Brain injuries are incredibly scary and difficult to deal with because the brain is pivotal to a person’s human experience. Both your conscious and unconscious self rely on this one organ. In this post, we will be exploring acquired brain injury (ABI) in particular, where the term “acquired” is used to signify that the injury occurred after birth.
There are two subcategories of ABI: traumatic and non-traumatic. The traumatic brain injury (TBI) label is used when there is an external force to the head during a particular incident. Motor vehicle accidents, falls, playing sports, a blast injury, and violence are the most common causes. A direct physical impact is not required for an injury to occur, such as in cases of whiplash. Non-traumatic brain injury (nTBI) describes all other causes such as illness, infection, stroke and brain tumours.
Traumatic Brain Injury (TBI)
When you break a bone, such as your arm, there is a typical procedure to be followed so that it will heal. You will visit a doctor who will likely place your arm in a cast. For more serious breaks, you may require surgery and permanent pins and screws to ensure your bone is as strong as it can be. After a period of time, x-rays will be taken to confirm when the bone has healed. While healing times can vary significantly from person to person due to factors such as age, infection, and the nature of the injury, there is little deviation from this procedure. As such, a doctor can give you a timeline that you can reasonably expect to be accurate. None of this exists when dealing with a TBI. Every injury is different, and it is very common for people to have vastly different experiences during their recovery. Further, there are those who never fully recover. Due to this, any timeline a patient receives for recovery is merely guesswork on the part of the doctor. It is this uncertainty that causes so much frustration for victims of such an injury.
The harsh reality is simply that doctors and researchers do not currently know enough about the complexity of the brain to better inform and guide patients. Fortunately, research is progressing due to external factors such as increased spotlight on the effects of concussion injuries caused during sports. Yet, new developments and guidelines can take up to a decade to trickle down into the arsenal of a general practitioner. The same can be true of neurologists. Typically, a specialist is much better equipped to help a person recover from a brain injury, but lengthy waitlists mean that a person may wait up to a year or even longer to see one.
It is estimated that 1.3 million Canadians currently live with an ABI. A significant contributor to this figure is the incidence of concussion. There are 400,000 new cases of concussion every year in Canada. The average recovery for a person who has a concussion is a few weeks, but up to 1 in every 5 can experience symptoms for much longer than that. Symptoms and complications can last months to years, or for the worst experiences, an entire lifetime.
Symptoms of a concussion include:
- Feeling slowed down
- Difficulty thinking clearly
- Difficulty remembering new information
- Difficulty concentrating
- Fuzzy or blurred vision
- Vomiting (early on) or nausea
- Sensitivity to light or noise
- Balance problems
- Feeling tired, having no energy
- Nervousness or anxiety
- More emotional
- Sleeping more than usual
- Sleeping less than usual
- Difficulty falling asleep
Not everyone experiences each symptom, but with a list of symptoms as significant as the ones above, even suffering a few will have serious consequences for the person’s way of life. Prolonged experiences will make it difficult to return to work, school, and even personal enjoyments.
Moderate & Severe TBI
A concussion is considered a mild TBI. 10% of injuries are further classified as moderate, and another 10% are considered severe. What separates each classification is how long there was a loss of consciousness in the individual. If it was less than 30 minutes, then it is mild, between 30 minutes to 6 hours is moderate, and greater than 6 hours is severe. Due to the likelihood that a person has experienced more damage to the brain when unconscious for a greater amount of time, recovery for these injuries is typically longer and more intensive. Then there are those that will lapse into a coma, which brings further complications.
The most important thing you can do after sustaining a TBI is to receive medical attention quickly. A doctor will examine you and monitor your status and determine if further testing is required. A CT or MRI scan may be ordered depending on how you respond to examination. These tests will show whether there is any brain bleeding that has occurred, where surgery may be required in serious cases. It is important to note that the majority of TBIs will not show anything on a scan. This does not mean that no injury has occurred, and the individual may still experience significant symptoms.
It is generally agreed in the medical community that rest early on after the injury is pivotal to a successful and quick recovery. Total brain rest is often advised and includes limited exposure to light, sound, use of screens (such as cellphone and television), and reading. You will be advised to continue this rest from a range of a few days to a week after the injury. Fortunately, many people recover from a mTBI within 7-10 days, and about 85% do so within three months. After the initial rest phase, your treatment will be personalized based on your response to increased activity. A doctor will advise you on how to proceed from this point. It is often wise to seek multiple opinions when dealing with a serious injury, and this is especially true of a TBI. If you know someone who has undergone a similar injury ask them about their recovery, and who helped guide them. Also, consider reviewing this guideline released by the Ontario Neurotrauma Foundation. If you are still having cognitive issues, have a caregiver review it for you. Please remember to review any treatment guidelines with a medical professional, as what worked for one person may not work for another. A brain injury is a highly individualized experience.
Non-traumatic brain injury (nTBI)
It is important to also address nTBIs and their distinctive characteristics. These types of ABIs are also very serious, and have their own unique sense of danger. This is due to diagnosis being difficult, as the condition progresses internally, absent of any clear external event. Consistent dialogue with your doctor is important, so that symptoms can be properly assessed.
Dementia is a brain disorder that leads to the loss of cognitive functioning and behavioural abilities. It is a progressive disorder that worsens over time, and is irreversible. Eventually, the person becomes completely dependent on others to perform the basic activities of daily living. Alzheimer’s disease is the most well known of the types of dementia, and it is also the most common. Others include: Lewy body dementia, frontotemporal disorders, and vascular dementia. The condition is caused due to abnormal deposits of proteins that form throughout the brain. This causes neurons to stop functioning, lose connections with other neurons, and die. When enough neurons have died, symptoms will start to manifest. This process can last a decade before cognitive issues appear.
A brain tumour is a growth of abnormal cells within or around brain tissue. They are either benign or malignant. A benign tumour does not spread, and grows slowly. A malignant tumour grows quickly, and can spread to surrounding tissue. The sooner the tumour is discovered, the better the outcome of the patient will be. Symptoms of brain tumours include: headaches, seizures, visual changes, personality changes, one-sided weakness, hearing loss, dizziness, nausea and vomiting, and one-side paralysis. Treatment will vary depending on the individual’s situation. Options include surgery, radiation therapy and chemotherapy.
A stroke occurs when there is an interruption of blood flow to the brain (ischemic stroke) or blood vessels in the brain are ruptured (hemorrhagic stroke). In both types of stroke, brain cells in the affected area die, which is what causes brain damage. How a person reacts to a stroke will vary based on which part of the brain was injured, and how much damage there was. Your mobility, sight, memory, reading and writing skills, speech, and reasoning ability are some of the ways you may be affected after such an injury.
A final cause of ABI is infection. Bacteria and viruses can invade the body, which then produces an immunological response. This response is what can cause damage, as inflammation and pus can exert undue pressure on the brain. The invading microorganisms may directly injure nervous tissue, or could indirectly cause damage by interrupting blood supply. Treatment involves clearing the infection and alleviating the symptoms.
The caregiver of someone suffering from an ABI has an immense task due to the critical role of the organ involved. Even the mildest of symptoms can cause a patient to require significant help. A wide range of conditions has been discussed in this post, and so specific responsibilities will vary. A highly important and universal duty will be to ensure that the loved one is able to attend any doctor and rehabilitation appointments. With individualized recovery plans, it is likely that there will be many such appointments while the person is undergoing treatment.
The road to recovery for a person who has experienced a TBI can be lengthy. Along this journey they will be advised to try to perform tasks that they did prior to the injury. Such effort will be exhausting, and so providing as much help as possible will relieve some of the stress of the individual. It could be a monumental moment for a sufferer to be able to walk to the grocery store and bring groceries home. But, this could leave them at their maximum output for the day, now unable to cook a meal. As important as pushing the limit of their ability will be ensuring that they properly rest afterwards. They will need the energy for the next day’s battle within. This process will continue for an indeterminable amount of time, but it is likely that progress will be made. Unfortunately, there is not always a linear progression, and setbacks can occur. One day they may be able to perfectly handle a scenario, and the next day they may find it beyond their capabilities. This is why having access to a supporting caregiver can greatly improve a person’s recovery experience.
Similarly, nTBIs require constant support. Unlike a concussion, a person experiencing dementia will only require more help over time as the condition worsens. During such a time it can be beneficial to remain in surroundings that are comfortable and familiar. As a result, memories may be more readily available, and stress can be reduced with the onset of increased confusion. While there is no current cure for this condition, this does not mean that a reasonable quality of life cannot be maintained. Experienced caregivers will be able to draw upon their knowledge of how best to handle a particular situation.
Finally, providing moral support to your loved one is essential. Talk to your loved one and tell them that you are prepared to help them through this difficult time. Please remember to also listen to their concerns. Confusion, sadness, and frustration may be partly mitigated through understanding and patience on the part of the caregiver.
While it is likely that you already understood how serious a brain injury can be prior to reading this post, an important takeaway is that many people do have a full recovery. Try to maintain a healthy sense of hope through this phase. Perseverance through difficult and lengthy treatments is necessary to a successful recovery. With continued and extensive research, the future outlook of a person with an ABI will only improve. New techniques for treatment of ABIs have followed from this expanded research. Cannabinoids are being used to target certain receptors in the brain. Ice and cold therapy is being applied to helmets to address inflammation concerns post injury. Even certain light frequencies are now being used for recovery in devices that appear as if out of science fiction like Star Trek. In many cases, an ABI does not have to be an end to your former self.
Get ABI Care
Our caregivers don't just provide home health care services, they are also an integral part of the multi-disciplinary rehabilitation team. As our staff is front line, we work very closely with your Personal Injury lawyer, Case Manager, Occupational Therapist, Physical Therapist, Speech Language Therapist, Rehab Therapist, and Social Worker. We believe in a client focused team solution to rehabilitate your injury.