Frequently Asked Questions (FAQ's) about Acquired Brain Injury (ABI)

• What is Traumatic Brain Injury (TBI)?
• What causes TBI?
• What are the consequences of TBI?
• Why is TBI called "The Silent Epidemic"?
• What is an Acquired Brain Injury?
• Is it ABI only if there has been coma?
• What are the symptoms of an ABI?
• How long does a brain injury last?
• Is a mild brain injury unimportant?
• Does everyone who hits their head get a brain injury?

What is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) is also known as a head injury. It is an injury to the brain, most often caused by external force to the skull. Other causes of brain injuries (aneurysms, brain tumors, etc.) are not classified as "traumatic."

What causes TBI?

The most common causes of TBI are motor vehicle crashes and falls, but it can be anything that causes the head to abruptly strike a solid object and the brain to hit the interior wall of the skull. Other causes are: physical assaults (such as gunshot wounds and child abuse) and sports/recreational injuries.

What are the consequences of TBI?

TBI varies in severity from mild to severe. People who experience a mild injury very often appear fine, yet can have some lingering effects that affect their ability to handle their normal responsibilities at home, work, or school. They may exhibit difficulties with:

• concentration
• organization
• managing multiple tasks simultaneously
• memory
• relationships with family, business associates, friends
• personality changes

People whose injuries are considered to be moderate or severe exhibit varying degrees of difficulty in cognition (thinking), emotional, behavioral, physical, and social areas. They may suffer permanent disabilities that complicate the return to a pre-injury lifestyle.

Why is TBI called "The Silent Epidemic"?

TBI has been referred to as "The Silent Epidemic" because of the staggering number of people who are injured each year and the lack of public awareness about its consequences.

What is Acquired Brain Injury?

ABI is the impairment of normal brain function due to a neurological insult, such as

• open or closed head injury (traumatic brain injury)
• select cerebral vascular lesions (e.g., aneurysm, hemorrhage, brain stem stroke)
• hypoxic event (loss of oxygen, e.g, near drowning)
• intracranial tumor
• select neurological diseases (e.g., encephalopathy)

Usually, brain damage from congenital or genetic origins or birth trauma is not included within this standard definition. Neither are degenerative neurological diseases or disabilities stemming from mental illness. However, definitions vary from organization to organization.

Is it an ABI only if there has been coma?

No. ABI has many levels of intensity. It is possible for someone to acquire a brain injury without loss of consciousness or external bruising or tangible confirmation from diagnostic tools such as CAT scans, skull x-rays, or EEGs.

Individuals who have even a mild brain injury may continue to experience a wide variety of symptoms that can have life-changing implications. However, each injury is unique.

What are the symptoms of an ABI?

Symptoms and related deficits fall into four major groups: Cognitive, Perceptual, Physical, and Behavioral/Emotional.

Because of the uniqueness of each injury, survivors may or may not exhibit all symptoms. The number of symptoms doesn't fully describe the impact that the injury will have on the survivor. Much of that depends on where the injury is located. The following is by no means a comprehensive listing.

Cognitive Symptoms

• Difficulty in processing information (decreased speed, accuracy, and consistency)
• Shortened attention span
• Inability to understand abstract concepts
• Impaired decision making ability
• Inability to shift mental tasks or to follow multi-step directions
• Memory loss or impairment
• Language deficits (difficulty expressing thoughts and understanding others, inappropriate word selection)

Perceptual Symptoms

• Change in vision, hearing, or sense of touch
• Loss of sense of time and space and spatial disorientation
• Disorders of smell and taste
• Altered sense of balance
• Increased pain sensitivity

Physical Symptoms

• Persistent headache
• Extreme mental and/or physical fatigue
• Disorders of movement-gaiting, ataxia, spasticity, and tremors
• Seizure activity (traumatic epilepsy)
• Impaired small motor control
• Photosensitivity (sensitivity to light)
• Sleep disorders
• Paralysis
• Speech that is not clear due to poor control of the muscles in the lips, tongue, and jaw, and/or poor breathing patterns

Behavioral/Emotional Symptoms

• Irritability and impatience
• Reduced tolerance for stress
• Lack of initiative, apathy
• Dependence (failure to assume responsibility for one's actions)
• Denial of disability
• Lack of inhibition (may result in aggression, cursing, and inappropriate sexual behavior)
• Inflexibility
• Flattened or heightened emotional responses/reactions

How long does a brain injury last?

Each injury is unique. Much depends on getting the correct diagnosis and treatment, and ensuring that good support systems are in place for the entire family. Changes and improvement continue, although sometimes they are slight. Some deficits may remain for a lifetime while others may improve to the point that they are not a major factor in day-to-day living.

Is a mild brain injury unimportant?

No. A mild brain injury can have the same devastating effects that a moderate or severe injury can have. Only now are the impacts of mild brain injury being understood, identified, and treated. The key point is location.

Most survivors of mild brain injury don't lose consciousness and may be in the emergency room for only a short time before being sent home, without knowing they have sustained a brain injury. They and their family and friends may notice changes—sometimes very subtle, sometimes very obvious. Since they weren't diagnosed with a brain injury, and since they never lost consciousness, far too many will never receive the help they need.

Typically, mild brain injuries are received in car accidents where the brain is "sloshed" around in the skull by the collision.

Does everyone who hits their head get a brain injury?

In the mildest cases, the brain still gets bruised, much as your leg might get bruised if you bump into a coffee table. However, the head and the brain are resilient and can usually handle that kind of injury. Sometimes people get a tremendous blow to the head without any external effect. Again, much depends of the location of the injury and the brain's ability to compensate.