This is called a coup/countercoup injury. The ensuing
bleeding and swelling can build pressure up in the enclosed
skull and surgery may be required to relieve the pressure
from the swelling.
An Open Head Wound is
when the skull is fractured. A
Penetrating Head Wound occurs
when an object penetrates into
the skull into the brain. In
these situations infection also
becomes a concern.
A second mechanism of brain
injury is twisting and shearing.
This occurs when the head is twisted and shaken violently.
Although commonly associated with Shaken Baby Syndrome,
it frequently occurs in motor vehicle accidents where there
was a lot of acceleration/deceleration and violent spinning.
This injury is called a Diffuse Axonal Injury. It is called
diffuse because it affects every area of the brain. Axonal
means that the long, tender axons which allow the neurons
to communicate are torn. This works to stop communication
much like cutting a telephone wire.
The third mechanism is an Anoxic Injury. This occurs when
oxygen has been deprived from the brain. This could be
suffocation, near drowning, strangulation and even loss
of blood. The lack of oxygen to the brain causes brain cell
death.
What can I expect?
Although it doesn’t take long to get a brain injury, recovery
is often a long process. While the person is in the hospital
they will first be treated to make sure that further damage is
stopped and the person can survive the injury. The Glasgow
Coma Scale allows medical professionals to accurately
communicate the level of coma the person has. The Ranchos
Los Amigos Scale helps to describe the level or stage of
recovery the person with the injury is making.
Just as a brain injury may be mild, moderate or severe, a
person may recover with mild, moderate or severe disabilities.
A person may recover and need little to no assistance, they
may need moderate assistance to live independently or they
may need major assistance and need constant help. Some
problems are evident early into the injury and others become
evident when a person returns home and has problems
adjusting to their injury.
Common Issues
While a person may not know what to expect, there are
some issues that are common to most brain injuries. These
issues may affect a person’s thinking or cognitive skills; they
may affect a person’s physical abilities or they may affect
the person’s emotional and behavior. Some of the problems
in these areas may be severe even if the injury to the brain
wasn’t.
Physical Issues
A brain injury may affect the body’s ability to function.
Examples of physical disabilities from brain injury include:
• They may tire easily and need frequent naps
• Balance issues that affect walking and getting around
• A person may lose use of one side of their body
• They may lose their sense of taste and smell
• They may have persistent headaches
• They may start slurring their words
• They may be sensitive to light or sound
Thinking or Cognitive Skills
Common problems for people after brain injury are:
• Short-term memory loss
• Inability to find or use the correct word – this is called
aphasia
• Problems organizing and sequencing for daily
activities
• A slower mental processing speed
• Initiating or beginning an activity
Emotional or Behavioral Skills
The person with an injury may act in ways they haven’t
before:
• Depression
• Mood swings
• Explosive anger
• Inability to inhibit remarks
• Inappropriate behavior, such as flirting with women
• They may ask the same question repeatedly and forget
the answer
• They may start doing things obsessively or
compulsively
The injured brain is like the non-injured brain in that no
two are exactly the same. In brain injury the person may
never fully regain consciousness and remain in a vegetative
state, or they may return to near normal functioning. In the
early stages of injury, there is no way to truly foresee the
outcome.
You can expect the most dramatic improvement in the first
six months to a year. However, many brain injury survivors
report making progress many years after the injury – only
the changes will seem smaller because they will appear to
be healed to people who do not know them well.
You and the person with the injury can expect care and
assistance with needs while in the care of a medical or
rehabilitation hospital. The resource section of this journal
will help you locate services you may need after you return
home. Please feel free to call BIAK at 1-800-592-1117 or visit
our web site at www.biak.us for more information.
8 2020-2022 BIAK Resource Journal
/www.biak.us