Acquired Brain Injury
Acquired Brain Injury is the “multiple disabilities arising from damage to the brain acquired after birth. It results in deterioration in cognitive, physical, emotional or independent functioning. It can be as a result of accidents, stroke, brain tumours, infection, poisoning, lack of oxygen, degenerative neurological disease etc.”The National Community Services Data Dictionary (Australian Institute of Health and Welfare, Canberra, 2012)
A blood-filled sac formed stretching of an artery or blood vessel. The stretching of the artery or blood vessel may have be caused by disease. The wall of the artery or blood vessel weakens as the sac grows larger, and may eventually burst, causing a haemorrhage.
Closed Brain Injury
Occurs when the head accelerates and then rapidly decelerates or collides with another object (e.g., the windshield of a car) and brain tissue is damaged by violent smashing, stretching, and twisting.
Open Brain Injury
Injury to the brain due to the penetration of a foreign object that tears soft tissue and blood vessels in its path.
Traumatic Brain Injury
An injury to the brain due to force applied to the head from, for example, a motor vehicle accident, a fall, or an assault.
Cerebrovascular Accident (CVA)
Also stroke. Where blood supply to the brain is stopped by a clot or bleeding.
A state of unconsciousness from which the patient cannot be woken or aroused, even by powerful stimulation.
The common result of a blow to the head or sudden deceleration usually causing an altered mental state, either temporary or prolonged.
Diffuse Axonal Injury (DAI)
A brain injury involving shearing of large nerve fibers in many areas of the brain rather than in one specific location.
Diffuse Brain Injury
Injury to cells in many areas of the brain rather than in one specific location.
The collection of blood in tissues or a space following rupture of a blood vessel.
Weakness on one side of the body.
Paralysis affecting one side of the body. Compare quadriplegia and paraplegia.
Insufficient oxygen reaching the tissues of the body.
Brain injury due to lack of thiamine (Vitamin B1) caused by chronic alcoholism, and the severe malnutrition that often accompanies it. Korsakoff’s is a continuum of Wernicke’s encephalopathy (see Wernicke’s encephalopathy).
Paralysis of the lower limbs (from the waist down).
Weakness or paralysis affecting all four limbs.
Stroke, (or Cerebrovascular Accident, CVA)
Where blood supply to the brain is stopped by a clot or bleeding.
A brain injury caused by a severe deficiency of deficiency of thiamine (Vitamin B1), usually associated with chronic alcoholism.
Cognition is “the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.”Oxford Dictionary
Thinking about concepts, associations and generalisations rather than concrete, factual information.
The capacity to formulate, plan and carry out plans effectively. These functions are essential for independent, creative and socially constructive behavior.
Memory for ongoing events in a person’s life.
This refers to recall thirty minutes or longer after presentation. Requires storage and retrieval of information which exceeds the limit of short term memory.
Primary or ‘working’ memory; its contents are in conscious awareness. Momentary storage of information and then reproduction (not exceeding approximately 30 seconds).
Changes in Cognition After Brain Injury
Loss of motivation, difficulty with initiating activities, gives the appearance of lethargy.
Inability to create new memories after the cause of amnesia (e.g., accident, trauma), leading to a partial or complete inability to recall the recent past. Long-term memories from before the cause of amnesia remain intact.
Loss of the ability to speak or understand language caused by damage to the brain.
Verbalisations about people, places, and events with no basis in reality.
Cognitive disability involves challenges in thinking, concentrating, reacting to emotions, formulating ideas, problem solving, reasoning and remembering.
With Acquired Brain Injury, cognitive disability can also include Autism Spectrum Disorder, the dementias, and learning difficulties, such as dyslexia etc.
Inability to suppress impulsive behaviours and emotions.
Mild form of aphasia. Involves difficulty in understanding and using language.
Overestimation of personal abilities and ambitions. It may come across to other people as boastfulness, bragging, excessive self-praise.
The extent to which an individual accurately judges one’s own strengths and weaknesses.
Getting stuck on a word, an idea or an activity and not being able to move on from it.
Post-Traumatic Amnesia (PTA)
Refers to the period immediately following a Traumatic Brain Injury when the person is confused, disoriented and unable to remember day-to-day events. PTA can last for hours, days or weeks, depending upon the severity of injury to the brain.
Inability to access memories, or information that was learned, before an injury or the onset of a disease.
Changes in Emotions After Brain Injury
Exhibiting rapid and drastic changes in emotional state (e.g., laughing, crying, anger) inappropriately without apparent reason.
Changes in Movement After Brain Injury
Loss of the ability to speak (or understand language) caused by damage to the brain.
Inability to carry out learned movement or activity due to damage to the brain.
Inability to coordinate voluntary muscle movements, resulting in diminished ability to walk, talk, eat or perform self-care tasks.
Difficulty in forming words or speaking them because of weakness of muscles used in speaking, leading to slurred or difficult to understand speech. Often affects skills associated with the same muscles, e.g. swallowing.
Altered ability to control and coordinate voluntary muscles resulting in clumsy movements or inability to produce some actions.
A swallowing disorder characterised by difficulty in oral preparation for the swallow, or in moving material from the mouth to the stomach. This also includes problems in positioning food in the mouth.
Partial loss of the ability to do purposeful movements while still being able to move and be aware of movement. (See apraxia.)
Awareness of the position of the body parts with or without movement.
Changes in the Senses After Brain Injury
Inability to recognise familiar objects, sounds etc, although functioning of sense organs, intelligence and consciousness are normal. Can be visual, auditory, or tactile.
Complete or partial loss of the sense of smell.
Tools to Assess the Brain
CT (Computed Tomography) or CAT (Computerised Axial Tomography) scan
A scan that creates a series of cross-sectional X-rays of the head and brain. It is often taken soon after the injury to help decide if surgery is needed. The scan may be repeated later to see how the brain is recovering.
EEG is a test used to record any changes in electrical activity of the brain by placing electrodes on the scalp. An EEG is used in the testing for epilepsy, coma and brain death.
An insertion of needle electrodes into muscles to study the electrical activity of muscle and nerve fibres. It may be somewhat painful to the patient. Helps diagnose damage to nerves or muscles.
Glasgow Coma Scale
Provides a score between 3 and 15 on a person’s level of consciousness after Traumatic Brain Injury, based on their ability to open their eyes and on their verbal and motor function.
Glasgow Outcome Scale (GOS)
A system for classifying the outcome Traumatic Brain Injury. Relates to functional independence.
Magnetic Resonance Imaging (MRI)
Scanning by machine to take detailed pictures of the brain, central nervous system, musculoskeletal systems and soft tissues using a strong magnet rather than X-rays.
Parts of the Brain and their Functions
Front part of the brain involved in planning, organizing, problem solving, personality, and cognition.
Area in the back of the brain whose primary function is processing visual information. Damage to this area can cause difficulties in vision.
The temporal lobes are parts of the brain that are involved in speech, memory, and hearing.
Brain Surgeries Associated with Brain Injury
Surgical removal of the skull in small pieces.
Surgical removal of a sizeable piece of skull.
A procedure to draw off excessive fluid in the brain. A surgically placed tube runs from the ventricles taking excess fluid away draining it into the abdomen, heart or neck veins.
Disorders of the Central Nervous System
Disorders of the central nervous system characterised primarily by seizures, which may vary in degree of frequency or severity.
An uncontrolled discharge of nerve cells which may spread to other cells nearby or throughout the entire brain. It usually lasts only a few minutes.
Seizure may be associated with loss of consciousness, loss of bowel and bladder control and tremors. May also cause aggression or other behavioural changes.
Health Professions Involved in Brain Injury
A physician who specialises in the nervous system and its disorders.
A psychologist who specialises in evaluating, with tests, brain/behaviour relationships, planning training programs to help someone with brain injury return to normal functioning and recommending alternative cognitive and behavioural strategies to minimise the effects of brain injury.
Occupational Therapy is the therapeutic use of self-care, work and play activities to increase independent function, enhance development and prevent disability.
OT may include the adaptation of a task or the environment to achieve maximum independence and to enhance the quality of life.
The term occupation, as used in occupational therapy, refers to any activity engaged in for evaluating, specifying and treating problems interfering with functional performance.
Physiotherapists work to maintain and improve the movement and function of joints and limbs.
Social workers assist with the emotional and social needs of people with an Acquired Brain Injury and their families.
Speech therapists are responsible for the evaluation and treatment of problems with speech and language, auditory, cognitive (comprehension), attention, writing, reading and expression skills.
Therapy and Management of Brain Injury
Short-term medical treatment, usually in a hospital, for patients having an acute illness or injury or recovering from surgery.
Activities of daily living. Routine activities carried out for personal hygiene and health (including bathing, dressing, feeding) and for running a household.
A specific behaviour is identified and an intervention method is designed. Uses positive reinforcement to encourage desired behaviour, and negative reinforcement to discourage unwanted behaviour.
Enabling the access of a patient to appropriate medical, rehabilitation and support programs, and coordination of the delivery of services.
Case Management may involve liaison with various professionals and agencies, advocacy on behalf of the patient, and arranging for purchase of services where no appropriate programs are available.
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