After a TBI, several factors, including the person’s age and general health status, the severity of the brain injury and its location, that is, what parts of the brain are damaged, all affect the person’s recovery, and the kinds of disabilities they will face.
About 40 percent of patients with brain injuries, especially those with mild TBI, develop Post Concussion Syndrome. This is a collection of symptoms that includes dizziness, headache, problems with concentration, memory impairment and sleep disturbance. People with Post Concussion Syndrome may become restless, irritable, depressed, apathetic, or anxious. The symptoms may persist for a few weeks as the brain heals, or they may last for months. The causes of PCS are not well understood.
Pain symptoms can be treated with pain medication and depression, irritability and anxiety often respond well to antidepressants. Occupational therapy can help patients learn new skills for organization and helping with memory loss, and psychotherapy is often helpful in patients’ coming to terms with what has happened to them and what capacities they have lost.
Cognition is the term for mental processes such as memory, reasoning, thinking, problem solving, planning, and integrating new information. Cognitive skills are particularly at risk in traumatic brain injury, and most people who sustain a TBI will suffer some loss of cognitive skills. Among people with mild or moderate brain injury, cognitive impairments are more likely to be in the areas of concentration and attention. They report difficulty in concentrating, and are much more vulnerable to being distracted. Because capacities to reason, plan, and organize may be significantly impaired, returning to the work a person did before the injury may not be possible.
After a TBI a person may become confused easily, especially in situations with high levels of stimuli such as loud noises, bright lights, crowds, and a lot of activity going on around them. The person may want to avoid high-stimulus situations and public places where he or she is are likely to become overwhelmed.
People who have suffered a severe brain injury almost always have substantial memory loss. Memories for some events are no longer retrievable, and they may be less able to record and store new memories. When a person loses memory for events that occurred before the injury, this is called retrograde memory loss. Inability to retrieve memory of events since the injury is called anterograde memory loss.
Changes in sensory capacity are also common. After a TBI a person may have dysfunctions of vision, taste, hearing, touch, or smell. They may be less able to recognize objects, and slower to make sense of what they are seeing. Eye-hand coordination may be impaired, so that a person with TBI, a may be more likely to drop things, bump into things, and be unsteady on their feet. They may have difficulty driving a car, operating machinery, or playing sports. Some people experience tinnitus, a persistent ringing sound in their ears, or a bitter taste in their mouth or a continuing unpleasant smell.
Language and communication difficulties are common. Different speech and language functions are in different areas of the brain, so that depending on the brain area that has affected, a person may have problems with different aspects of language. Aphasia means difficulty understanding what’s being said, or being able to form words and speak. Patients with Broca’s aphasia have great difficulty recalling words and speaking in whole sentences. In Wernicke’s aphasia, the patient speaks fluently, but in nonsense words, and usually has no awareness that he isn’t making sense.
Mood changes, including depression, irritability, and anxiety, and behavioral changes such as impulsivity, social inappropriateness and impaired social judgement, increased aggression and other personality changes are frequent consequences of TBI. These changes can cause significant stress for family members as well as for the person with the TBI.
Thorough testing by a neuropsychologist experienced with TBI can provide a picture of a person’s cognitive, behavioral, language and memory functions, both the areas in which they’ve lost function and also their strengths. This assessment becomes the basis for planning the person’s rehabilitation, and can help the person and their family know what levels of recovery they can expect. Family members should be involved in the rehab process, both to support the patient, and to gain a better understanding of the changes in the person’s needs and capacities.
You may also want to read “TBI Basics – Rehabilitation after TBI.”
If you or a loved one has suffered a Traumatic Brain Injury as a result of negligence on the part of another party, you should discuss your situation as soon as possible with an experienced brain injury lawyer, to determine whether you may have a claim.
San Diego personal injury lawyer David S. Casey has dedicated his practice to providing legal representation for victims and their families who have suffered serious injuries or death due to traumatic brain injury. Throughout his 30 year career as a San Diego traumatic brain injury lawyer, Mr. Casey has been recognized by his peers; he was named Lawyer of the Year in 2002 by the San Diego County Bar Association, and was the recipient of the Broderick Award for Civility, Integrity and Professionalism in 2004.
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