What is an acquired brain injury?
An acquired brain injury is any brain injury that occurs, usually with a rapid onset, during a person’s life and after birth. Acquired brain injury commonly results in life-long challenges, including changes to behaviour, emotions and physical function.
The injuries may be traumatic, caused by a sudden blow or jolt to the brain, for example as a result of a fall, assault or road traffic accident. They may also be non-traumatic, brought about because something happens within the body such as a stroke, brain haemorrhage or a viral infection.
Every brain is different, and every brain injury is unique to the person affected.
Causes of Brain Injury
Concussion
Concussion is a very common cause of brain injury and must be taken seriously. A concussion can be caused by a direct blow to the head but can also occur when a person takes a hard knock to another part of the body, resulting in a rapid movement of the head, causing a disturbance of brain function.
The good news is that concussion is a manageable injury. Once a concussion is managed effectively from the time it occurs, it should lead to the avoidance of tragic injuries.
Most people with a concussion will recover quickly and fully. However, for some people signs and symptoms of concussion can last for days, weeks or longer. It’s important to keep a close eye on the person concussed. In all cases of suspected concussion, we recommend referral to a medical or healthcare professional for guidance.
Common symptoms of a concussion
• headache or pressure
• dizziness
• memory disturbance
• balance problems
• double or blurry vision
• sensitivity to light or noise
• feeling sluggish, hazy, foggy or groggy
• confusion
• you don’t ‘feel right’ or you are ‘feeling down’
Treatment
Rest is the cornerstone of concussion treatment. Complete rest for a minimum of 24 hours is recommended following a blow to the head. Unlike a broken arm, or other injuries that you can feel with your hands or see on an x-ray, you can’t see a concussion. It is a disruption of how the brain works. It is not a bruise to the brain, which is why brain CAT scans and MRIs appear normal with most concussions. An injury that cannot be seen must be monitored with a gradual return to normal activity.
After concussion, it is highly recommended to avoid:
• TV
• Computers
• Bright Lights
• Reading
• Texting
• Radio
• Loud Noise
• Physical Exercise
• Alcohol
• Driving
• Exertion of any Kind
While planned rest and fatigue management are still crucial for the concussion recovery process, recent research suggests that some active rehabilitation is also important for those impacted.
Post-concussion syndrome
Concussion is frequently experienced by sportspeople of all levels and abilities, on the field of play. If a player returns to the field with concussion, they put themselves at risk of suffering post-concussion syndrome.
This can result in a much longer-term collection of concussion symptoms including: headaches, depression, personality change, memory and concentration problems, sleep disturbance and mood swings.
Symptoms usually clear up within three months after the initial brain injury. The Graduated Return to Play (GRTP) programme is a progressive exercise programme that introduces a player back to the field of play in a safe, six-stage process.
Second impact syndrome
Second Impact Syndrome (SIS) is a rare condition characterised by an athlete sustaining a second concussion before the symptoms of the first concussion have resolved. This can be particularly dangerous if hits to the head are experienced within a short period of time.
Receiving another blow to the head can result in more severe symptoms which may last longer. SIS can be very serious and result in seizures, long-term memory loss, and lifetime disabilities. Symptoms progress rather rapidly and include the appearance of dilated pupils, loss of eye movement, unconsciousness and, in some cases, fatality.
Stroke
Stroke is the number one cause of brain injury in our services. In 2021, almost 50% of the people referred to us acquired their injury as the result of a stroke.
A stroke occurs when the blood supply to the brain is interrupted, preventing oxygen flow to the brain. There are two main types of stroke: a blocked artery (ischaemic stroke) is the most common form of stroke in Ireland. A stroke may also be caused by a blood vessel leaking or bursting (haemorrhagic stroke).
Brain Aneurysm
A brain aneurysm is a swelling in the wall of a weakened blood vessel in the brain. This may be caused by smoking, high blood pressure, drug abuse or family history, among other reasons. Aneurysms can grow over time, causing pressure on the surrounding brain tissue. In many cases people have no symptoms. However a ruptured aneurysm causes serious bleeding in the brain and is classified as a brain injury.
Brain Tumour
A brain tumour is an abnormal mass of tissue inside the skull, caused by cells divided at an increased speed. Malignant (or cancerous) tumours can invade and destroy healthy, surrounding brain tissue. Benign tumours grow more slowly but they can put pressure on the brain which may compress and damage healthy tissue. The impacts of a brain tumour depend on its size, location and how much it has spread.
Encephalitis
Encephalitis is an inflammation of the brain, most often caused by infection. While encephalitis can be caused by bacteria or viruses, the root cause often remains unknown. Many people make a good recovery from encephalitis, but it can damage nerve cells in the brain. This can lead to long-term effects such as fatigue, memory problems and changes to behaviour.
Meningitis
Meningitis is a bacterial, viral or fungal infection that can cause inflammation in the meninges – the protective membranes around the brain. While most people with meningitis make a full recovery, bacterial meningitis is more serious and, if left untreated, can result in damage to the brain. The inflammation may lead to hearing or vision loss, memory problems, seizures or problems with balance and coordination.
Hydrocephalus
The brain and spine are surrounded by cerebrospinal fluid (CSF), an essential fluid that cushions the brain, provides nutrients and removes waste. Hydrocephalus is caused by a build up of the fluid inside the skull, which can increase pressure and damage the brain. This usually happens because the flow of CSF is blocked or interrupted, for example as the result of a stroke, haemorrhage or brain tumuor.
Hypoxic/Anoxic Brain Injury
The brain needs a constant supply of oxygen to survive. If the oxygen supply is interrupted – for example as a result of suffocation, choking, cardiac arrest or near drowning – brain functioning is affected immediately. Damage to the brain begins to occur within minutes. This is known as hypoxic or anoxic brain injury.
What is rehabilitation?
“Rehabilitation is a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment.”
- World Health Organisation (WHO), 2017
Rehabilitation maximises people’s ability to live, work and learn to their best potential.
What is neuro-rehabilitation?
Neuro-rehabilitation treats and supports people impacted by a neurological injury or disease, including acquired brain injury.
Neuro-rehabilitation aims to increase a person’s ability and improve their quality of life. This happens by looking at how the person has been affected by the injury, and what symptoms may be preventing them from living more independently.
The neuro-rehabilitation process may include work with Psychologists, Occupational Therapists, Physiotherapists, Speech and Language Therapists, Social Workers, and other experts.
At Acquired Brain Injury Ireland, we take a community-based neuro-rehabilitation approach. This means providing a range of supports specific to the needs of each person with a brain injury within their own community, where they feel at home.
