Each year almost 1.5million people attend hospital with a brain injury and, at this moment, 1 million people are living with the effects of a long term brain injury.
Brain injury impacts people and their lives in many different ways. Symptoms can include headaches and nausea. Some suffer with vertigo or dizziness. It is common to have cognitive symptoms such as impaired memory, impaired concentration and problems with processing information (taking on new information). Excessive tiredness is very common. People can find that everyday tasks, such as dressing, washing etc take much more effort than before the accident. They find themselves becoming exhausted quickly and may sleep at night for many more hours than they did before the accident. On the other hand, many may also suffer with insomnia.
Mobility may also be impaired. Brain injury survivors may present with paralysis, spasticity and/or weakness, often affecting one side of the body more than the other.
Eyesight may be adversely affected. Slurred speech is another symptom People may demonstrate ‘ataxia’ – the symptoms of which include uncontrollable tremors, and poor balance and co-ordination.
People with a brain injury can experience ‘pre-traumatic amnesia’ and/or ‘post-traumatic amnesia,’ that is loss of memory of events leading up to and following the accident that caused the injury.
A brain injury can lead to epilepsy or an increased risk of epilepsy.
It is not uncommon for brain injured people to have difficulty controlling their emotions, in particular their temper. People may find that they are less ‘socially disinhibited’, in other words they may make inappropriate or offensive comments in social situations, without realising the effect that their comments are having. This can often place relationships and marriages under pressure, as the partner of the brain injured person finds it difficult to cope with the personality change that they see in their loved one.
One relatively little known symptom is what is called ‘pseudobulbar affect’ (PBA), which causes episodes of uncontrollable crying or laughing in those with brain injury and other neurological conditions. People can find themselves crying even when they do not feel upset or laughing when they do not feel particularly happy.
Another less common outcome of traumatic brain injury (observed in only a small percentage of brain injury survivors) is psychosis. Although it appears that this is not yet fully understood, studies have shown a higher incidence of psychosis and schizophrenia in those that had had a brain injury.
A more common side effect of brain injury is anxiety and depression.
Although their injury may have continue to have devastating impact on their day-to- day lives, people often understandably feel that their injury is effectively invisible to others, particularly if their mobility is unaffected and there are no external visible signs. This can include confrontations in public caused by people taking offence at a person’s disinhibited comments, or people getting in trouble with police due to their difficulties with controlling their behaviour. A study carried out earlier this year showed that approximately 60% of the prison population in the UK have suffered some form of brain injury in the past.
Headway initiative – Identity card
The brain injury charity Headway provides people with a ‘Brain Injury Identity Card’, which they can use to show others that they have a long term injury and help them find greater confidence in dealing with everyday situations.
The importance of early treatment
The range of symptoms is vast and so, early treatment is vital. The earlier the rehabilitative care and treatment can be introduced – the greater the chance of recovery
One of my main priorities when acting for brain injured clients (and any other client) is to secure for them rehabilitation at the earliest possible stage. This may include treatment by a neuropsychologist, physiotherapist (for the physical effect of the brain injury or other injuries) and occupational therapist. The occupational therapist can help to teach coping mechanisms and recommend equipment that may assist. It is important that the therapists and doctors work together in a ‘joined-up’, multi-disciplinary fashion and in a serious injury case, we will usually appoint a case manager to co-ordinate and oversee the treatment.
