Key facts about brain injury
What is a 'brain injury'?
Even after a minor head injury, brain function can be temporarily impaired. This is referred to as concussion. This can lead to difficulties including headaches, dizziness, fatigue, depression, irritability and memory problems. While most people are symptom-free within two weeks, some can experience problems for months or even years after a minor head injury.
The more severe the brain injury, the more pronounced the long-term effects are likely to be. Survivors of more severe brain injury are likely to have complex long-term problems affecting their personality, their relationships and their ability to lead an independent life. Even with good rehabilitation, support and help in the community, survivors and their families are likely to face uncertain and challenging futures.
The effects of brain injury
Cognitive effects of brain injury
The cognitive effects of a brain injury affect the way a person thinks, learns and remembers. Different mental abilities are located in different parts of the brain, so a brain injury can damage some, but not necessarily all, skills such as speed of thought, memory, understanding, concentration, solving problems and using language.
Problems with memory, particularly short-term and ‘working 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, while previously learned skills may still be intact. The damaged brain is now unable to organise and remember new material.
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 is needed on both sides. Remember – just because a person cannot express themselves, does not mean they do not need or want to be heard.
Impairments in visual-perceptual skills
The person may have difficulty making sense out of ordinary pictures and shapes, finding the way around a building, or drawing or constructing objects. Some people have difficulties recognising certain objects (agnosia), such as human faces (prosopagnosia or ‘face blindness’).
Impairments in visual perception may mean that a person cannot assess the speed of oncoming traffic accurately. It is important therefore to make sure that they are safe when crossing roads.
Reduced initiative 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 be affected by memory problems. Completing tasks can be a problem, and the task may be abandoned before reaching the end. A person may initially appear eager to start a task but then lose interest very quickly.
Reduced information processing ability
It may be difficult for the person to organise facts in their mind, particularly if there are also memory problems. ‘Information overload’ can be quickly reached, and can cause frustration and anger.
Repetition or ‘perseveration’
The person may be unable to move on to another topic in the same conversation, or they may return to the same topic over and over again. They may also repeat the same action, appearing unable to break the cycle.
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 insight and empathy
Impaired insight and empathy 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.
Insight, also referred to as self-awareness, is the ability of a person to observe and reflect on their own thoughts and actions. Brain injuries, especially injuries to the frontal lobes, often cause this ability to be significantly affected.
Families, friends and carers can find it problematic and upsetting because the brain injury survivor may behave inappropriately without being aware that there is anything wrong with their actions.