General Overview of Acquired Brain Injuries
The effects of a brain injury are diverse and wide ranging. Each person’s symptoms and situation are unique; however most people suffering with an acquired brain injury will find themselves going through a challenging process, as they learn to adapt to their new reality of life with a brain injury.
It can be a very difficult time for the injured person and their family, as the realization of the effects of the damage, along with the increased need and dependence placed on others, begins to become more apparent. This can leave everyone involved feeling overwhelmed and without a sense of control. There is a good chance if you are reading this that you may be experiencing something similar. You may be feeling confused, or perhaps unsure of what exactly has happened, and what to expect next.
As a starting point, when facing the difficulties of an acquired brain injury, people often find it helpful to gain a basic understanding of how we currently understand and define different types of brain injuries. Medical terminology can be intimidating, but it doesn’t have to be.
The following information should help you better understand what exactly acquired brain injuries are, what makes them traumatic or non-traumatic injuries, and how we classify them by severity.
What are Acquired Brain Injuries (ABI) exactly?
When the brain is injured or damaged any time after birth, it is called an Acquired Brain Injury, or ABI for short.
There are two types:
Traumatic Brain Injury (TBI) is damage resulting from an external, mechanical force. This can include rapid acceleration or deceleration, a direct impact to the head, and penetration of the skull. Sometimes injuries are further defined by whether they are open or closed. All injuries in which the skull has been broken, fractured, or penetrated are considered open.
Non-Traumatic/Atraumatic Brain Injury is any damage not resulting from external, mechanical force. This kind of injury often occurs at the cellular level, such as with strokes, aneurysms, or tumors.
How does brain damage or injury occur?
The brain may be damaged through the bruising of the tissue, bleeding inside the brain, lack of oxygen to particular areas, as well as large or small cuts or lacerations to the brain. Damage can occur at the location in which the head was directly hit. However, if the initial force is strong enough it may also damage the brain on the direct opposite side, where the tissue forcefully impacts the inside of the skull as a result of the blow. The brain may also experience further damage following the initial injury due to secondary swelling, seizures, fever, or neurochemical imbalances.
What determines the severity of a Traumatic Brain Injury?
Brain injuries can be quite diverse; the direction and strength of the force, as well as the location of injury in the brain, are all critical in determining the extent of the injury. Given the variety of injuries possible it is helpful to categorize acquired brain injuries by their severity (mild, moderate or severe).
Doctors often determine severity based on the duration of loss of consciousness or coma, brain imaging results, and the presence and the extent of post-traumatic amnesia (or PTA is a state of confusion, disorientation, and inability to remember events that occur after the injury).
Mild TBI, or concussion, usually results in a brief loss of consciousness (a few seconds or minutes). Post-traumatic amnesia lasts for less than an hour following the time of injury, and brain imaging results are normal.
Moderate TBI, is often associated with a loss of consciousness lasting between 1 to 24 hours. Post-traumatic amnesia usually occurs for approximately 1 to 24 hours following the time of injury, and abnormal brain image results are detected.
Severe TBI, results in a loss of consciousness or coma for more than 24 hours. Post-traumatic amnesia is present for more than 24 hours following the time of injury, and brain imaging results are abnormal.
– Severe TBI may be further classified by the level of conscious states resulting after the injury.
These include: Coma (unable to wake from state of unconsciousness), Vegetative State (individual is not in a coma, but is not aware of their environment), Persistent Vegetative State (vegetative state that lasts for more than a month), and Minimally Responsive State (when a person is no longer in a coma or vegetative state, and inconsistently interacts and responds to the environment).
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