident, gunshot wound, or fall.
A secondary brain injury refers to changes that evolve over a period of time after the primary brain injury. It includes an entire series of steps or stages of cellular, chemical, tissue, or blood vessel changes in the brain that contribute to further damage of brain tissue.
What are the possible results of brain injury?
The results from a brain can vary greatly. Some brain injuries are mild, with symptoms disappearing over time with proper attention, but others are more severe and may result in permanent disability. A brain injury may require post-injury and possible lifelong rehabilitation. Effects of brain injury may include:
Cognitive deficits
- Confusion or shortened attention span
- Memory problems and amnesia
- Inability to understand abstract concepts
- Inability to accept more than 1 -2 commands simultaneously
Motor deficits
- Paralysis or weakness
- Poor balance and coordination
- Decreased endurance
- Tremors
- Swallowing problems
Perceptual or sensory deficits
- Changes in hearing, vision, taste, smell, and touch
- Loss of sensation or heightened sensation of body parts
- Difficulty understanding where limbs are in relation to the body
- Double vision, lack of visual acuity, or limited range of vision
Communication and language deficits
- Difficulty speaking and understanding speech (aphasia)
- Difficulty choosing the right words to say (aphasia)
- Difficulty reading or writing
- Slow, hesitant speech and decreased vocabulary
- Difficulty forming sentences that make sense
- Problems with reading, writing, and ability to work with number
Functional deficits
- Impaired ability with activities of daily living
- Problems with organization, shopping, or paying bills
- Inability to drive a car or operate machinery
Traumatic Epilepsy
- Epilepsy is common with severe or penetrating injuries.
- Seizures can occur anytime after the injury
- Epilepsy; both major/generalized and minor/partial seizures.
Regulatory disturbances
- Fatigue or dizziness
- Changes in sleep patterns and eating habits
- Headache
- Loss of bowel and bladder control
Social difficulties
- Difficulties in making and keeping friends
- Difficulties understanding nuances of social interaction
Personality or psychiatric changes
- Lack of empathy
- Anxiety and depression
- Aggression, lowered frustration tolerance, and inappropriate sexual behavior
Brain Injury Rehabilitation Programs
Rehabilitation of the patient with a brain injury begins during the acute treatment phase. As the patient’s condition improves, a more extensive rehabilitation program can begin. The goal of brain injury rehab is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life. The success of rehabilitation depends on many variables. Some include:
- Nature and severity of the brain injury
- Degree of any resulting impairments and disabilities
- Overall health of the patient
- Family support
Areas covered in brain injury rehab programs may include:
- Self-care skills, such as feeding, grooming, bathing, dressing, toileting, and sexual functioning
- Physical care like nutritional needs, medicines, and skin care
- Ensuring mobility via walking, transfers, and self-propelling a wheelchair
- Communication and cognitive skills
- Interacting with others at home and within the community
- Work-related skills
- Pain management
- Identifying problems and solutions with thinking, behavioral, and emotional issues
- Assistance with adapting to lifestyle changes, financial concerns, and discharge planning
- Educating patient and family about brain injury, safety issues, home care needs, and adaptive techniques
The above content was created using the following resources:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/traumatic-brain-injury
https://www.biausa.org/brain-injury/about-brain-injury/basics/overview
