Acquired Brain Injury

Brain injury includes a complex group of medical and surgical problems that are caused by trauma to the head. Some of these problems result from a direct impact to a particular portion of the skull or brain: a skull fracture occurs when the bone of the skull cracks or breaks, and in a depressed skull fracture pieces of broken skull press into the brain

caused by events after birth, rather than as part of a genetic or congenital disorder such as fetal alcohol syndrome, perinatal illness or perinatal hypoxia. ABI can result in cognitive, physical, emotional, or behavioural impairments that lead to permanent or temporary changes in functioning.^[1] These impairments result from either traumatic brain injury (e.g. physical trauma due to accidents, assaults, neurosurgery, head injury etc.) or nontraumatic injury derived from either an internal or external source (e.g. stroke, brain tumours, infection, poisoning, hypoxia, ischemia, encephalopathy or substance abuse).^[1] ABI does not include damage to the brain resulting from neurodegenerative disorders.^[1]
While research has demonstrated that thinking and behavior may be altered in virtually all forms of ABI, brain injury is itself a very complex phenomenon having dramatically varied effects.^[2] No two persons can expect the same outcome or resulting difficulties.^[2] The brain controls every part of human life: physical, intellectual, behavioral, social and emotional. When the brain is damaged, some part of a person's life will be adversely affected.^[2]
Consequences of ABI often require a major life adjustment around the person's new circumstances, and making that adjustment is a critical factor in recovery and rehabilitation.^[2] While the outcome of a given injury depends largely upon the nature and severity of the injury itself, appropriate treatment plays a vital role in determining the level of recovery.

Common Causes of Acquired Brain Injury

Trauma to the head is the most common cause of brain injury and can result in mild, moderate or severe traumatic brain injuries. Although rare, this trauma can occur in the birth canal during the birthing process. Head trauma, however, is most often caused by accidents, falls, and sports injuries.

Traumatic brain injuries, due to Improved Explosive Devices (IED) became the signature wound sustained by troops in Iraq and Afghanistan.

Brain tumors can also cause brain injury. The severity, of course, depends on the location and size of the tumor.

Strokes are another common cause. A stroke is caused by oxygenated blood not properly reaching brain cells, resulting in those cells dying. The severity of brain injuries caused by strokes, then, depends on the location of the dead cells and how many cells died during the stroke event.

Readers of Brain Injury Survivor's Guide are familiar with the fact that Beth's brain injury was caused by an anoxic stroke after suffering Adult Respiratory Distress Syndrome (ARDS).

Cerebral hemorrage is another cause of acquired brain injury. One such event of cerebral hemmorage is known as Arterio-Venous Malformation. Even though a person is born with AVM, it is usually a number of years before it shows its ugly self.

Hydrocephalus gets its name from the Greek words hydro (meaning water) and cephalus (meaning head). It is a condition caused by too much fluid in the brain causing pressure on it. The brain and spinal cord float in a fluid called cerebrospinal fluid (CSF). The amount of CSF surrounding the brain is a delicate balance, and too much causes the unwanted pressure. Hydrocephalus can be present at birth, or it can be caused by head trauma or stroke.

Brain Aneurysms are another cause of brain injury. An aneurysm is an abnormal bulging inside a blood vessel. Brain aneuryms, also called intracranial or cerebral aneuryms, are often not noticed until they rupture. This rupture, in turn, becomes a cerebral hemorrage (mentioned above). It has been estimated that as many as 1 in 15 people in the United States will develop a brain aneurym during their lifetime.

Acquired brain injuries are about the last thing any person would want to acquire but they are more common than most people believe. People would like to see world peace; they would like to acquire fame and fortune. Acquiring a brain injury is not on anyone's list.

Once acquired, though, there are many strategies available on a self-help level and many therapies available from speech therapists, occupational therapists, psysiatrists and neuromedical personnel that can benefit both those who have suffered an ABI and those that love them

Symptoms of Acquired Brain Injury

Unlike a traumatic brain injury, an acquired brain injury occurs on a cellular level within the brain, which means that instead of one area of the brain being affected - such as the one that governs speech or movement - cells throughout the entire brain are affected. Despite the difference in the type of injury, signs and symptoms of an acquired brain injury are strikingly similar to those of a traumatic brain injury. However, some signs or symptoms are experienced more frequently or are more pronounced in people with acquired brain injuries. In particular, these are:

• Cognitive impairment when it comes to thinking skills, memory skills in particular
• Longer time spent in a coma or vegetative state
• More pronounced behavioral issues such as anger, hostility, combativeness, depression, restlessness, and psychosis
• Muscle movement issues

If a person experiences the above signs or symptoms following a blow to the head or after experiencing one of the major causes of acquired brain injury, such as airway obstruction, electrical shock or lightning strike, vascular disruption, infectious disease, or toxic exposure to poisonous chemicals or gases, a physician should be seen immediately.

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.