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Types of Brain Injury

Brain injury refers to the occurrence of an insult to the brain, causing temporary or permanent damage. It is often described as either traumatic or acquired, depending on the underlying cause.

The Brain Injury Association of America (BIAA) developed the following definitions:

• An Acquired Brain Injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative or induced by birth trauma. Acquired brain injuries are caused by conditions including strokes, tumors, blood clots, seizures, infections (encephalitis, meningitis), anoxia (lack of oxygen to the brain), metabolic disorders, abuse of illegal drugs and/or neurotoxic poisoning.

• A Traumatic Brain Injury (TBI) is defined as a jolt or blow to the head or a penetrating head injury that disrupts the normal functioning of the brain. It is an insult to the brain caused by an external physical force. Causes of traumatic brain injuries include motor vehicle accidents, falls, gunshot wounds, sports-related injuries, military actions, physical violence, child abuse, shaken baby syndrome and other injuries caused by trauma.

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According to the CDC, more than 2 million Americans a year sustain a TBI. Falls are the number one cause of TBIs, accounting for 40%, with rates highest in those over 65 years of age. Men have higher rates of TBI than women and are nearly three times as likely to die of a TBI.

There has been a lot of media attention lately on TBI, especially in regard to sports-related concussions and domestic violence. Increased military action over the past decade or more has resulted in a number of combat related TBIs in soldiers as well.

The recent Hollywood film Concussion and this Frontline documentary center on the discovery and cover-up that repeated concussions can lead to dementia in professional athletes.

Severity of Brain Injury

Brain injury severity can range from mild to severe, depending on a number of factors. Severity is traditionally based on duration of loss of consciousness, coma rating scale score, post-traumatic amnesia (PTA), and brain imaging results.

• A mild brain injury may be temporary; causing brief loss of consciousness, headaches, some confusion, nausea, and PTA of less than an hour or so.

• In a moderate brain injury, symptoms may last from 1-24 hours and are usually more pronounced.

• With a severe brain injury, the individual may suffer life-changing and debilitating problems. People who are in a coma or a minimally responsive state may remain dependent on the care of others for the rest of their lives.

Although brain injuries are given an initial severity rating, this may not accurately reflect the impact of the injury on the individual and their family’s lives.

Impact on the Individual

A brain injury, whether acquired or traumatic, can have a devastating impact on the affected individual. It may result in impairments of cognitive abilities, physical functioning, communication abilities, and/or behavioral and emotional functioning. Some of these problems include:

Cognitive Impairments

• Poor judgement or safety-awareness

• Memory or attention problems

• Impaired decision-making

• Difficulty processing information

• Inability to understand abstract concepts

Speech and Language Impairments

• Slurred speech (dysarthria)

• Difficulty understanding or producing language (aphasia)

• Difficulty in programming muscles for speech production (apraxia)

• Difficulty communicating thoughts effectively (cognitive-communication)

• Problems interpreting social cues or using socially-appropriate language

• Loss of reading and writing skills

Physical Impairments

• Weakness or Paralysis

• Tremors

• Seizures

• Sleep disorders

• Changes in the senses (hearing, sight, touch etc.) and sensitivity to light, sound, and sensation

• Problems in swallowing (dysphagia)

Behavioral/Emotional Impairments

• Irritability and impatience, perhaps with aggressive behavior

• Reduced tolerance for stress

• Inappropriate emotional reactions

• Tendency to be more self-centered with decreased empathy for others

• Depression or Anxiety

Our role and how ST&B will help with Brain Injury Rehabilitation

Brain injury rehabilitation is a marathon, not a sprint. Recovery from brain injury is a process that takes time. While the most dramatic recovery often happens in the first year, progress is always possible as the brain continues to heal, learn, and practice. It’s important to never give up and keep working toward your goals. Our specialized team will be responsible for the evaluation and treatment of deficits related to speech, language, swallowing, and cognitive-communication in individuals with brain injury.

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• An individualized treatment plan is developed after our initial evaluation. Our team will develop a treatment program which will vary depending on the stage of recovery, however, will always focus on increasing and returning to a life of independence. Independence matters most. The ultimate goal of rehabilitation is to be able to help our clients  progress to the most independent level of functioning possible; to restore a sense of normalcy and help re-integrate them to the community.

5 Things to Remember about Brain Injury Rehabilitation

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• No two brain injuries are alike. Treatment and rehabilitation will vary according to the type of injury, deficits and needs of each individual.

• ‘More’ does not mean ‘better’. Therapy should be intensive; however it will only be effective if it is functional and meaningful for the individual.

• Restore and compensate. Brain injury rehabilitation should focus on regaining lost skills as well as learning new ways to compensate for abilities that have been permanently changed because of the injury.

• You are not alone. This is the most important statement that individuals and family members of those with a brain injury should remember. There are millions of others who have gone through the same thing you have. Don’t be afraid to ask questions, seek support, get involved and participate in the rehabilitation process. Your involvement can make all the difference!

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