Traumatic Brain Injury - Topic Overview

Are you or someone you know living with the impacts of a brain injury? Life has changed hasn't it? A traumatic brain injury...even a "mild" one...can result in dramatic changes for the person injured. Memory, speech, thinking ability, movement, headaches and more...are now a part of every day life. Difficulty managing emotions, PTSD, and depression are also common for those living with a traumatic brain injury (TBI).

How are you managing? What coping skills have you developed to help you manage your day to day life? Life after a TBI is possible but it does take work. I hope the following information will help you to open the lines of communication with those you share your life with and to give you some things to think about too.
 
This information is being shared for your personal use and entertainment only. Please do not use this information to self-diagnose or to change your medications or treatment plan. If you have any questions about what you read here please speak to your doctor and/or treatment team.

Traumatic Brain Injury - Topic Overview

What is a traumatic brain injury?
A traumatic brain injury (TBI) can range from a mild concussion to a severe head injury. It is caused by a blow to the head or body, a wound that breaks through the skull (such as from a gunshot), a fall, or another injury that jars or shakes the brain. This can cause bruising, swelling, or tearing of brain tissue.

With rest, most people fully recover from a mild brain injury. But some people who have had a severe or repeated brain injury may have long-lasting problems with movement, learning, or speaking.

What are the symptoms?
Symptoms of a traumatic brain injury range from mild to severe and can last for hours, days, weeks, or even months. These symptoms may include:

• Not thinking clearly, or having trouble remembering new information.
  
• Having headaches, vision problems, or dizziness.
  
• Feeling sad, nervous, or easily angered.
  
• Sleeping more or less than usual.
  

If you develop these kinds of symptoms at any time after a head injury—even much later—call your doctor.

How is a traumatic brain injury diagnosed?
The doctor will ask you questions about the injury. He or she may ask questions that test your ability to pay attention, learn, remember, and solve problems. The doctor will check for physical signs of a brain injury by checking your reflexes, strength, balance, coordination, and sensation. The doctor may order imaging tests such as a CT scan or an MRI to make sure that your brain isn't bruised or bleeding. You may need tests to see if your brain is working as it should.

How is it treated?
If your brain has been damaged, you may need treatment and rehabilitation, perhaps on a long-term basis. This might include:

• Physical and occupational therapy to help you regain the ability to do daily activities and to live as independently as possible.
  
• Speech and language therapy to help you with understanding and producing language, as well as organizing daily tasks and developing problem-solving methods.
  
• Counseling to help you understand your thoughts and learn ways to cope with your feelings. This can help you feel more in control and help get you back to your life's activities.
  
• Social support and support groups so that you get the chance to talk with people who are going through the same things you are. Your family or friends may be able to help you get treatment and deal with your symptoms.
  
• Medicines to help relieve symptoms like sleep problems, chronic pain, and headaches. Medicine can also help if you have anxiety, depression, or memory problems. Talk with your doctor about what medicines might be best for you.
  

You may need to try different types of treatment before finding the one that helps you. Your doctor can help you with this. Treatment can help you feel more in control of your emotions, have fewer symptoms, and enjoy life again.

What is it like to live with a traumatic brain injury?
Your brain will need time to heal. Rest is the best way to recover. Here are some tips to help you get better:

• Get plenty of sleep, and take it easy during the day.
  
• Don't drink alcohol or use illegal drugs.
  
• Return to your normal activities gradually.
  
• Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
  
• Avoid activities that make you feel worse. These may be physically or mentally demanding activities like housework, exercise, schoolwork, or video games.
  
• Ask your doctor which medicines you should and shouldn't take.
  
• If you feel grumpy or irritable, get away from whatever is bothering you.
  

Long after the brain injury, you may still feel mental and physical effects (postconcussive syndrome), or new symptoms may develop.

• Headaches: They are especially common after a brain injury, even months later. You may find that your headaches evolve into chronic pain, which can make even the lightest activities difficult.
  
• Thinking skills: Brain injuries can affect how well you can concentrate. It may be hard for you to learn a lot of new information all at once. You may not be able to remember things that just happened.
  
• Communication: You may have trouble expressing yourself clearly or understanding what other people are saying. When you talk in a group of people, you might find it hard to keep up.
  
• Emotions: You may feel anxious or depressed, have rapid mood changes, or lose interest in things you used to enjoy. Your emotional ups and downs may be tied to struggles with speaking, thinking, and memory.
  
• Sleep: You may have changes in your sleep patterns, such as not being able to fall asleep or stay asleep, or sleeping much more of the time. Not getting good sleep can affect how well you recover and how severely other symptoms affect you.
  
• Drug or alcohol abuse: You may use drugs or alcohol to get rid of feelings of anxiety, depression, and stress or to feel normal or accepted. If you are having problems with drugs or alcohol, treatment can help. The first step is often detoxification, along with medical care.
  
• Post-traumatic stress disorder: Along with the physical damage from a brain injury, you might have long-lasting effects from the trauma of the injury. You may have fears about a loss of safety and control in your life. You may pull away from other people, work all the time, or use drugs or alcohol. It's important to get treatment for post-traumatic stress disorder (PTSD). Talk to your family doctor. Or, if you're a veteran, contact your local VA hospital or Vet Center.
  
• Developmental problems: In children, a brain injury, even a mild one, can interrupt the brain's development. This can have a permanent effect on a child's ability to keep up with his or her peers. If your child has had a head injury, call your doctor for advice on what to do.
  

If you find that you are feeling sad or blue or aren't enjoying the activities or hobbies that you enjoyed in the past, talk to your doctor about these feelings. You may have depression, which is common with chronic pain and other symptoms of a brain injury. If you have thoughts about hurting yourself or someone else, call 911 or 1-800-273-TALK (suicide hotline), or go to a hospital emergency room.

What can you do for a loved one who's had a brain injury?
If someone you care about has had a traumatic brain injury, you may feel helpless. It's hard to watch someone who used to be active or happy become inactive, struggle with speech and memory, or suffer from chronic pain. But there are some things you can do to help.

• Help the person get treatment or stay in treatment.
  
• Encourage and support the person.
  
• Learn about brain injuries and the long-lasting symptoms that can interrupt a life.
  
• Help the person have good health habits, such as being active, eating healthy foods, getting enough sleep, and limiting alcohol.
  
• Help the person take it one day at a time, setting small goals on the way to getting better.
  
• If the person isn't getting better, help him or her get treatment with a doctor who specializes in brain injury.
  

It's possible for long-lasting effects of a brain injury to lead to depression. And depression can lead to suicide. Call 911 or the national suicide hotline at 1-800-273-TALK (1-800-273-8255) or other emergency services if the person plans to harm himself or herself or others.


Brain Damage: Symptoms, Causes, Treatments
Brain damage is an injury that causes the destruction or deterioration of brain cells.

In the U.S., every year, about 2.6 million people have some type of brain injury -- whether as a result of trauma, stroke, tumor, or other illnesses, according to the Brain Injury Association of America. About 52,000 die as a result of traumatic brain injury, and more than 5 million Americans who've suffered traumatic brain injury require assistance in performing daily activities. Approximately 130,000 Americans die of stroke each year, according to the National Stroke Association.

What Are the Types of Brain Damage and How Severe Are They?
All traumatic brain injuries are head injuries. But head injury is not necessarily brain injury. There are two types of brain injury: traumatic brain injury and acquired brain injury. Both disrupt the brain’s normal functioning.

• Traumatic Brain Injury (TBI) is caused by an external force -- such as a blow to the head -- that causes the brain to move inside the skull or damages the skull. This in turn damages the brain.
  
• Acquired Brain Injury (ABI) occurs at the cellular level. It is most often associated with pressure on the brain. This could come from a tumor. Or it could result from neurological illness, as in the case of a stroke.
  

Both traumatic brain injury and acquired brain injury occur after birth. And neither is degenerative. Sometimes, the two terms are used interchangeably.

There is a kind of brain damage that results from genetics or birth trauma. It's called congenital brain damage. It is not included, though, within the standard definition of brain damage or traumatic brain injury.

Some brain injuries cause focal -- or localized -- brain damage, such as the damage caused when a bullet enters the brain. In other words, the damage is confined to a small area. Closed head injuries frequently cause diffuse brain damage, which means damage to several areas of the brain. For example, both sides of the brain are damaged and the nerves are stretched throughout the brain. This is called diffuse axonal injury or DAI.

The severity of brain damage can vary with the type of brain injury. A mild brain injury may be temporary. It causes headaches, confusion, memory problems, and nausea. In a moderate brain injury, symptoms can last longer and be more pronounced. In both cases, most patients make a good recovery, although even in mild brain injury 15% of people will have persistent problems after one year.

With a severe brain injury, the person may suffer life-changing and debilitating problems. He or she will have cognitive, behavioral, and physical disabilities. 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. .

What Causes Brain Damage?
When the brain is starved of oxygen for a prolonged period of time, brain damage may occur. Brain damage can occur as a result of a wide range of injuries, illnesses, or conditions. Because of high-risk behaviors, males between ages 15 and 24 are most vulnerable. Young children and the elderly also have a higher risk.

Causes of traumatic brain injury include:

• Car accidents
  
• Blows to the head
  
• Sports injuries
  
• Falls or accidents
  
• Physical violence
  

Causes of acquired brain injury include:

• Poisoning or exposure to toxic substances
  
• Infection
  
• Strangulation, choking, or drowning
  
• Stroke
  
• Heart attacks
  
• Tumors
  
• Aneurysms
  
• Neurological illnesses
  
• Abuse of illegal drugs
  

What Are the Symptoms of Brain Damage?
There are numerous symptoms of brain damage, whether traumatic or acquired. They fall into four major categories:

• Cognitive
  
• Perceptual
  
• Physical
  
• Behavioral/emotional
  

Cognitive symptoms of brain damage include:

• Difficulty processing information
  
• Difficulty in expressing thoughts
  
• Difficulty understanding others
  
• Shortened attention span
  
• Inability to understand abstract concepts
  
• Impaired decision-making ability
  
• Memory loss
  

Perceptual symptoms of brain damage include:

• Change in vision, hearing, or sense of touch
  
• Spatial disorientation
  
• Inability to sense time
  
• Disorders of smell and taste
  
• Balance issues
  
• Heightened sensitivity to pain
  

Physical symptoms of brain damage include:

• Persistent headaches
  
• Extreme mental fatigue
  
• Extreme physical fatigue
  
• Paralysis
  
• Tremors
  
• Seizures
  
• Sensitivity to light
  
• Sleep disorders
  
• Slurred speech
  
• Loss of consciousness
  

Behavioral/emotional symptoms of brain damage include:

• Irritability and impatience
  
• Reduced tolerance for stress
  
• Sluggishness
  
• Flattened or heightened emotions or reactions
  
• Denial of disability
  
• Increased aggressiveness
  

How Are Brain Damage and Brain Injuries Treated?
Anyone who has a head or brain injury needs immediate medical attention.

A brain injury that seems mild -- referred to as a concussion -- can be as dangerous as clearly severe injuries. The key factor is the extent and location of the damage. Brain injury does not necessarily result in long-term disability or impairment. But the correct diagnosis and treatment is needed to contain or minimize the damage.

The extent and effect of brain damage is determined by a neurological exam, neuroimaging testing such as MRI or CT scans, and neuropsychological assessments. Doctors will stabilize the patient to prevent further injury, ensure blood and oxygen are flowing properly to the brain, and ensure that blood pressure is controlled.

Almost all patients will benefit from rehabilitation to assist in long-term recovery. That may include:

• Physical therapy
  
• Occupational therapy
  
• Speech and language therapy
  
• Psychological support
  

Can I Prevent Brain Injuries?
Most injuries that cause brain damage are preventable. Here are some rules to follow to reduce the risk of brain damage:

• Never shake a child.
  
• Install window guards to keep young children from falling out of open windows.
  
• Install shock-absorbing material on playgrounds.
  
• Wear helmets during sports or cycling.
  
• Wear seatbelts in cars, and drive carefully.
  
• Avoid falls by using a stepstool when reaching for high items.
  
• Install handrails on stairways.
  
• Don't keep guns; if you do, keep them unloaded and locked away.
  
• Don't use illegal drugs.
  
• Drink alcohol only in moderation, and never drink and drive.