Information: about Brain Injury

New Horizons Un-limited is not endorsing and assumes no responsibility in guaranteeing the products, services, programs or conditions as described. If you are interested in a resource listed below, call or contact the resource to verify the current situation. Evaluate the information, analyze your unique circumstances, use your best judgment and make your own decisions when using the information. Before making any change, consult your health care professional.
See also Cerebral Palsy, Birth Injury
Quick link to the information of your choice on Brain Injury:

What is Brain Injury?

  • Brain Injury is a damage caused to the brain from accident, illness, trauma, that affects the person with a temporary injury or a permanent disability. Some brain injuries may heal in a few days without problems, such as slight bruising or swelling, some injuries if more severe, however, can cause brain damage or cerebral palsy. There are many ways the brain can experience injury and brain injury can be mild to severe.

What are the Causes of Brain Injury?

    According to the Centers for Disease Control and Injury Prevention, the leading causes of Traumatic Brain Injury are:

    • Falls (40.5%)
    • Other/Unknown (19%)
    • Struck by/against events (15.5%)
    • Motor Vehicle-traffic crashes (14.3%)
    • Assaults (10.7 %)
    • Newborns may experience major injuries due to different obstacles or causes which may cause brain injury. For more information about these circustatnces see Birth Injury .

What are the Types of Brain Injury?

The following are some common types of Brain Injury:
  • Diffuse Axonal Injury
  • Concussion - for more information visit Prevention: Brain Injury and Safety: Recreation
  • Contussion
  • Acquired Brain Injury
  • Traumatic Brain Injury
  • Anoxic Brain Injury
  • Hypoxic Brain Injury

What are the signs and characteristics of Brain Injury?

Depending on the cause and the type of brain injury, the location of the brain that is injured, the severity of the injury, the age of the person and many other factors, the person may or may not experience the following symptoms or manifest with the following characteristics::

    Signs:
    • Swelling
    • Bruising
    • Pain
    • Spinal fluid (thin water-looking liquid) coming out of the ears or nose
    • Loss of consciousness; however, loss of consciousness may not occur in some concussion cases
    • Dilated (the black center of the eye is large and does not get smaller in light)or unequal size of pupils
    • Vision changes (blurred vision or seeing double, not able to tolerate bright light, loss of eye movement, blindness)
    • Dizziness, balance problems
    • Respiratory failure (not breathing)
    • Coma (not alert and unable to respond to others) or semicomatose state
    • Slow pulse
    • Slow breathing rate, with an increase in blood pressure
    • Vomiting
    • Headache that will not go away
    • Ringing in the ears, or changes in ability to hear

    Injury to the brain can manifest in the following characteristics:
    • Reduced thinking, attention and concentration
    • Confusion
    • Fatigue
    • Paralysis, difficulty moving body parts, weakness, poor coordination
    • Impaired cognitive skills
    • Inappropriate emotional responses (irritability, easily frustrated, inappropriate crying or laughing)
    • Slurred speech, difficulty swallowing
    • Numbness or tingling
    • Loss of bowel control or bladder control
  • The Center for Disease Control and Prevention offers the following article for acquired and/or traumatic brain injury Symptoms
  • The Center for Disease Control and Prevention and the National Center on Birth Defects and Developmental Disabilities offers this article, Early Signs which explains what to look for in developmental milestones in regard to controlling head, arm, leg, hand and body muscles in the developing infant.

    Statistics:

    • 2.4 million people sustain a traumatic brain injury (TBI) each year.
    • "Traumatic Brain Injury (TBI) is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Each year there are a reported 1.7 million civilian brain injuries in the United States. In the military from 2000 through 2012, more than 266,000 service members sustained a TBI. Brain injury has become known as the signature wound of the wars in Iraq and Afghanistan. Most brain injuries are mild, and most people recover in a matter of weeks. From BrainLineMilitary.org provides military-specific information and resources on traumatic brain injury to veterans; service members in the Army, Navy, Air Force, Marines, National Guard, and Reserve; and their families."
    • "It has been estimated that, for every 1000 babies born in the U.S., five will be injured during birth and the type of birth injury can vary, ranging from temporary bone fractures, bleeding and bruising, to cerebral palsy and even permanent brain damage." Early evaluation (within the first one to two months of life) is important to determine whether therapy or surgery is required." This information is from Birth Injuries, birthinjuries.net

    Awareness

    • People First Language from disabilityisnatural.com by Kathie Snow offers insight into society's use of language when using the term disability. The term disability is a societal construct to identify characteristics related to a medical condition that may entitle an individual for services or legal protections. The use of this language encourages freedom, respect and inclusion for all, and recognizes forms of language that can isolate, create negative stereotypes and place attitudinal barriers for individuals. "Using People First Language, putting the person before the disability—and eliminating old, prejudicial, and hurtful descriptors, can move us in a new direction. People First Language is not political correctness; instead, it demonstrates good manners, respect, the Golden Rule, and more—it can change the way we see a person, and it can change the way a person sees themself!" For more articles by Kathie Snow to "help us begin to use more respectful and accurate language and create positive change," visit People First Language and More

    Viewpoint

    Solutions/Needs

      Treatment/Prognosis:

      • Physical Therapy

      • Surgery to improve or restore nerve function

      • New treatments based on research:

          • NHU has received reviews of research on various new interventions for persons with brain injury. The following articles discuss interventions that are fairly new or at least need more research and replication. They all cover relatively simple interventions that may be something a human service worker would be involved in or exposed to. All of these interventions are non-pharmacological. Click on the links below to view the NHU summary article on each research.

          New Horizons Un-limited is not endorsing and assumes no responsibility in guaranteeing the products, services, programs or conditions as described. If you are interested in a resource listed below, call or contact the resource to verify the current situation. Evaluate the information, analyze your unique circumstances, use your best judgment and make your own decisions when using the information. Before making any change, consult your health care professional.
          • The first research article is based on an Exercise Intervention for persons with brain injury. (Blake & Batson, 2009).

            This article discusses the effects of a Tai Chi Qigong exercise intervention with people who have brain injuries. Tai Chi Qigong was chosen because it is an easier to master form of Tai Chi Chuan and does not require extraordinary physical fitness or cognitive abilities and therefore is suitable for people with brain injuries. People with head injuries often suffer from difficulties with low self-esteem, sedentary lifestyle, mood problems, and behavior problems. The goal of the exercise intervention is to see if the conditions of those characteristics can be improved in the injured persons. The authors describe the benefits of Tai Chi Qigong as positive impacts in balance, coordination, and movement. They point out that sedentary lifestyles common to people with brain injuries can lead to “secondary disease” (Blake & Batson, 2009) such as diabetes. Although the results show that physical activity was not improved by this intervention, the persons did find an improvement in mood. More research and replication is needed to learn more about the effects of Tai Chi Qigong exercise intervention for people who have brain injuries.

          • This next summary research article is based on Eight years of Nutrition Intervention for a young person with an acquired brain injury

            The main goal of the nutrition intervention was to provide the energy needed specifically due to the brain injury (people with these injuries tend to need more protein and energy in the acute stage of recovery) while gaining weight in such a way that lean body mass (as opposed to fat) was gained up to a goal weight (80kg). The nutrition intervention addressed some specific issues that result from brain injuries such as rigid muscles and reflux. It also helped bring a brain injured client up to his goal weight, comparable to what he was at the time of his accident. The intervention addressed some of the client’s specific symptoms successfully and also was successful in getting the client to the goal weight. Due to these successes, the authors suggest that nutrition interventions including planning and management consisting of a two hour initial assessment, one hour monthly review and frequent testing of blood for nutrition and recording of weight continue to be tested with people with brain injuries. The intervention technique promotes an active stance toward nutrition, fostering “active treatment and rehabilitation” and not just “convalescence and maintenance” (Voevodin & Haala, 2007). The study is a starting point for further research.

          • This summary research article is based on handheld personal digital assistants (PDAs) as cognitive aids for people with brain injuries.

            • This research goal was to find the efficacy of handheld personal digital assistants (PDAs) as cognitive aids for people with brain injuries. The authors did an 8 week trial of the use of PDAs (the Handspring Visor and the Palm Zire 31) with no extra software installed by people with traumatic brain injury. The major occupational problems were within 4 categories: “forgetting appointments, time and task management, money management, and medication management” (Gentry, et al., 2008). Subjects were shown to improve in the areas of everyday life task functioning and in cognitive independence, mobility, and occupation. The authors pointed out that behavioral memory, or remembering when important things in life should be done such as taking medication or going to an appointment, is often compromised in people with brain injuries. This can lead to deficiencies in areas such as self efficacy and employment. The data of this research showed that subjects improved in cognitive independence, mobility, and occupation. This study, however, needs further research.

          • This summary research article is based on a research on Internet-based cognitive rehabilitation therapy sessions for people with brain injuries.

            Previous research had not been able to show that there were definite improvements in daily functioning for people with brain injuries who had participated in previous Internet interventions. This study was a pilot study in order to test the feasibility of offering rehabilitative services over the Internet for people with brain injuries. This study explored the option of Internet based interventions to bridge the gap to services for people with limited mobility or who live in rural areas. Most of the subjects were able to regularly attend their online sessions. People close to the subjects all reported that they had been able to access the online sessions independently. For well educated clients with computer and Internet access, online services could be considered. However, more research needs to be done and results need to be replicated with a larger and more varied sample. (Bergquist, et al., 2008)

          • Treatment to Improve self-awareness in persons with acquired brain injury.

            This study explores the efficacy of a self-awareness training program to assist with instrumental activities of daily living (IADLs) for people with brain injuries. Previous similar research has found that there are multiple effective ways to help people with brain injuries become more self-aware. Feedback, games, self-prediction, self-evaluation are some examples of methods that have been used with some success for this purpose. Lack of self awareness of impairments, mistakes, and inability to judge when assistance will be needed are very common awareness impairments for people with brain injuries. This can lead to many problems in everyday life as well as in employment. This study’s goal was to research the efficacy of an occupational intervention to help with self-awareness and self-regulatory skills. Improvements in task-specific awareness were not found. Improvements in self-regulation were found to be significant. Improvements in cognitive processes when completing tasks were also found to be significant. Improvement in satisfaction with the treatment was not found. More research needs to be done with larger sample sizes and perhaps additional sessions of treatment. (Goverover, 2008).

    Learn More About Brain Injury

    Organizations and websites that provide information about Brain Injury.

    References

    • Disability and Rehabilitation Handbook, by Robert Goldenson, McGraw-Hill, New York, NY, 1978, p.284.
    • Bergquist, T., Gehl, C., Lepore, S., Holzworth, N., & Beaulieu, W. (2008). Internet-based cognitive rehabilitation in individuals with acquired brain injury: a pilot feasibility study. Brain Injury, 22(11), pp. 891-897. Retrieved February12, 2010 from CINAHL database, Columbia College library.

    • Blake, H., & Batson, M. (2009). Exercise intervention in brain injury: a pilot randomized study of Tai Chi Qigong. Clinical Rehabilitation, 23(7), pp. 589-598. Retrieved January 19, 2010 from Academic Search Elite database, Columbia College library.
    • Gentry, T., Wallace, J., Kvarfordt, C., & Lynch, K. (2008). Personal digital assistants as cognitive aids for individuals with severe traumatic brain injury: a community-based trial. Brain Injury, 22(1), pp. 19-24. Retrieved February 2, 2010 from CINAHL database, Columbia College library. File: Gentry.pdf
    • Goverover, Y., Johnston, M., Toglia, J., & DeLuca, J. (2007). Treatment to improve self-awareness in persons with acquired brain injury. Brain Injury, 21(9), 913-923
    • National Institutes of Health
    • National Institute of Neurological Disorders and Stroke
    • Voevodin, M., & Haala, R. (2007). Eight years of nutrition intervention for a young person with an acquired brain injury. Nutrition & Dietetics: The Journal of the Dietitians Association of Australia, 64, 3. p.207(5). Retrieved January 19, 2010 from Health Reference Center Academic, Columbia College Library File: Voevodin.pdf

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