Potential Complications of Acquired Brain Injury (ABI)

Despite the protective nature of the skull, blunt traumas, car accidents, or sports injuries can injure the brain. Head trauma can tear or rupture the nerves, the blood vessels, or the tissues in and around the brain.

When there is bleeding, swelling, or buildup of fluid inside the skull, the increased pressure destroys brain tissue. Damage might be limited to a specific area or widespread.

Impairment resulting from a brain injury depends upon where and how badly the brain was injured. Possible impairments include

• cognitive changes
• dizziness and falls
• emotional or behavioral changes
• headaches
• impaired mobility
• seizures
• spasticity
• sleep disorders

Cognitive Changes

Cognitive changes can differ depending on the portion of the brain that has been damaged.

Frontal Lobe Injury

Substantial injury in the frontal lobes may cause

• apathy
• indifference
• inattention
• personality change

Large defects in the front or side of the frontal lobes tend to make you

• easily distracted
• inappropriately euphoric (feeling joyful, with an elated sense of well-being)
• argumentative or rude

You might also disregard the consequences of your behavior.

Temporal Lobe Injury

Right temporal lobe damage impairs memory of sounds and shapes. Damage to the non-dominant right temporal lobe can reduce your appreciation of humor, make you more obsessive, or diminish your sexual drive.

Damage to the left temporal lobe interferes with your understanding of language and usually prevents you from expressing language. "Aphasia" is the term for the loss of language ability.

You may experience difficulty with recall of specific words. This is sometimes described as "tip of the tongue" phenomenon, where the brain is having difficulty recalling information from storage.

Coping with Cognitive Changes

To overcome cognitive changes that follow a head injury, try to become as organized as possible. The idea is to limit the number of things the brain must remember.

• Buy a daily planner and write everything down in one location.
• Make a "to do" list. Remind yourself to run errands, complete chores, etc.
• Maintain your general health and get adequate sleep, because fatigue affects brain performance.
• Talk to your physician about memory or cognitive changes. You might be taking medications that are adversely affecting your mental performance.
• Seek out a specialist who works with head injuries similar to yours. Neuropsychologists or speech therapists may offer specialized programs to assist you in improving your memory or cognitive functioning.

Dizziness and Falls

A brain injury might make you more susceptible to falls and their resulting injuries. Falls can result in orthopedic injuries such as broken arms, legs, or hips. Or you may suffer bruises and lacerations.

When walking, you might not judge height difference or depth as well as before. You might also experience dizziness or feeling "lightheaded." This usually happens when moving from a reclining position to a sitting or standing position, or when walking.

Driving or riding in a vehicle can also trigger dizziness. Having a friend or family member available while driving can help reduce accidents.

The best way to prevent falls is to use ambulation aids: a cane, or assistance from an attendant or family member. "Fall-proof" your home by taking sharp or dangerous objects out of the way of foot traffic.

Emotional/Behavioral Changes

After a brain injury, you may experience emotional changes. There is usually a level of frustration, especially when you're unable to do things you could before, or when you can't recall day-to-day information.

Common emotional responses following a head injury are depression and anxiety. Behavioral problems may include an increase in socially inappropriate behavior.

Headaches

Research indicates that a year after hospital discharge, about 1 in 3 people with ABI are still reporting headaches.

Pain might be located in the back of the head, in the neck and shoulder, or it may spread over the top to the front of the head. It can be the result of "nerve damage" and/or "muscle tension" in the affected area.

A headache can trigger a worse, "migraine-like" headache, a throbbing or pounding in your head. This may be the result of altered blood flow. Another type of headache is experienced as a sudden, sharp pain that lasts several seconds to a minute or so.

To relieve the discomfort of a brain injury headache, your physician might recommend one or more approaches:

• physical therapy
• massage
• stretching
• water therapy
• sleep
• rest
• stress management

Selected medications might also be recommended. Consult your physician before trying any over the counter medications designed for "migraines." Likewise, before beginning any form of therapy, discuss your options with your physician.

Impaired Mobility

A brain injury can reduce your ability to walk or use your arm or hands. When mobility is impaired, even common daily activities can become more difficult or impossible. You may be unable to walk, feed, wash, or dress yourself. If confined to a bed or wheelchair, you may require additional care by family members or other caregivers.

However, you may be able to find reacher tools, grooming aids, feeding aids, or other utensils that can assist you. Look on the Internet and peruse mail order catalogues.

Seizures

According to a study by Merck, seizures develop in about 10% of people who have severe head injuries with no penetrating wound of the brain, and in 40% of those with a penetrating wound. If seizure activity occurs, it usually comes on immediately after the accident, during inpatient rehabilitation, or within one year after injury.

During a seizure, you could injure yourself or even cause a second head injury. There are several types of seizures, including Grand Mal and partial seizures.

Some people have a warning of a seizure—called an "aura"—that consists of bodily sensations, seeing lights, or smelling something. Other people do not have warning signs. After a seizure, you may have a feeling of intense fatigue.

To diagnose seizures, tests such as an EEG (electroencephalogram) are used. Once diagnosed, anti-seizure medications, such as carbamazepine, may be prescribed. Routine visits to the neurologist might be required, and routine laboratory tests may be recommended to monitor the levels of anti-seizure medication in your body.

Spasticity

Spasticity (and contractures) are complications that often result from a brain injury.

Spasticity is an increase in the normal reactivity of muscles, leading to unequal forces on the joint. A contracture may result from spasticity. A contracture is a fixed muscle shortening.

Contractures occur when electrical messages from the brain don't coordinate muscles properly. To move a joint, the muscle has a stop (contract) and start (extend) signal. With a brain injury, the messages may be disrupted, causing one side of the muscle to be over stimulated. This affects the control of muscle movement. The result is a stiffening in the arms or legs, which "freeze" in one position.

Sleep Disorders

If you have sustained a head injury, you may experience some form of sleep disorder. Your sleep mechanism is regulated by your brain, so a brain injury can impair the mechanism.

Perhaps you were able to sleep much better before your injury. This could be due to the change in your daily activity, difficulty in the healing process, or anxiety about the injury.

Discuss difficulty sleeping with your physician. There are a number of recommendations he/she may be able to make. Medications might be prescribed to assist you.

Try to practice these good "sleep habits."

• Go to bed a the same time each night.
• Avoid caffeine.
• Keep your room at a comfortable sleeping temperature.
• Keep the room dark and quiet.
• Avoid naps during the day.

Sleep is an important function. It helps your body heal and rejuvenates you, so that you have energy for daily activities.