Brain injury effects
Some of the main difficulties that can affect people after Brain Injury - Fact Sheet
All Brain Injuries are different and people
may be affected to a varying degree by any number of these problems
depending on the severity of their injury and the area of the brain
which is affected.
We have grouped the main effects of Brain Injury into three
- Physical - affecting how the body works
- Cognitive - affecting how the person thinks, learns and
- Emotional and behavioural - affecting how the person feels
Excessive tiredness is common to all severities of Brain
Injury, including mild injuries. Tasks that we take for
granted, such as getting dressed or walking around can require
much more effort after Brain Injury. It is important to
allow for rest periods at regular intervals during
the day, and not to feel that everything has to be done
Movement can become very slow and balance can be affected.
Indeed, having a Brain Injury can sometimes feel like 'living
life in the slow lane'. Some people may need a
wheelchair or other mobility aids, because their
poor balance and co-ordination means they cannot walk
without support. The fact that they use a wheelchair does not
necessarily mean that the person cannot stand or walk for
Sensation of touch on the skin may be reduced, lost or
exaggerated. It may also be difficult for the person to know
where their limbs are positioned without looking at
them. Eyesight may be affected and this may not be
correctable with glasses. Odd postures or walking patterns may
also be explained by sensory impairments. Taste or sense of
smell may be impaired or lost, either in the short
or long term.
Difficulties with speech
Slow, indistinct or rapid speech is common after a Brain
Injury. It may be hard to understand the person's speech at
first, but the listener may learn to 'tune in'. Some people
may repeat what they have said many times over: this is known
as perseveration. Some people may lose the ability to
speak altogether. Remember, their inability to express
themselves does not mean that they have lost their
Brain injury can make a person prone to epileptic seizures or
'fits'. Many people who have had a seizure after a Brain
Injury are given a drug for a number of years to reduce
the chance of it recurring. The drug may have an overall
'dampening' effect on the person's level of arousal, and
therefore on the performance of everyday tasks. Remember the
added effect that this could have if the person already
has excessive fatigue. It is important to remember that a
person who suffers from seizures may
not be allowed to drive and should contact the relevant
authorities for advice.
Limbs may be stiff or weak, and the range of movement
limited. Often one side of the body is affected more than the
other, depending on the area of brain that is damaged. This is
known as hemiplegia. Spasticity may cause pain
or discomfort. If this occurs it is advisable to
seek help from a GP, who may be able to prescribe drugs
to reduce muscle spasms. Weakness or paralysis often affects
one side of the body more than the other. This could mean
that help is needed during personal care and when getting
dressed or undressed. Muscle weakness may affect continence,
and continence aids may be needed.
This is irregular, uncontrolled movement or tremor affecting
the co-ordination of movements. The person's hands may be
shaky or clumsy, and handwriting may be difficult
Brain injury may cause damage to the hypothalamus and/or
pituitary gland, which are small structures at the base of the
brain responsible for regulating the body's
hormones. Damage to these areas can lead to
insufficient or increased release of one or more
hormones, which causes disruption of the body's
ability to maintain a stable internal
environment (homeostasis). If damage to the pituitary
gland leads to a reduction in hormone production
the resulting condition is known as
hypopituitarism. Another hormonal condition which can
be caused by Brain Injury is neurogenic
diabetes insipidus, which is usually a short-term problem
in the acute stage after injury but can occasionally persist
in the long-term.
Problems with memory, particularly shortterm memory, are
common after Brain Injury. Some people may be unable to
remember faces or names, or what they have read or
what has been said to them. New learning may be affected,
whilst previously learned skills may still be intact.
Reduced initiation and problems with motivation. Problems
with getting started on tasks are common, and can often be
mistaken for laziness. These problems may also be
a symptom of depression.
Reduced concentration span
This is very common and can also impact on memory problems.
Completing tasks can be a problem and the task may be
abandoned before reaching the end. The person may
initially appear eager to start a task, but then
lose interest very quickly.
Slower information processing
People can take longer to think things through or work out
what has been said to them. 'Information overload' can be
quickly reached, and can cause frustration and anger.
It may be difficult for the person to work out what to do if
they encounter an unexpected problem.
Repetition or 'perseveration'
The person may be unable to move on to another topic in the
same conversation, and they may return to the same topic over
and over again. They may also repeat the same
action, appearing unable to break the cycle.
Reasoning, judgement &
Impaired reasoning may affect a person's ability to think
logically, to understand rules, or follow discussions. The
person may easily become argumentative due to lack
of understanding. Impaired judgement can cause
difficulties in accurately perceiving and interpreting
one's own and other people's behaviour and
feelings. Putting oneself 'in someone else's shoes' can
be almost impossible. Lack of insight means the person may
have an unrealistic view of themselves and others, and
may not appreciate that they have certain problems. This may lead
to unattainable goals being set, which then leads to failure
Language loss (aphasia)
This may be 'receptive' (difficulty making sense of what is
said or read) or 'expressive' (difficulty finding the right
words to say or write), or both. This can be very
frustrating for the person and for others, and patience
needed on both sides. Remember - just because a person
cannot express themselves, does not mean they do not need
or want to be heard.
The person may have difficulty making sense out of ordinary
pictures and shapes, finding the way around a building, or
drawing or constructing objects. These problems can be
particularly frustrating for a person who is quite competent
in their language and social skills. Occasionally, people may
fail to respond to stimuli coming from one side of their
visual field, or may ignore a particular side of
their body, for example when shaving or dressing. This
condition is known as visual neglect.
Emotional & Behavioural
Loss of confidence
This is very common after Brain Injury and a person can need
a lot of encouragement and reassurance.
Mood swings or 'emotional
The person may have a tendency to laugh or cry very easily,
and to move from one emotional state to another quite
suddenly. Depression and sense of loss are common. Depression
may be caused by injury to the areas of the brain that control
emotion, but can also be associated with the person gaining an
insight into the other effects of their injury. After
Brain Injury, many things that are precious to
the individual may be lost forever and there may be much
sadness, anger, guilt and confusion, surrounding this.
Anxiety & frustration
Anxiety can be another consequence of Brain Injury. Life has
been changed forever in a matter of seconds, and the future
can look frightening. Anxiety can quickly lead to frustration
and anger and needs to be identified and alleviated as
early as possible. Frustration can build up quickly,
especially when things that were once so easy are
now difficult or impossible. The resulting anger may be
very difficult for the person to control. Abusive or obscene
language may be used. This may be spontaneous and
uncontrollable, and may be an outlet for the person's anger
and frustration. This behaviour can obviously be embarrassing
and upsetting for those nearby.
There may be a loss of control over social behaviour, so that
the person may behave in an over-familiar manner or may make
sexual advances with the wrong people at the wrong time.
They may also be unable to inhibit what they are thinking and
may make inappropriate and offensive outbursts.
A person with a Brain Injury may tend to speak or act without
thinking things through properly first. Obsessive
behaviour can occur. For example, a person may be afraid that
their possessions will be stolen, and may check their
References and further information
This article is reproduced from www.headway.org.uk with the
permission of Headway - the Brain Injury association.
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