Brain Injury: Basic Questions Answered

What is traumatic brain injury?

1.7 million Americans sustain a traumatic brain injury each year which requires hospitalization. Traumatic brain injury is an insult to the brain, not of a degenerative or congenital nature but caused by an external physical force or by internal damage such as anoxia (lack of oxygen) or tumor. It may produce a diminished or altered state of consciousness, which results in impairment of cognitive abilities and physical functioning. These impairments may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment. Fifty percent of brain injuries occur as a result of a motor vehicle accident.


What does the brain do?

The brain is the center of our body’s control system. One part of the brain controls our breathing, heart beat, and circulation. Other parts of the brain control our vision, physical movement, memory, hearing, and emotions, to name a few. The brain is our most vital organ and is involved in every aspect of our body’s functioning.


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. Follow-up treatment and evaluation are required on a regular basis.


What is a skull fracture?

A skull fracture results in damage to the skin and bone of the skull as well as to 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 be between the skull and the covering of the brain (epidural) or may occur between the membrane covering the brain and the brain itself (subdural). Hematomas may require surgery (a craniotomy) to be performed.


What is a coma?

Coma is defined as a prolonged state of unconsciousness. A person in a coma does not respond to external stimuli. There is no speech, the eyes are closed, and the person cannot obey commands. Coma can last from hours to days, depending on the severity of the brain damage. It is possible for a person to remain in a comatose state for months or even years. A person may eventually open their eyes, but if they remain unresponsive, they could be in what is termed a “vegetative state.”


What happens in the emergency room and Intensive Care Unit?

Most accident victims enter the hospital through the emergency room. The injury is diagnosed and appropriate action is taken. Some patients must go to the Intensive Care Unit (ICU) of the hospital for close, 24 hour monitoring of their condition. Other injuries sustained at the time of the brain injury may require (ICU) services not necessarily related to the head trauma.


What is medical stabilization?

Many brain injury patients 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 patients 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 patients will go home with their families and return to the hospital or a specialized outpatient program for their therapies and treatment.

Some patients who require extended skilled nursing care will be transferred to a long term care facility.

Some patients will return home to receive therapy and around the clock nursing care.


What is rehabilitation?

Rehabilitation is the process which 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.


What 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 patient’s 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 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 which 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 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 your brain injured individual.


What can the family expect?

Every brain injury case is different. You cannot compare brain injuries like you can a broken arm or leg. The effects of each brain injury are very individualized. No one person has all the answers. You must start to read and gather information on brain injury, its effects and possible treatment avenues open to you. Educating yourself is important in setting realistic expectations.


Helpful suggestions for families?

  • Establish a balance between pushing the brain injured person beyond his or her ability to function and not giving enough encouragement.
  • Establish and maintain a daily routine.
  • Approach the brain injured on their good side.
  • Use familiar photographs of family members, friends, pets or possessions
  • Speak of familiar names, places, interests, or activities.
  • Be yourself with the brain injured.
  • 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.


Where can the family go for information and support?

To obtain further information or locate the nearest support group, call (801) 716-7993.


What is the BIAU?

The Brain Injury Alliance of Utah is a nonprofit organization made up of individuals with brain injury, family members, friends and professionals dedicated to providing information, advocacy and support.  The BIAU is Associate Member of the United States Brain Injury Alliance.


What is the Brain Injury Alliance’s mission?

The mission of the Brain Injury Alliance of Utah, Inc. is “Creating a better future through brain injury prevention, research, education, and advocacy.”

Stimulate public and professional awareness of the problems of brain injury.
Provide a central clearinghouse for information and resources for the brain injured and their families.

Develop a support group network for the brain injured and their families.
Established specialized brain injury rehabilitation programs. Encourage existing programs and develop new programs where none exist.


Why is support from others important?

You cannot go through this trauma alone! We all need support from those who understand the pain and loss we are suffering. Support groups for both the patient and family are available to you. Take advantage of this now!