Brain Injury

What is traumatic brain injury?

Traumatic brain injury (TBI) occurs when a sudden, external, physical assault damages the brain. 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 occur to the brain. The damage can be focal (confined to one area of the brain) or diffuse (occurs in more than one area of the brain). The severity of a brain injury can range from a mild concussion to a severe injury that results in coma or even death.

Each year, about 1.4 million people in the U.S. experience a brain injury, and 230,000 are hospitalized and survive. Each year, more than 50,000 people in the U.S. will die following traumatic brain injuries.

What are the possible results of brain injury?

Some brain injuries are mild, with symptoms disappearing over time with proper attention. Others are more severe and may result in permanent disability. The long-term or permanent results of brain injury may require post-injury and possibly lifelong rehabilitation. Effects of brain injury may include:

Cognitive Deficits

  • Coma
  • Confusion
  • Memory problems and amnesia
  • Problem solving deficits
  • Problems with judgment
  • Inability to understand abstract concepts
  • Loss of sense of time and space
  • Decreased awareness of self and others
  • Inability to accept more than one- or two-step commands simultaneously
  • Shortened attention span

Motor Deficits

  • Paralysis or weakness
  • Spasticity (tightening and shortening of the muscles)
  • Poor balance
  • Decreased endurance
  • Inability to plan motor movements
  • Delays in initiation
  • Tremors
  • Swallowing problems
  • Poor coordination

Perceptual or Sensory Deficits

  • Changes in hearing, vision, taste, smell, and touch
  • Loss of sensation or heightened sensation of body parts
  • Left- or right-sided neglect
  • Difficulty understanding where limbs are in relation to the body
  • Vision problems, including 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 (alexia) or writing (agraphia)
  • Difficulty knowing how to perform certain very common actions, like brushing one's teeth (apraxia)
  • Slow, hesitant speech and decreased vocabulary
  • Difficulty forming sentences that make sense
  • Problems identifying objects and their function
  • Problems with reading, writing, and ability to work with numbers

Functional Deficits

  • Impaired ability with activities of daily living (ADLs), such as dressing, bathing, and eating
  • Problems with organization, shopping, or paying bills
  • Inability to drive a car or operate machinery

Social Deficits

  • Impaired social capacity resulting in difficult interpersonal relationships
  • Difficulties in making and keeping friends
  • Difficulties understanding and responding to the nuances of social interaction

Regulatory Disturbances

  • Fatigue Changes in sleep patterns and eating habits
  • Dizziness
  • Headache
  • Loss of bowel and bladder control

Personality or Psychiatric Changes

  • Apathy Decreased motivation
  • Emotional lability
  • Irritability
  • Anxiety and depression
  • Disinhibition, including temper flare-ups, aggression, cursing, lowered frustration tolerance, and inappropriate sexual behavior

Certain psychiatric disorders are more likely to develop if damage changes the chemical composition of the brain.

Traumatic Epilepsy

Epilepsy can occur with a brain injury, but more commonly with severe or penetrating injuries. While most seizures occur immediately after the injury, or within the first year, it is also possible for epilepsy to surface years later. Epilepsy includes both major or generalized seizures and minor or partial seizures.

Can the brain heal after being injured?

Most studies suggest that once brain cells are destroyed or damaged, for the most part, they do not regenerate. However, recovery after brain injury can take place, especially in younger people, as, in some cases, other areas of the brain compensate for the injured tissue, or the brain learns to reroute information and function around the damaged areas. The exact amount of recovery is not predictable at the time of injury and may be unknown for months or even years. Each brain injury and rate of recovery is unique. Recovery from a severe brain injury often involves a prolonged or lifelong process of treatment and rehabilitation.

The brain injury rehabilitation program

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 is often begun. The success of rehabilitation depends on many variables, including the following:

  • Nature and severity of the brain injury
  • Type and degree of any resulting impairments and disabilities
  • Overall health of the patient
  • Family support

It is important to focus on maximizing the patient's capabilities at home and in the community. Positive reinforcement helps recovery by improving self-esteem and promoting independence.

The goal of brain injury rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life--physically, emotionally, and socially.

Areas covered in brain injury rehabilitation programs may include:

  • Self-care skills, including activities of daily living (ADLs) — Feeding, grooming, bathing, dressing, toileting, and sexual functioning
  • Physical Care — Nutritional needs, medications, and skin care
  • Mobility Skills — Walking, transfers, and self-propelling a wheelchair
  • Communication Skills — Speech, writing, and alternative methods of communication
  • Cognitive Skills — Memory, concentration, judgment, problem solving, and organizational skills
  • Socialization Skills — Interacting with others at home and within the community
  • Vocational Training — Work-related skills
  • Pain Management — Medications and alternative methods of managing pain
  • Psychological Testing and Counseling — Identifying problems and solutions with thinking, behavioral, and emotional issues
  • Family Support — Assistance with adapting to lifestyle changes, financial concerns, and discharge planning
  • Education — Patient and family education and training about brain injury, safety issues, home care needs, and adaptive techniques

Types of brain injury rehabilitation programs

There are a variety of brain injury treatment programs, including the following:

  • Acute rehabilitation programs
  • Sub-acute rehabilitation programs
  • Long-term rehabilitation programs
  • Transitional living programs
  • Behavior management programs
  • Day-treatment programs
  • Independent living programs

Click here to learn about neurological rehabilitation programs at Lakeland. 

© Spectrum Health Lakeland 2021