Brain Injury:Adapted from the Brain Injury Association of Kentucky Web Site: http://www.braincenter.org/
Frequently Asked Questions
How serious is brain injury?
Each year, an estimated 2 million people sustain a head injury. About 500,000 to 750,000 head injuries each year are severe enough to require hospitalization. Head injury is most common among males between the ages of 15-24. Many head injuries are mild, and symptoms usually disappear over time with proper attention. Others are more severe and may result in permanent disability. If so, your life has been changed. Depending on how bad this injury is, life will never return to the way it once was. This is a reality. When a person sustains a traumatic brain injury, whether from an accident, tumor, stroke, or any other cause, his or her life will never be the same. There are others who have gone through what you are going through. There is much to learn together. Most importantly, you are not alone.
What is acquired brain injury?
There are currently 5.3 million Americans living with a disability caused by brain injury. Brain injury is acquired damage to the brain, the result of either an external physical force or internal causes, which results in an impairment of cognitive, emotional, and/or physical functioning. It is not of a degenerative or congenital nature but caused by an external physical force or by internal damage such as anoxia (lack of oxygen), stroke, disease, or tumor. It may produce a diminished or altered state of consciousness, which results in impairment of "thinking processes" and physical abilities. These impairments may be either temporary or permanent, and cause partial or total functional disability or psychosocial maladjustment.
What is a concussion?
A concussion results from a blow to the head which causes the brain to strike the skull. A concussion does not cause any structural damage to the brain, but can cause temporary loss of functioning. Headaches, memory loss and sleep disturbance may be some of the problems suffered after such an injury.
What is a contusion?
A contusion is a more serious blow to the brain, which results in bruising of the brain and more noticeable loss of functions. More comprehensive care is required for a contusion.
What is a skull fracture?
A skull fracture results in damage to the skin and bone of the skull as well as the brain itself. The form of medical treatment varies with the location and severity of the fracture. Close observation and follow up treatment are always required. Many skull fractures result in mild to severe problems associated with daily functioning such as walking, memory, vision and behavior.
What is a hematoma?
The collection of blood in one or several locations of the brain creates a hematoma. A hematoma may occur between the skull and the covering of the brain (epidural) or may occur between the membrane covering the brain itself (subdural). Hematomas may require surgery.
What is a stroke?
Stroke is a "brain attack," cutting off vital supplies of blood and oxygen to the brain cells that control everything we do... from speaking, to walking, to breathing. A stroke happens when an artery leading to or in the brain becomes blocked or ruptures.
What is a coma?
Coma is defined as a prolonged state of unconsciousness. There is no speech, the eyes are closed and the person cannot obey commands. Coma can last from hours to days to months or even years.
What is a seizure?
These are electrical discharges in the brain that disturb normal brain function. They can involve changes in behavior or consciousness. Roughly one-fourth of people with brain injuries also have seizure activity.
What is medical stabilization?
Many patients with a head injury require time in the hospital for medical treatment such as recovery from surgery, healing of wounds, and setting of fractures. This is known as medical stabilization. Patients may be transferred from the emergency room or ICU to a medical floor for observation, medical treatment and the beginning of rehabilitation services such as physical therapy.
What happens after medical stabilization?
After the patient has gone through medical stabilization, which can take from several days to several months, there are a variety of directions which may be taken:
- The patient may be transferred to a physical rehabilitation unit within a general hospital, or a specialized rehabilitation treatment center providing skilled nursing care. Physical, occupational, speech/cognitive and neuropsychological services can be provided on an intensive basis.
- Some people will not require skilled nursing care and may be transferred to a community program for brain injury patients. These programs offer both inpatient and outpatient services.
- Some people will go home with their families and return to the hospital or a special outpatient program for their therapies and treatment.
- Some people who require extended skilled nursing care will be transferred to a long-term care facility.
- Some people will return home to receive therapy and "around-the-clock" nursing care.
What is rehabilitation?
Rehabilitation is the process that helps an individual reach optimum function by providing a variety of services. Rehabilitation often uses a team concept which includes services of the physicians as well as physical, occupational and speech therapists, neuropsychologists, social workers, therapeutic recreational specialists and nurses. In addition, other professionals in education and vocational training help provide treatment services. However, the most important members of the treatment team are the patient and the patient's family.
Which is the best choice?
The appropriate choice for continued treatment is a major decision to be made by the patient and family. It is important to talk to your treatment team and fully understand the patients needs. Each person with a brain injury is different, with a set of individual needs. You must seek out as much information as possible to educate yourself about available resources.
What do families go through?
Shock, anger, hurt, denial, and depression are some of the first reactions families experience. A loved one's brain injury can change the family's life as well. A grown and independent child may require more attention from you. An injured parent may need the assistance of adult children. As the patient goes through the stages of recovery, so does the family. Support and guidance may help you deal with changes that are ahead. The key is to take one day at a time.
Signs of stress
The stress placed on the family of the brain injured is tremendous. Each individual and family will handle and cope with stress differently. The signs of stress may include the following: inability to sleep, poor appetite, lack of interest in personal care or appearance, a strong sense of guilt, reduced self worth, loneliness, excessive use of drugs and/or alcohol, forgetfulness, or an inability to understand things that are said. When stress builds, seek support from friends, clergy, and the medical staff caring for the individual.
Helpful suggestions for families:
- A skull fracture results in damage to the skin and bone of the skull as well as the brain
- Establish a balance between pushing the person with the brain injury beyond his or her ability to function and not giving enough encouragement.
- Establish and maintain a daily routine.
- Approach the person with the injury on their good side.
- Use familiar photographs of family members, friends, pets or possessions.
- Speak of familiar names, places, interests, and activities.
- Be yourself with the individual with a brain injury.
- Do not overwhelm or overload the person with information.
- Provide the individual with ample time to respond.
- Do not present the person with a task that is too complex.
- Try to reduce confusion in his/her surroundings.
- Talk openly about his/her gains and abilities.
- Communicate with the doctors, nurses, therapists, and the brain injured individual.
- Include and respond to appropriate humor.
Prevention is the best medicine, especially with brain injury.
Wear your helmet!
Dr. Rick Allen is a chiropractor, massage therapist and dance student who splits his time between Portland, Oregon and Trout Lake Washington. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone at 503-257-1324 in Portland, 509-395-0024 in Trout Lake, or toll free at 1-888-247-3248, email or on the World Wide Web: www.CascadeWellnessClinic.com
DISCLAIMER: The information included in this website is meant to encourage thinking concerning choices of care for and insight pertaining to possible causes of various problems. It is not a prescription for or diagnosis of any disease or condition. Suggestions are based on the assumption by the writer that a thorough examination was done previously and the reader is under care by a healthcare professional. This information is not a substitute for a live doctor.
© Dr. Rick Allen
Cascade Wellness Clinic