What
is Traumatic Brain Injury (TBI)?
Traumatic
brain injury is sudden physical damage to the brain. The
head forcefully hitting an object, called 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.
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Traumatic
Brain Injury Occurs When:
•
the head is struck with force
•
the
head strikes an object
•
the brain undergoes movement within the skull without
visual
•
trauma
to the exterior of the head
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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.
Effects of Traumatic Brain Injury:
The
effects of the brain damage are generally greatest immediately
following the injury. However, long-term problems are difficult
to assess because some damage may be caused by contusion,
bruising of the brain that is usually temporary. Focal damage
may result in long-term and permanent difficulties. Other
areas of the brain can learn to take over the functions
of the damaged areas over time and can improve the condition.
When a traumatic brain injury occurs in a child they may
progress better than an adult because their brain has a
greater capability to be flexible.
The
brain stem regulates basic arousal and regulatory functions,
as
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**According
to the Brain Injury Association, someone in the United
States sustains a traumatic brain injury every 15
seconds.**
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well as being involved in attention and short-term memory.
When a traumatic brain injury occurs and affects this area
disorientation, frustration and anger can result. In moderate
to severe injuries swelling can cause pressure on the brainstem.
Consciousness or wakefulness can be affected so a person
may fall into a coma.
Higher
up in the brain, than the brain stem, is the limbic system,
which helps regulate emotions. The temporal lobes are connected
to the limbic system and are involved in many different
cognitive skills, including memory and language. Behavioral
disorders have resulted from damage to the temporal lobes,
or seizures in this area. Almost always, the frontal lobe
is injured in traumatic brain injuries because it is so
large in size and is located near the front of the cranium.
The frontal lobe is considered the emotional and personality
control center, as well as many cognitive functions. Damage
to the frontal lobe can lead to decreased judgment and increased
impulsivity.
Traumatic
brain injury can cause cognitive impairments, like trouble
concentrating, trouble organizing thoughts, and becoming
easily confused or forgetful, may occur in conscious people.
Learning new information may be difficult and interpreting
actions of others will lead to social problems, like making
inappropriate statements. Problem solving, decision-making,
and planning could be difficult as well as judgment.
Language
issues like articulating words and forming sentences may
become difficult after TBI. Frustration and anger can be
directed at the other person because of the difficulties
a person with TBI can experience when trying to carry on
a conversation or others may not even be aware of their
errors. Reading and writing becomes a problem also. Mathematical
abilities, simple or complex, are also often affected.
A
traumatic brain injury can cause conditions, such as dysarthia,
which starts to slow, slur, and make speech difficult to
understand if the speech mechanism muscles become damaged.
Swallowing can become problematic brought on by dysphagia,
and a condition called apraxia can make repeating words
in a consistent manner difficult.
Treatment
for Traumatic Brain Injury:
It is best to begin treatment early when cognitive and communication
problems arise from a TBI. 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 TBI 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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