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.
The severity of brain damage can vary depending on the type of brain injury. A mild brain injury may be temporary. It can cause headaches, confusion, memory problems, and nausea. In a moderate brain injury, the symptoms can last longer and be more noticeable. In both cases, most people will 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, behavioural, and physical disabilities. People who are in a coma or a minimally responsive state may be dependent on the care of others for the rest of their lives.
Causes of traumatic brain injury include:
- Car accidents
- Blows to the head
- Falls or accidents
- Physical violence
- Sports injuries
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
Behavioural/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
Almost everyone with a brain injury will benefit from specialist neurological rehabilitation to help in long-term recovery. This may include:
- Speech and language therapy
- Psychological support
- Physiotherapy
- Occupational therapy
Rehabilitation after brain injury is largely unpredictable as every injury is different.
Unlike most other cells in the body, the brain cells don’t regenerate when they are destroyed. However, this does not mean that no recovery can occur. The brain can reorganise itself to a certain extent which can mean some lost function is regained. This is known as brain ‘plasticity’.
During recovery, new nerve pathways can be established in the brain using undamaged brain cells. Engaging in specialist rehabilitation and activities helps these new pathways to develop and minimises the long-term impact of a brain injury.
It is impossible to predict the length of time recovery will take and the likely outcome. Recovery will take months or years rather than weeks and is a slow process with ups and downs. People do sometimes talk about there being a limited 'window' for recovery after brain injury, However, this is now known not to be the case and people may actually continue to improve for a number of years after brain injury. Indeed, many people say that they never stop re-gaining the skills that they lost following the injury.
Timescales for recovery and rehabilitation
In the first month or two after a severe brain injury it is only possible to guess at the length of time that recovery will take and the likely outcome. All that is certain is that recovery is a slow process and will take months or years rather than weeks.
Six months after the injury the picture will be clearer, but it is wise to wait until about a year after the accident before making any important decisions regarding the future. After a year or so one can be reasonably certain about the eventual degree of physical recovery. However, psychological recovery can take considerably longer and it is usually these more subtle psychological problems that cause longer-term difficulties, particularly for family members.
People do sometimes talk about there being a limited 'window' for recovery after brain injury, for example, that recovery ceases to take place beyond two years. However, this is now known not to be the case and people may actually continue to improve for a number of years after brain injury. Indeed, many people say that they never stop re-gaining the skills that they lost following the injury.