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The Realities of a Brain Injury

  • Synopsis: Published: 2012-10-07 - Informative article examines TBI including signs symptoms and importance of seeking medical aid as soon as possible - Wendy Taormina-Weiss.
Traumatic Brain Injury
Traumatic Brain Injury - Also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism (closed or penetrating head injury), or other features (e.g. occurring in a specific location or over a widespread area). Head injury usually refers to TBI, but is a broader category because it can involve damage to structures other than the brain, such as the scalp and skull.

Main Document

A traumatic brain injury (TBI) is a form of acquired brain injury, one that happens when a sudden trauma causes damage to a person's brain. A TBI can happen when a person's head suddenly and violently hits another object, or when an object pierces a person's skull and enters their brain tissue. The symptoms of a TBI can be mild, moderate, or severe depending upon the extent of the damage to the person's brain.

A person who has experienced a mild TBI might remain conscious, or they may experience a loss of consciousness for a few seconds or minutes. The person may have a headache, experience some lightheadedness, confusion, dizziness, tired eyes or blurred vision, a bad taste in their mouth, ringing in their ears, some lethargy or fatigue, as well as changes in their mood or behavior, sleep patterns, and difficulties with concentrating, attention, memory, or thinking. A person who has experienced a moderate or severe form of TBI might experience the same symptoms, yet may also experience a headache that worsens or does not go away. They may vomit repeatedly or experience nausea, seizures, dilation of one or both pupils in their eyes, an inability to wake up from sleep, weakness, numbness, slurred speech, and increased confusion, a loss of coordination, agitation, and restlessness.

A person who has signs of a moderate or severe TBI needs to receive medical attention as quickly as possible. There is little that can be done to reverse the initial brain damage caused by the trauma, although medical professionals will attempt to stabilize the person and concentrate on preventing additional injury. The main concerns include insuring the person receives an appropriate oxygen supply to their brain and body, maintains an adequate flow of blood, and controlled blood pressure.

Imaging tests can help medical professionals to determine a diagnosis and a prognosis for a person who has experienced a traumatic brain injury. People with mild to moderate injuries might receive neck and skull X-rays to check for spinal instability or bone fractures. People who have experienced a moderate or severe TBI may receive a CT scan, as well as rehabilitation. The rehabilitation often involves individually designed types of treatment in areas including physical, speech/language, and occupational therapy, as well as psychiatry, social support, and psychology or psychiatry.

Nearly 50% of people who experience a severe brain injury require surgery to repair or remove ruptured blood vessels also known as, 'hematomas,' or bruised brain tissue referred to as, 'contusions.' The forms of disabilities resulting from a TBI depend upon the severity of the injury the person has experienced, the location of their injury, as well as the person's age and general health. Common forms of disabilities include issues with thinking, memory, reasoning, hearing, sight, taste, touch, smell, understanding, and expression. Others may include issues with behavior or mental health such as anxiety, depression, aggression, personality changes, 'acting out,' or social inappropriateness.

People who have experience a more serious brain injury might experience stupor or an unresponsive state - yet may be aroused briefly through a strong type of stimulus such as sharp pain. A person with a serious brain injury may also experience coma and remain unconscious, unaware, unresponsive and un-arousable, essentially in a vegetative state and unaware of their surroundings, continuing to have a sleeping/waking cycle with periods of alertness, or the person may remain in a persistent vegetative state.

The consequences of a brain injury are unpredictable, affecting who we are and the way we think, feel, and act. A brain injury can change everything about a person in mere seconds. While this may seem overwhelming it is important to remember:

  • No two brain injuries are exactly the same
  • A person with a brain injury is a person first
  • The effects of a brain injury are complex and differ greatly between people
  • The effects of a brain injury depend on factors including the cause, location, and severity

Every year approximately 1.7 million people experience a form of traumatic brain injury. The leading causes of TBI include falls, motor vehicle accidents, assaults, and being struck by something.

The Brain in a Healthy State

To help with understanding what occurs when a person's brain is injured, it is important to understand what a healthy brain is made of and what it does. A person's brain is enclosed inside of their skull, which acts as a protective covering for their brain, which is soft. A person's brain is made of nerve cells or, 'neurons,' which form tracts that route throughout the person's brain. The nerve tracts carry messages to different parts of a person's brain, which uses the messages to perform various functions.

The functions of a person's brain include coordinating their body's systems, to include their heart rate, breathing, metabolism, body temperature, body movements, thought processing, behavior, and personality. The brain's functions also include ones such as hearing, vision, smell, taste, and touch. Every part of a person's brain performs a specific function and links with other parts of their brain to form more complex functions. Every part of a person's brain needs to be working well for their brain to work well as a whole. Even minor or mild forms of brain injuries may significantly disrupt a person's brain's ability to function well and as it should.

The Brain in an Injured State

When a person experiences a brain injury the functions of their neurons, nerve tracts, or sections of their brain may be affected. If the neurons and nerve tracts are injured, the person may be unable to, or experience difficulties with, carrying the messages that tell their brain what to do. A brain injury can change the way a person acts, thinks, moves their body, or feels.

A brain injury may also change the complex internal functioning of a person's body, to include functions such as blood pressure, body temperature regulation, and bladder or bowel control. The changes might be temporary or permanent, depending upon the injury. The changes a person experiences due to a brain injury might cause impairment, or a complete inability to perform a particular function.

A person's brain is divided into main functional sections or, 'lobes.' The brain lobes are referred to as the, 'Frontal Lobe,' 'Temporal Lobe,' 'Parietal Lobe,' 'Occipital Lobe,' the, 'Cerebellum,' and the, 'Brain Stem.' Each lobe of a person's brain has a specific function. What follows are basic descriptions of the functions of each lobe of a person's brain.

Frontal Lobe Functions:

  • Emotions
  • Speaking
  • Judgment
  • Personality
  • Organization
  • Self-monitoring
  • Problem solving
  • Mental flexibility
  • Inhibition of behavior
  • Planning and anticipation
  • Attention and concentration
  • Motor planning and initiation
  • Awareness of abilities and limitations

Temporal Lobe Functions:

  • Hearing
  • Memory
  • Sequencing
  • Organization
  • Understanding language

Parietal Lobe Functions:

  • Sense of touch
  • Visual perception
  • Spatial perception
  • Identification of size, shapes, and colors

Occipital Lobe Functions:

  • Vision

Cerebellum Lobe Functions:

  • Balance
  • Coordination
  • Visual perception
  • Skilled motor activity

Brain Stem Functions:

  • Breathing
  • Heart rate
  • Sleep and wake cycles
  • Arousal and consciousness
  • Attention and concentration

The Right and Left Sides of the Brain

The functional sections, or lobes, of a person's brain are also divided into right and left sides. The right side and left side of a person's brain are responsible for different functions. General patterns of dysfunction may happen if the injury a person has experienced is located on the right or left side of their brain. What follows are descriptions of potential functional impairments based upon injuries to a particular side of a person's brain.

Injuries to the Right Side of a Person's Brain May Cause:

  • Visual memory deficits
  • Visual-spatial impairment
  • Decreased awareness of deficits
  • Altered creativity and music perception
  • Loss of, "the big picture," type of thinking
  • Decreased control over left-sided body movements
  • Left neglect or inattention to the left side of the body

Injuries to the Left Side of a Person's Brain May Cause:

  • Impaired logic
  • Verbal memory deficits
  • Sequencing difficulties
  • Difficulties in understanding language
  • Difficulties in speaking or verbal output
  • Decreased control over right-sided body movements
  • Catastrophic reactions such as depression or anxiety

'Diffuse,' or Injuries to Both Sides of a Person's Brain May Cause:

  • Fatigue
  • Confusion
  • Reduced thinking speed
  • Impaired thinking skills in all areas
  • Reduced attention and concentration

Every year an estimated 1.7 million children and adults in America experience a form of traumatic brain injury. Another 795,000 people experience a form of acquired brain injury due to non-traumatic causes every year. There are currently more than 3.1 million children and adults in America living with a lifelong form of disability as a result of a traumatic brain injury and an estimated 1.1 million people have a disability as a result of a stroke.

Citations and References:

Traumatic Brain Injury
nichcy.org/disability/specific/tbi

A traumatic brain injury (TBI) is an injury to the brain caused by the head being hit by something or shaken violently. This injury can change how the person acts, moves, and thinks.

Study of Brain-Injured Man Sheds Light on Self-Awareness
www.nlm.nih.gov/medlineplus/news/fullstory_128522.html

Self-awareness is the product of pathways that are spread throughout the brain, according to a new study. Researchers say their findings challenge previous theories that people's awareness of their own feelings and behaviors was confined to just three specific areas of the brain.

Head trauma: First aid
www.mayoclinic.com/health/first-aid-head-trauma/FA00008/METHOD=print

Most head trauma involves injuries that are minor and don't require hospitalization. However, call 911 or your local emergency number if any of the following signs or symptoms are apparent.

Related Information:

  1. Concussion - Signs, Symptoms and Treatment - Symptoms and treatment of concussion and post-concussive syndrome the most common type of traumatic brain injury.
  2. Living with a Traumatic Brain Injury - There are many ways to receive a traumatic brain injury and complications from a TBI and living with the effects can be complicated.
  3. Preventing Secondary Damage After Traumatic Brain Injury - Targeted Oxidation-blocker - Researchers developed agent XJB-5-131 which can cross the blood-brain barrier and prevent oxidation of cardiolipin.


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