What
is Traumatic Brain Injury (TBI)?
Traumatic brain injury is sudden physical damage to the
brain. The head forcefully hitting an object, a closed head
injury, may cause the damage or by something passing through
the skull and piercing the brain, like a gunshot wound,
penetrating head injury. The major cause of traumatic brain
injury is from motor vehicle accidents. Other causes include
falls, sports injuries, violent crimes, and child abuse.
Physical,
behavioral, or mental changes are dependent upon which areas
of the brain are injured. Most often focal brain damage
is done, which is damage confined to just a small area of
the brain. This point is usually where the head has hit
an object. Closed head injuries often times causes scattered
brain injuries or damage to other areas of the brain. Diffuse
damage is the result of an impact causing the brain to move
back and forth against the skull. Frontal and temporal lobes,
responsible for speech and language, are often the most
affected because they sit in the areas of the skull that
allows more room for the brain to shift and sustain injury.
Speech and language is therefore affected, as well as voice,
swallowing, walking, balancing, and coordination difficulties
and changes in the ability to smell and in memory and cognitive
skills.
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What
Types of Cognitive and Communication Problems Can Result
From Traumatic Brain Injury?
Cognitive
and communication problems that result from traumatic brain
injury vary from person to person. These problems depend
on many factors, which include an individual's personality,
pre-injury abilities, and the severity of the brain damage.
The
effects of the brain damage are generally greatest immediately
following the injury. However, some effects from traumatic
brain
|
**According
to the Brain Injury Association, someone in the United
States sustains a traumatic brain injury every 15
seconds.**
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injury
may be misleading. The newly injured brain often suffers
temporary damage from swelling and a form of "bruising"
called contusions. These types of damage are usually not
permanent and the functions of those areas of the brain
return once the swelling or bruising goes away. Therefore,
it is difficult to predict accurately the extent of long-term
problems in the first weeks following traumatic brain injury.
Focal
damage, however, may result in long-term, permanent difficulties.
Improvements can occur as other areas of the brain learn
to take over the function of the damaged areas. Children's
brains are much more capable of this flexibility than are
the brains of adults. For this reason, children who suffer
brain trauma might progress better than adults with similar
damage.
In
moderate to severe injuries, the swelling may cause pressure
on a lower part of the brain called the brainstem, which
controls consciousness or wakefulness. Many individuals
who suffer these types of injuries are in an unconscious
state called a coma. A person in a coma may be completely
unresponsive to any type of stimulation such as loud noises,
pain, or smells. Others may move, make noise, or respond
to pain but be unaware of their surroundings. These people
are unable to communicate. Some people recover from a coma,
becoming alert and able to communicate.
In
conscious individuals, cognitive impairments often include
having problems concentrating for varying periods of time,
having trouble organizing thoughts, and becoming easily
confused or forgetful. Some individuals will experience
difficulty learning new information. Still others will be
unable to interpret the actions of others and therefore
have great problems in social situations. For these individuals,
what they say or what they do is often inappropriate for
the situation. Many will experience difficulty solving problems,
making decisions, and planning. Judgment is often affected.
Language
problems also vary. Problems often include word-finding
difficulty, poor sentence formation, and lengthy and often
faulty descriptions or explanations. These are to cover
for a lack of understanding or inability to think of a word.
Many have difficulty understanding multiple meanings in
jokes, sarcasm, and adages or figurative expressions. Individuals
with traumatic brain injuries are often unaware of their
errors and can become frustrated or angry and place the
blame for communication difficulties on the person to whom
they are speaking. Reading and writing abilities are often
worse than those for speaking and understanding spoken words.
Simple and complex mathematical abilities are often affected.
The
speech produced by a person who has traumatic brain injury
may be slow, slurred, and difficult or impossible to understand
if the areas of the brain that control the muscles of the
speech mechanism are damaged. This type of speech problem
is called dysarthria. These individuals may also experience
problems swallowing. This is called dysphagia. Others may
have what is called apraxia of speech, a condition in which
strength and coordination of the speech muscles are unimpaired
but the individual experiences difficulty saying words correctly
in a consistent way.
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How
Is Traumatic
Brain Injury Detected?
The
assessment of cognitive and communication problems is
a continual, ongoing process that involves a number
of professionals. Immediately following the injury,
a neurologist or another physician may conduct an informal,
bedside evaluation of attention, memory, and the ability
to understand and speak. Once the person's physical
condition has stabilized, a speech-language pathologist
may evaluate cognitive and communication skills, and
a neuropsychologist may evaluate other cognitive and
behavioral abilities. Occupational therapists also assess
cognitive skills related to the individual's ability
to perform "activities of daily living" (ADL)
such as dressing or preparing meals. An audiologist
should assess hearing. All assessments continue at frequent
intervals during the rehabilitative process so that
progress can be documented and treatment plans updated.
The rehabilitative process may last for several months
to a year.
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Is
Traumatic Brain Injury Always Properly Diagnosed?
Some
traumatic brain injury cases are difficult to detect
because even a CT scan can show proper brain functioning
when there is in fact brain damage. Brain damage is
not just a result of unconsciousness, and headaches
and mood swings are both symptoms that can come from
a closed head injury. Some symptoms may not appear until
much after the injury. Often times neurologist reserve
their time for only serious head injuries and a regular
physician may not catch a problem in a routine office
visit.
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How
Are Traumatic Brain Injuries Treated?
It
is best to begin treatment early when cognitive and
communication problems arise from a traumatic brain
injury. If a hospital visit resulted from the injury
treatment usually begins there. A therapist will work
with the individual to help them focus on improving
their orientation to the surrounding situation and to
stimulate speech and understanding. Oral motor exercises
are used when there is speech and swallowing problems.
Long-term rehab can be assessed by the individual’s
injuries and needs. There is rehab specific to people
with traumatic brain injury, including speech language
pathologists, physical therapists, occupational therapists,
and neuropsychologists.
Rehab
will help a traumatic brain injury sufferer reach the
highest level of independent functioning that they can,
depending on the seriousness of the accident. Therapy
works on restoring lost skills. Some people lose abilities
after a traumatic brain injury and will have to learn
to compensate for them. The most difficult part of traumatic
brain injury is receiving the proper treatment. If a
head injury does not result in a hospitalization and
the injury is a closed head injury, failure to diagnose
a problem during an office visit may result.
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How
Frequently Does Traumatic Brain Injury Occur?
According
to the Centers for Disease Control and Prevention (CDC),
1 million cases of traumatic brain injury occurred in
the United States in 1995-1996. Of those, 230,000 people
were hospitalized and survived and 50,000 people died.
Around three quarters of TBI survivors are diagnosed
as having suffered a mild to moderate injury.
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What
Are My Legal Rights Concerning
a Traumatic
Brain Injury Accident?
Traumatic
brain injury sufferers often face an array of medical,
legal and financial issues. Some TBI sufferers may appear
unharmed, especially with a closed head injury, but
may need physical, cognitive, and emotional treatment.
If you have questions regarding a traumatic brain injury
that you, or a family member, have suffered from, please
contact us.
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