Acquired Brain Injury - What It Is
From: www.biausa.org
Acquired Brain Injury
An acquired brain injury is an injury to the brain, which is not hereditary, congenital, degenerative, or induced by birth trauma. An acquired brain injury is an injury to the brain that has occurred after birth.
An acquired brain injury commonly results in a change in neuronal activity, which effects the physical integrity, the metabolic activity, or the functional ability of the cell. An acquired brain injury may result in mild, moderate, or severe impairments in one or more areas, including cognition, speech-language communication; memory; attention and concentration; reasoning; abstract thinking; physical functions; psychosocial behavior; and information processing.
Adopted by the Brain Injury Association Board of Directors, March 14, 1997.
Symptoms
Acquired brain injury takes place at the cellular level within the brain. Therefore, injury from acquired brain injury can affect cells throughout the entire brain, instead of just in specific areas as with traumatic brain injury.
Most symptoms of acquired brain injuries are very similar to that of traumatic brain injuries; however, there are some difficulties that are experienced more frequently or to a greater degree by persons with acquired brain injuries. These symptoms can include:
Cognitive impairment- Thinking skills, especially memory
Longer lengths of time spent in a vegetative state
Severe behavior problems- Psychosis, depression, restlessness, combativeness, hostility
Muscle movement disorders
Causes of acquired brain injury can include, but are not limited to:
Airway obstruction
Near-drowning, throat swelling, choking, strangulation, crush injuries to the chest
Electrical shock or lightening strike
Trauma to the head and/or neck
Traumatic brain injury with or without skull fracture, blood loss from open wounds, artery impingement from forceful impact, shock
Vascular Disruption
Heart attack, stroke, arteriovenous malformation (AVM), aneurysm, intracranial surgery
Illegal drug use, alcohol abuse, lead, carbon monoxide poisoning, toxic chemicals, chemotherapy (not all the time).
Levels of Brain Injury
The terms Mild Brain Injury, Moderate Brain Injury, and Severe Brain Injury are used to describe the level of initial injury in relation to the neurological severity caused to the brain. Keep in mind that there is nothing “Mild” about a brain injury—again, the term “Mild” Brain injury is used to describe a level of neurological injury. Any injury to the brain is a real and serious medical condition.
Mild Traumatic Brain Injury
Mild traumatic brain injury occurs when:
Loss of consciousness is very brief, usually a few seconds or minutes
Loss of consciousness does not have to occur—the person may be dazed or confused
Testing or scans of the brain may appear normal
A mild traumatic brain injury is diagnosed only when there is a change in the mental status at the time of injury—the person is dazed, confused, or loses consciousness. The change in mental status indicates that the person’s brain functioning has been altered, this is called a concussion.
Symptoms of mild traumatic brain injury:
Headache
Fatigue
Sleep disturbance
Irritability
Sensitivity to noise or light
Balance problems
Decreased concentration and attention span
Decreased speed of thinking
Memory problems
Nausea
Depression and anxiety
Emotional mood swings
This information is not intended to be a substitute for medical advice or examination. A person with a suspected brain injury should contact a physician immediately, go to the emergency room, or call 911 in the case of an emergency. Symptoms of Mild Traumatic Brain Injury can be temporary. The majority of people with Mild Traumatic Brain Injury recover after one year.
Department of Defense and Veteran's Head Injury Program & Brain Injury Association of America (1999). Brain Injury and You. Horn, L.J. & Zasler, N. (1996). Medical Rehabilitation of Traumatic Brain Injury. Hanley & Belfus, Inc: Philadelphia, PA.
Kay, T. Brain Injury Association of America. Mild traumatic brain injury.
Moderate Traumatic Brain Injury
A moderate traumatic brain injury occurs when:
A loss of consciousness lasts from a few minutes to a few hours
Confusion lasts from days to weeks
Physical, cognitive, and/or behavioral impairments last for months or are permanent.
Persons with moderate traumatic brain injury generally can make a good recovery with treatment or successfully learn to compensate for their deficits.
Department of Defense and Veteran's Head Injury Program & Brain Injury Association of America (1999). Brain Injury and You.
Severe Brain Injury
Severe brain injury occurs when a prolonged unconscious state or coma lasts days, weeks, or months. Severe brain injury is further categorized into subgroups with separate features:
Coma
Vegetative State
Persistent Vegetative State
Minimally Responsive State
Akinetic Mutism
Locked-in Syndrome
Coma
Coma is defined as a state of unconsciousness from which the individual cannot be awakened, in whichthe individual responds minimally or not at all to stimuli, and initiates no voluntary activities.
Persons in a coma appear to be asleep, but cannot be awakened
There is no meaningful response to stimulation.
Persons who sustain a severe brain injury can make significant improvements, but are often left with permanent physical, cognitive, or behavioral impairments.
Department of Defense and Veteran’s Head Injury Program & Brain Injury Association of America (1999). Brain Injury and You.
Vegetative State (VS)
Vegetative State (VS) describes a severe brain injury in which:
Arousal is present, but the ability to interact with the environment is not.
Eye opening can be spontaneous or in response to stimulation
General responses to pain exist, such as increased heart rate, increased respiration, posturing, or sweating
Sleep-wakes cycles, respiratory functions, and digestive functions return
There is no test to specifically diagnose Vegetative State; the diagnosis is made only by repetitive neurobehavioral assessments.
Giacino, J. & Zasler, N. (1995). Outcome after severe traumatic brain injury: Coma, the vegetative state, and the minimally
responsive state. Journal of Head Trauma Rehabilitation, 10, 40-56.
Persistent Vegetative State (PVS)
Persistent Vegetative State (PVS) is a term used for a Vegetative State that has lasted for more than a month.
The criteria is the same as for Vegetative State
The use of this term is considered controversial because it implies a prognosis. Giacino, J. & Zasler, N. (1995). Outcome after severe traumatic brain injury: Coma, the vegetative state, and the minimally
responsive state. Journal of Head Trauma Rehabilitation, 10, 40-56.
Minimally Responsive State (MR)
Minimally Responsive State (MR) is the term used for a severe traumatic brain injury in which a person is no longer in a coma or a Vegetative State. Persons in a Minimally Responsive State demonstrate:
Primitive reflexes
Inconsistent ability to follow simple commands
An awareness of environmental stimulation
The frequency and the conditions in which a response was made are considered when assessing the meaningfulness or purposefulness of a behavior.
Giacino, J. & Zasler, N. (1995). Outcome after severe traumatic brain injury: Coma, the vegetative state, and the minimally
responsive state. Journal of Head Trauma Rehabilitation, 10, 40-56.
