Brain injury effects
The many effects of a brain injury
A brain injury is potentially one
the most devastating disabilities as it can impact on virtually
every aspect of what we think, feel, say and do in everyday
The range and severity of problems vary for each person, but the
purpose of this fact sheet is to show how difficult the recovery
period is after a brain injury - many say it is the greatest
challenge they have ever faced in their lives.
This is by no means a comprehensive list but covers some of the
more common problems of brain disorders such as traumatic
brain injury (TBI), brain tumours, Alzheimer's disease,
meningitis, encephalitis and epilepsy.
Myths & misconceptions
A brain injury is often called the invisible disability. Often
there are no outward physical signs of a disability so it is easy
to accuse a person of being lazy, self-centred, rude, dumb or moody
when they are dealing with very real issues caused directly by a
traumatic brain injury and other brain disorders.
This fact sheet should help family members, partners and friends
understand how a brain injury can impact on a person's life, and be
able to provide more effective support as a result.
Cognitive changes after a brain injury
Cognition is simply the brain working to perceive, think, learn,
understand and remember. Problems with our cognition will often
only become apparent with time.
Short-term memory problems are very common
after a brain injury, and a range of strategies are needed to help
with remembering names, appointments and all aspects of daily
Poor concentration and attention are very
common outcomes, causing people to be distracted easily or jump
from one task to the next. Family members often misunderstand these
problems and think the person is being lazy or deliberately rude by
not listening to them.
Slowed responses occur because it takes longer
for a person to process information then answer. People who do not
understand brain injuries may think the person is not intelligent,
but they simply need time to form a response. Stress can arise when
there is too much information to process at once, so a person may
struggle in group conversations or when returning to the
Sensory overload and fatigue are similar
problems, where if the brain receives too much information at once
then this can become very stressful. Noisy, crowded or complicated
environments such as a supermarket can be very difficult to cope
with. Fatigue is an almost universal symptom after a brain injury -
people need to ensure they don't push themselves too hard or it can
lead to several days of extreme tiredness.
Poor planning and problem-solving is
common with many brain injuries. People may encounter trouble with
open-ended decision-making and complex tasks need to be broken down
into a step-by-step fashion.
Lack of insight can create many
problems as a person loses their ability to realize when their
thoughts, speech and behaviour are inappropriate. They may even
refuse to believe that the brain injury has affected them at all.
Providing frequent, clear and simple feedback is needed, and often
positive behaviour support plans are needed for challenging
Lack of initiative is when a person with a
brain injury has trouble taking the first steps to begin a task -
it is often seen as laziness by those who don't understand the
effects of a brain injury. Complex tasks need to be broken into
small steps, and regular prompting may be needed.
Inflexibility and self-centred
behaviour can occur after a brain injury. Our ability
to see others' points of view, adapt to new situations, listen to
others, and see 'shades of gray' can be lost after a brain
injury. These problems only worsen if others assume it
is deliberate behaviour and react, instead of responding
appropriately to these issues caused by the brain
Impulsive behaviour and irritability can
arise after a frontal lobe injury - a person loses the filtering
system that makes them stop and think before doing or saying
something inappropriate. This can lead to a wide range of problems
with relationships, behaviour in public, finances and drug use. It
usually goes hand in hand with a low tolerance for frustration.
Emotional changes are common after a brain
injury. There can be rapid mood changes, stronger than normal
emotional reactions, or inappropriate emotions such as laughing at
a sad situation. Depression is very common and understandable when
a brain injury influences so many aspects of life for the worse. A
brain injury tends to make a person susceptible to other mental
disorders as well.
This is not an exhaustive list and only covers common cognitive
issues - there are hundreds of lesser known problems such
as not being able to remember how to get home, the
inability to recognize faces, and recognizing an object but not
being able to name it.
Physical changes after a brain injury
Loss of taste and smell can occur after a
traumatic brain injury if the olfactory nerve is damaged by bony
protusions within the skull.
Dizziness and balance problems can emerge after
damage to the brain stem or injury to the inner ear.
Seizures and epilepsy are chronic medical
conditions produced by temporary changes in the electrical function
of the brain which are fairly common outcomes after a brain injury.
Medication is usually quite effective, and seizures often diminish
Headaches are extremely common after a brain
injury, especially the tension headache usually caused by
microscopic damage to nerves within the brain. Any headaches should
be reported to your doctor in case in case it is a symptom of a
serious medical issue.
Visual problems include double vision,
field cuts, sector losses, rapid eye movement and near-sightedness
depending on which parts of the brain have been affected. There are
many compensatory strategies available to manage vision
Paralysis can occur in differing degrees
depending on which part of the brain has been injured.
Effects can include poor coordination, difficulty walking, visual
difficulties or weakness on one side of the body.
Hearing problems arise after either mechanical
or neurological injury. Tinnitus, hyeracusis (sensitivity to
sound), Meniere's syndrome and auditory agnosia are some of the
more common issues after a brain injury.
Coordination and proprioception issues
affect our movement and balance. Proprioception involves our
perception of where our body parts are, even if we can't see them.
In effect, the brain can lose its ability to know where your limbs
Sexual changes after a brain injury can include
a loss or increase in sexual drive, inability to orgasm, pain and
discomfort during sex, and sexually inappropriate
Sleep disorders are very common after a brain
injury. Although some may have problems with getting too much
sleep, the usual sleep disorder is trouble sleeping at night,
particularly problems with timing of sleep, then feeling drowsy
during the day.
There are many other less common physical problems after a brain
injury, such as an inability to regulate body temperature, abnormal
bone growth in selected joints and chronic neuroendocrine
The need for understanding
It is very important for family members, partners, friends and
employers to fully understand TBI and other brain disorders so that
instead of simply reacting and being part of the problem, they can
respond appropriately and be part of the solution.