Types of brain disorders
Traumatic Brain Injury (TBI)
Traumatic Brain Injury is the most
frequent cause of death and disability worldwide. It can be the
result of a motor vehicle accident, fall, assault or sporting
Traumatic Brain Injury or TBI is an injury to the brain caused
by a blow to the head or other external force, which causes rapid
movement of the brain inside the skull. As a result the
brain may be torn, stretched, penetrated, bruised or become
Possible effects of TBI
The effects of a Traumatic Brain Injury and the degree
of recovery that can be expected will depend on the location and
severity of the injury, as well as how successful the
rehabilitation process is. Common cognitive effects can
- Memory problems
- Fatigue and slowed responses
- Poor concentration and attention
- Irritability, anger and susceptibility to stress
- Inappropriate behaviour and poor social skills
- Self-centredness, dependency and lack of insight
- Poor problem-solving, initiative and motivation
- Depression and lack of emotional control
Common physical effects can include:
- Loss of taste and smell
- Dizziness and balance problems
- Epilepsy and seizures
- Headaches and chronic pain
- Visual problems
- Paralysis or movement disorders.
Assessing the severity of a TBI
The severity can range from a mild brain injury (often called
concussion) to severe or catastrophic brain injury. Two reliable
indicators of severity include how long the person is in a coma and
the length of time in post-traumatic amnesia.
Another widely used indicator is the Glasgow Coma Scale (GCS).
This scale measures a person's level of consciousness on a scale of
3-15, with 3 being the lowest level of consciousness. Scoring is
based on verbal, motor and eye-opening reactions to stimuli.
Generally, a score of 13 or above on the GCS is considered a mild
brain injury or concussion, 9-12 as moderate and 8 or below
Diagnosis & treatment of TBI
Initial diagnosis and treatment usually occurs in the Accident
& Emergency ward of a hospital. This stage generally focuses on
assessing and stabilizing the person's condition. Once the person
is assessed as not being in immediate medical danger a complete
neurological evaluation is performed to rule out conditions
requiring neurosurgery, such as hematomas, certain skull fractures,
and high intra-cranial pressure.
Different imaging tests may be used in diagnosis including:
- Computed tomography (CT) scans which provide a three
dimensional view of the brain o detect abnormalities
- Magnetic resonance imaging (MRI) which uses electromagnetic
radio waves to produce either 3-D or 2-D images of the brain
- X-radiation (composed of X-rays) is a form of radiation used as
a diagnostic tool that reveals damage to structures of the
- Inter-cranial pressure (ICP) monitor implanted inside the skull
to monitor changes in intracranial pressure.
Recovery from a TBI
It is difficult to predict accurately how far a person will
recover after a brain injury. Some people may find that life
eventually returns to normal with only a few lingering problems,
while others suffering a severe brain injury will face many
The brain does have a limited ability to heal itself with
usually the biggest improvements seen in the first year.
Rehabilitation seeks to make the most of this period when the brain
is recovering, and the effort put into rehabilitation has a very
large bearing on the degree of recovery. Some of the best
recoveries are from determined people with a positive attitude who
continue to apply rehabilitation techniques long after the formal
process has finished.
Closed & open head injuries
A TBI can be described as being a closed or open brain
injury. An open head injury results from the head hitting an
object, or an object piercing the skull and brain tissue (open or
penetrating head injury).
A closed head injury occurs without the skull being broken
or penetrated, so the brain has not been exposed. An example of a
closed head injury is when the rapid movement of the head backward
and forward (acceleration-deceleration movement) causes the brain
to move inside the skull and slam against its hard inner bone.
Focal & diffuse brain injury
A Traumatic Brain Injury can be focal or diffuse, meaning damage
may be isolated to one specific area of the brain, or widespread in
the case of diffuse injuries. Both types of injury can occur
Focal damage involves damage to specific areas of brain tissue.
Types of focal injuries include contusions (bruised brain tissue),
which often occurs under the sight of impact, lacerations (torn
brain tissue), and or hematoma (a collection of blood inside or
around the brain), which can be the result of hemorrhaging and can
lead to increased pressure on the brain.
Diffuse damage involves damage to axons, the brain's microscopic
communication pathways, which extend from brain cells. Damage
occurs when the axons are stretched or severed.
A TBI often results in secondary injuries, which arise due to
the brain's reaction to the first injury. These include brain
swelling and hemorrhaging. Swelling puts pressure on brain tissue,
which can restrict oxygen supply to other parts of the brain
leading to cell death. Treatment is focused on controlling the
secondary effects of a brain injury to prevent further damage.
References and further information