Brain damage is an injury that causes the destruction or deterioration of brain cells.
In the U.S., every year, about 1.4 million people have some type of brain injury. And approximately 5.3 million people suffer from the effects of brain damage. About 50,000 die as a result of brain injury. Medical costs and lost productivity are estimated at between $48 billion and $60 billion per year.
What are the types of brain damage and how severe are they?
All traumatic brain injuries are head injuries. But head injury is not necessarily brain injury. There are two types of brain injury: traumatic brain injury and acquired brain injury. Both disrupt the brain’s normal functioning.
Traumatic Brain Injury (TBI) is caused by an external force — such as a blow to the head — that causes the brain to move inside the skull or damages the skull. This in turn damages the brain.
An Acquired Brain Injury (ABI) occurs at the cellular level.
It is most often associated with pressure on the brain. This could come from a tumor. Or it could result from neurological illness, as in the case of a stroke.
Both traumatic brain injury and acquired brain injury occur after birth. And neither is degenerative. Sometimes, the two terms are used interchangeably.
There is a kind of brain damage that results from genetics or birth trauma. It’s called congenital brain damage. It is not included, though, within the standard definition of brain damage or traumatic brain injury.
Most brain injuries cause focal — or localized — brain damage, such as the damage caused when a bullet enters the brain. In other words, the damage is confined to a small area.
Closed head injuries frequently cause diffuse brain damage, which means damage to several areas of the brain. For example, both major speech and language areas might be involved.
The severity of brain damage can vary with the type of brain injury. A mild brain injury is temporary. It causes such symptoms as headaches, confusion, memory problems, and nausea.
In a moderate brain injury, symptoms can last longer and be more pronounced. In both cases, most patients make a good recovery.
With a serious brain injury, the person may suffer life-changing and debilitating problems. People who are in a coma or a minimally responsive state are examples of those who are likely to have permanent brain damage.
What causes brain damage?
When the brain is starved of oxygen for a prolonged period of time, brain damage may occur. Brain damage can occur as a result of a wide range of injuries, illnesses, or conditions.
Because of high-risk behaviors, males between the ages of 15 and 24 are most vulnerable. Young children and the elderly also have a higher risk.
Causes of traumatic brain injury include:
- car accidents
- blows to the head
- sports injuries
- falls or accidents
- physical violence
Causes of acquired brain injury include:
- poisoning or exposure to toxic substances
- strangulation, choking, or drowning
- heart attacks
- neurological illnesses
- abuse of illegal drugs
Symptoms of Brain Injury
Any brain function can be disrupted by brain trauma: excessive sleepiness, inattention, difficulty concentrating, impaired memory, faulty judgment, depression, irritability, emotional outbursts, disturbed sleep, diminished libido, difficulty switching between two tasks, and slowed thinking.
Sorting out bonafide brain damage from the effects of migraine headaches, pain elsewhere in the body, medications, depression, preoccupation with financial loss, job status, loss of status in the community, loss of status in the family, and any ongoing litigation can be a formibable task.
The extent and the severity of cognitive neurologic dysfunction can be measured with the aid of neuropsychological testing.
Neuropsychologists use their tests to localize dysfunction to specific areas of the brain. For example, the frontal lobes play an essential role in drive, mood, personality, judgment, interpersonal behavior, attention, foresight, and inhibition of inappropriate behavior.
The ability to plan properly and execute those plans is known as “executive function.” Frontal lobe injury is often associated with damage to the olfactory bulbs beneath the frontal lobes. Patients may note reduced or altered sense of smell.
One recent study (Varney 1993) showed that 92% of brain injured patient suffering anosmia (loss of smell) had ongoing problems with employment, even though their neuropsychological testing was relatively normal.
The effects of brain injury on the patient may be equaled or even surpassed by the effect on the patient’s family. Brain injuries are known for causing extreme stressors in family and interpersonal relationships.
In general, symptoms of traumatic brain injury should lessen over time as the brain heals but sometimes the symptoms worsen because of the patient’s inability to adapt to the brain injury.
For this and other reasons, it is not uncommon for psychological problems to arise and worsen after brain injury.
A wide variety of symptoms can occur after “brain injury.” The nature of the symptoms depends, in large part, on where the brain has been injured.
Below find a list of possible physical and cognitive symptoms which can arise from damage to specific areas of the brain:
Frontal Lobe: Forehead
- Loss of simple movement of various body parts (Paralysis).
- Inability to plan a sequence of complex movements needed to complete multi-stepped tasks, such as making coffee (Sequencing).
- Loss of spontaneity in interacting with others.
- Loss of flexibility in thinking.
- Persistence of a single thought (Perseveration).
- Inability to focus on task (Attending).
- Mood changes (Emotionally Labile).
- Changes in social behavior.
- Changes in personality.
- Difficulty with problem solving.
- Inability to express language (Broca’s Aphasia).
Parietal Lobe: near the back and top of the head
- Inability to attend to more than one object at a time.
- Inability to name an object (Anomia).
- Inability to locate the words for writing (Agraphia).
- Problems with reading (Alexia).
- Difficulty with drawing objects.
- Difficulty in distinguishing left from right.
- Difficulty with doing mathematics (Dyscalculia).
- Lack of awareness of certain body parts and/or surrounding space (Apraxia) that leads to difficulties in self-care.
- Inability to focus visual attention.
- Difficulties with eye and hand coordination.
Occipital Lobes: most posterior, at the back of the head
- Defects in vision (Visual Field Cuts).
- Difficulty with locating objects in environment.
- Difficulty with identifying colors (Color Agnosia).
- Production of hallucinations.
- Visual illusions – inaccurately seeing objects.
- Word blindness – inability to recognize words.
- Difficulty in recognizing drawn objects.
- Inability to recognize the movement of object (Movement Agnosia).
- Difficulties with reading and writing.
Temporal Lobes: side of head above ears
- Difficulty in recognizing faces (Prosopagnosia).
- Difficulty in understanding spoken words (Wernicke’s Aphasia).
- Disturbance with selective attention to what we see and hear.
- Difficulty with identification of, and verbalization about objects.
- Short term memory loss.
- Interference with long term memory.
- Increased and decreased interest in sexual behavior.
- Inability to catagorize objects (Categorization).
- Right lobe damage can cause persistent talking.
- Increased aggressive behavior.
Brain Stem: deep within the brain
- Decreased vital capacity in breathing, important for speech.
- Swallowing food and water (Dysphagia).
- Difficulty with organization/perception of the environment.
- Problems with balance and movement.
- Dizziness and nausea (Vertigo).
- Sleeping difficulties (Insomnia, sleep apnea).
Cerebellum: base of the skull
- Loss of ability to coordinate fine movements.
- Loss of ability to walk.
- Inability to reach out and grab objects.
- Dizziness (Vertigo).
- Slurred Speech (Scanning Speech).
- Inability to make rapid movements.
How are brain damage and brain injuries treated?
Anyone who has a head or brain injury needs immediate medical attention.
A brain injury that seems mild — referred to as a concussion — can be as dangerous as clearly severe injuries.
The key factor is the extent and location of the damage. Brain injury does not necessarily result in long-term disability or impairment. But the correct diagnosis and treatment is needed to contain or minimize the damage.
The extent and effect of brain damage is determined by a neurological exam, neuroimaging testing such as X-rays or CT scans, and neuropsychological assessment such as checking reflexes.
Doctors will stabilize the patient to prevent further injury, ensure blood and oxygen are flowing properly to the brain, and ensure that blood pressure is controlled.
About half of severely injured patients require surgery to repair a ruptured blood vessel or to relieve pressure on the brain.
If a patient is severely injured, rehabilitation may be ordered to assist in long-term recovery. That may include:
- physical therapy
- occupational therapy
- speech and language therapy
- psychological support
Can I prevent brain injuries?
Most injuries that cause brain damage are preventable. Here are some rules to follow to reduce the risk of brain damage:
- Never shake a child.
- Install window guards to keep young children from falling out of open windows.
- Install shock-absorbing material on playgrounds.
- Wear helmets during sports or cycling.
- Wear seatbelts in cars, and drive carefully.
- Avoid falls by using a stepstool when reaching for high items.
- Install handrails on stairways.
- Don’t keep guns; if you do, keep them unloaded and locked away.
- Don’t use illegal drugs.
- Drink alcohol only in moderation, and never drink and drive.