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Traumatic Brain Injury

Posted February 1st, 2007 by Josh

Traumatic Brain Injury (TBI) is an acquired injury to the brain caused by either movement of the brain within the skull or from penetration of an object into the skull, contacting the brain directly. The resulting injury(ies) causes impairment to cognitive (thinking), emotional, and/or physical functioning. Impairment may be partial or total; temporary or permanent. Some major causes of TBI are automobile or motorcycle accidents, either to the driver, passenger, or a pedestrian; gunshot wounds; shaken baby syndrome; accidents from recreational sports (i.e. football, boxing, etc.) or something as ordinary as a bad fall. Abuse and assault are also leading causes. TBI is the leading cause of death and disability in children and adolescents in the United States. More than one million children sustain head injuries annually and roughly 165,000 require hospitalization. Many children don’t even display visible impairments after a head injury. Many medical and educational professionals are unaware of the consequences of childhood head injury. Children with a TBI are often classified as have learning disabilities, emotional disabilities, or mental retardation. TBI is, however, included in the Individuals with Disabilities Education Act (IDEA) as its own disability category. Often when children with a TBI return to school, their educational and emotional needs are very different. Children may remember how they were before the trauma which can result in a collection of emotional and psychosocial problems.

Types of TBI’s- There are several different types of brain injuries, depending on how and where the brain is injured.

Cerebral Contusions are bruises on the brain tissue. This typically occurs at the surface of the brain, near the skull, though occasionally they affect deeper tissues. Cerebral contusions occur when the brain makes contact with the skull, like in the snapping motion of the head that car crash victims experience.

Diffuse anoxal injury (DAI) can have very serious consequences, sometimes resulting in either a coma or death. Axons are tiny connectors that extend from neurons in the brain. These “connectors” send and receive signals to and from other neurons. DAI occurs when trauma causes the brain to move and stretch in such a way that the axons rip apart from each other and from their neurons. As a result of this ripping and tearing, the axons die, disrupting neural connections and inhibiting brain function. Most cases of TBI result in DAI as the brain tends to ricochet inside the skull.

Symptoms
Physical impairments that are a possible result of TBI are impairments in speech, vision, hearing, and impairments of the other senses. Other impairments include headaches, lack of fine motor coordination, spasticity of muscles, paresis or paralysis of one or both sides, and/or balance and other gait impairments. Cognitive impairments include short- and long-term memory deficits, impaired concentration, slowness of thinking, and limited attention span. Other impairments include perception, communication, reading and writing skills, planning, sequencing and judgment. Psychosocial, behavioral or emotional impairments include fatigue, mood swings, denial, self-centeredness, anxiety, depression, lowered self-esteem, and restlessness.

Treatment
Rehabilitation is the process that will help the individual reach optimum function. Rehabilitation will likely take a treatment team based on the individual’s needs. The team will likely include physicians, physical, occupational and speech therapists, neuropsychologists, social workers, therapeutic recreational specialists and nurses. Educational and vocational professionals may also provide treatment services. The best course of action in rehabilitation is something that must be decided by the patient and the patient’s family. A few guiding principles to shopping for rehab. services are: remembering that you know your needs best; be curious, ask lots of questions about the service provided; learn from others who have used a particular service; explore more than one rehab. program; listen to your instincts; get it in writing, keep a log of who you spoke to, when, what time, and a summary of the conversation; and be involved.

For the Family
A brain injury is traumatic even for the family and friends of the injured person. It’s difficult to see someone you care about get hurt in such a manner. Listed are some tips and advice for friends and family.

  • Educate yourself on the topic of brain injury. Each injury is different, just like every individual is different.
  • Establish and maintain a daily routine
  • Use familiar photographs of family, friends, pets or possessions.
  • Talk about familiar names, places, interests and activities.
  • Be yourself with the individual with the brain injury. Most likely, the individual wants to be treated the same as before.
  • Don’t overwhelm or overload the person with information
  • Provide the individual with appropriate time to respond
  • Don’t present the person with a task that is too difficult or complex
  • Try to reduce confusion in his/her surroundings, and
  • Talk openly about his/her gains and abilities.
Traumatic Brain Injury Resources