TBI, also called “acquired brain injury” or simply “head injury,” occurs when a sudden trauma causes damage to the brain. The damage can be focal – confined to one area of the brain – or diffuse – involving more than one area of the brain. TBI can result from a closed head injury* or a penetrating head injury. A closed injury occurs when the head suddenly and violently hits an object but the object does not break through the skull. A penetrating injury occurs when an object pierces the skull and enters brain tissue.
Acquired brain injury (ABI) is an injury to the brain that occurs after a period of normal development. An acquired brain injury can result from internal occurrences (strokes, tumors, infections), or from external causes (falls, sports injuries, car accidents).
Common causes of brain injury include the following:
- Falls—falling out of bed, slipping in the bath, falling down steps, falling from ladders, and related falls are the most common cause of traumatic brain injury overall, especially in older adults and young children.
- Vehicle-related collisions—accidents involving cars, motorcycles or bicycles (including pedestrians when involved in such collisions) are a common cause of brain injury.
- Violence—about 10% of traumatic brain injuries are caused by violence, such as gunshot wounds, domestic violence or child abuse. Shaken baby syndrome is traumatic brain injury caused by the violent shaking of an infant that damages brain cells.
- Sports injuries—brain injuries may be caused by injuries from a number of sports, including soccer, boxing, football, baseball, lacrosse, skateboarding, hockey, and other high-impact or extreme sports.
- Explosive blasts and other combat injuries—explosive blasts are a common cause of brain injury in active-duty military personnel. Although the mechanism of damage isn’t well understood, many researchers believe that the pressure wave passing through the brain significantly disrupts brain function. Traumatic brain injury also occurs from penetrating wounds, severe blows to the head from shrapnel or debris, and falls or bodily collisions with objects following a blast.
It is difficult to predict how well a person will recover from a brain injury. Some injuries that appear mild may lead to more significant long-term disability than other injuries that appear more severe initially. Factors that can be predictors of recovery are duration of coma, post-traumatic amnesia (failure to remember events leading up to injury or failure to accumulate new memories after injury), age, location of injury, pre-injury functioning, and availability of support systems.
A coma is a state of unconsciousness in which the person cannot be aroused or does not respond, even to painful stimuli.
A concussion is a temporary loss of awareness or consciousness caused by a blow to the head. Severe blows may result in bleeding in the head or permanent damage to nerves. Some concussions can have serious, lasting effects.
Your brain floats within your skull surrounded by cerebrospinal fluid (CSF). One of the functions of CSF is to cushion the brain from light bounces of everyday movement. However, the fluid may not be able to absorb the force of a sudden hard blow or a quick stop.
Most concussions are mild and most people with mild brain injuries recovery fully, but the healing process takes time. Rest is the best recovery technique.
Signs and Symptoms:
The signs and symptoms of a concussion can be subtle and may not appear immediately. Symptoms can last for days, weeks or longer. Your behavior, mental ability and physical skills all are linked to specific areas of your brain. The severity and side effects of a head injury depend greatly on which area of your brain was most affected.
Immediate signs and symptoms of a concussion may include:
- Ringing in the ear (tinnitus)
- Unequal pupil size
- Unusual eye movement
- Loss of consciousness
- Slurred speech
Delayed signs and symptoms may include:
- Sleep disturbances, including insomnia or difficulty waking
- Loss of sense of taste or smell
- Trouble with memory
- Increased sensitivity to sounds, lights and distractions
- Difficulty with gait or in coordinating use of limbs
- Getting lost or becoming easily confused
- Poor concentration
Once neurons are severed they cannot yet be repaired. The brain generates new brain cells, but we do not yet know how to direct these cells to become neurons. Over time the secondary effects of brain injury subside, new information pathways may develop, and functioning generally improves. However, the extent of injury to neurons in the brain and the location of injuries determine to a great extent the level of recovery an individual will experience.
Swelling of the brain (or cerebral edema) is an accumulation of excessive fluid in the substance of the brain. The brain is especially susceptible to injury from edema, because it is located within a confined space and cannot expand. Diffuse cerebral edema may develop soon after head injury.
Both federal and state laws require school districts to provide each student with a disability a free, appropriate public education (FAPE). Traumatic brain injury (TBI) is one of the recognized categories of impairment under both federal and state law. Therefore, a school district has an obligation to provide each student who meets the eligibility criteria for TBI and who requires special education the specially designed instruction and related services he/she needs to receive FAPE.
Behavioral control requires multiple brain systems work together to process, interpret and act on information. Many students with TBI have difficulty remembering what they are supposed to do and controlling their emotions and behavior. Deficits in the area of attention and memory; physical and emotional regulation; executive functions; speed of processing and communication skills work together to produce challenging behaviors. Often, challenging behavior can be directly linked to the student’s TBI.
Our clients are referred to us by a primary care physician or institution and referrals are based on medical records and/or individual assessment. Please refer to your primary care physician to learn more about our services and whether or not we can provide the right solution for your individual case.