When an individual has been diagnosed with a traumatic brain injury, families and friends question the physician about the long-term effects on the individual. It\’s important to recognize that there is no \”typical\” person, nor results from rehabilitation of traumatic brain injury.
People who experienced a TBI vary and the severity of the initial injury, rate and completeness of the physiological ceiling, types of functions which are affected from the initial injury, the meaning of the dysfunction in the individual life in the context of their previous values and goals and the resources available to aid in recovery of function. The most important point to emphasize when addressing the long-term effects of a traumatic brain injury is that the consequences will be different for each individual and cannot always be predicted by the rehabilitation specialist or the physician.
The quickest recovery that will be seen by the families and friends is during the acute treatment of traumatic brain injury. This is because the patient will have significant deficits that will begin to resolve almost immediately as the brain swelling and edema begin to decrease. The immediate physiological recovery will give a baseline against which the rest of the rehabilitation can be gauged.
Any or all functions of the brain can be impacted by the trauma that was suffered. But, given that each individual will respond differently to the injury, any specific individual will experience one, a few or most of the possible effects. And, it is important to understand that not all functions of the individual will be affected. Feelings, abilities, talents, and knowledge may remain intact.
The two major areas of life that are affected when a traumatic injury is suffered are the cognitive and behavioral. While there can be other changes these are the most commonly affected and have the biggest affect long-term.
Those who suffer a moderate or severe traumatic brain injury will typically experience difficulties in some of the more basic skills such as attention, concentration, and remembering new material. These deficits will have a significant affect on their rehabilitation. This means that the individual may speak slowly, think slowly and be unable to learn new material without intensive repetition.
Unfortunately deficits in cognition will also result in individuals who become confused more quickly when their normal routines are changed or stimulation exceeds their threshold. Individuals may find that they jump to the first solution they need for a problem or that they persevere at problem solving too long, being unable to switch to a new task when asked.
Over time some of these cognitive issues can be compensated for. Some individuals may go on to learn abstract principles that are necessary to carry into new situations while others will not. Speech and language can be impaired which means that individuals may find it difficult to express the words they wish or understand the language of others.
One of the major classes of cognitive ability that can be affected by a traumatic brain injury are the executive functions. These are those complex processing bits of information that we need to use in order to be independent in a complex world. This means that after an injury an individual may be unable to function in their social roles because they are unable to plan ahead, keep track of time or coordinate events.
With appropriate training and community support families and patients can learn to put into place compensatory mechanisms to address these cognitive difficulties.
The second system that is often affected is the mood and behavior. The brain that controls our social and emotional lives has become damaged and the consequences can be difficult to integrate. Personality can be changed significantly. This means a person who was once an optimist may now be significantly depressed.
Another mood or behavior change of individuals who suffer from a traumatic brain injury is a lack of awareness of their surroundings. Some call this denial. A person is unable to compare their post-injury behaviors or abilities with free injury abilities. For some reason these individuals are unable to perceive the changes that have occurred to them because of the injury.
Aside from these two specific areas of the brain which are typically affected, individuals who have suffered a traumatic brain injury can also suffer from physical disabilities which include vision, seizure disorder, perceptual difficulties and varying degree of physical paralysis or specificity of the motor area of the brain is damaged.
Because of these specific variances in both injury and treatment it is extremely difficult for physicians to predict outcomes following rehabilitation. Each person uses their brains in very specific individualistic ways. The way in which neurons relate to each other get lost and impacted by the way in which a person have learned throughout their lives and the job which they held prior to the trauma. This variety is also impacted by any prior injury which had gone unreported or undiagnosed.
While physicians are fully to wear with many of the different long-term effects following a traumatic brain injury it is extremely difficult to make predictions which satisfy family and friends. Although researchers continue to seek statistical analyses which will make this process easier and give families a better understanding of the future, the reality is a significant difference in the future.
RESOURCES
BrainLine.org: What Impact will Moderate or Severe TBI Have on a Persons Life?
Center for Disease Control and Prevention: What are the Potential Effects of TBI?