Traumatic head injury, or brain injury, is the main cause of disability in people under forty. Although survival rates have greatly improved in recent years, due to the advent of new brain imaging techniques, such as MRI and PET scanning and advances in acute care, it’s important to start head injury rehabilitation as early as possible to maximise long-term positive outcomes.
Recent developments in cognitive neuroscience have greatly helped doctors understand head injuries and brain damage. This has led to increasing survival rates and the need for a complex network of long-term head injury rehabilitation services. People with severe head injuries have a very wide variety of needs depending on the extent of their injuries and the exact nature of the damage in the brain. The nature of their disability can result in a unique interplay of problems involving physical, cognitive, and behaviour difficulties, requiring a combination of professionals to help them rehabilitate.
This article on head injury / brain injury rehabilitation is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
Physical problems after head injury
The right hemisphere of the brain is responsible for movement in the left side of the body, and the left hemisphere is responsible for movement along the right side, so any brain damage that’s more severe on one side is likely to result in more pronounced problems to do with movement on a particular side of the body. Problems resulting from brain injury can also include difficulties with vision, touch, taste, and the movement of facial muscles.
Cognitive problems after head injury
A head injury can cause people to have difficulties with their memory, concentration, speaking, processing and calculating etc. Short term memory is usually more affected than long term memory, meaning that people often have clear memories of the past but a poor recollection of events that have happened afterwards.
Behavioural problems after head injury
Friends and family can be surprised by the apparent changes in the person’s behaviour or personality after brain injury. Patients may seem to have a lack of self-control and may become uninhibited so that things they may previously never have said or done are now spoken and acted out. This can be very distressing for family members if their loved one experiences sudden mood swings, acts impulsively, or appears sexually uninhibited. Other patients have great difficulty in expressing emotions and can appear cold and unresponsive.
Many of these problems spontaneously resolve themselves over time, however if the head injury has been severe and brain damage extensive, the individual may need help for many years with learning how to cope and overcome the effects.
The process of continued learning, improvement, and support, starting from immediately after the recovery of consciousness, and sometimes continuing until several years after, is called the process of rehabilitation.
Building and expanding upon a person’s natural recovery process, head or brain injury rehabilitation often involves a wide variety of medical professionals, from nurses, doctors, and physiotherapists, to occupational and speech language therapists, social workers, and clinical psychologists. A vital part of the recovery process, research shows that patients get better long-term results if rehabilitation starts as early as possible.
The overall aim of rehabilitation after serious head injury is to enable individuals to move from a state of high dependence in hospital, to being able to function independently and successfully at home and in society.
While still in hospital, and immediately after the head injury, rehabilitation begins by helping the patient regain basic skills, such as washing, dressing, speech, and communication. Once they’ve been made medically stable the emphasis of rehabilitation changes, and family and friends play a more important part in helping them regain a level of normality and independence. Although progress is most notable and visible in the first six months, changes and improvements can continue for years – some research suggests that up to ten years after patients are still rehabilitating. Maintaining informal rehabilitation at home is very important, with research showing that people whose families actively engage in helping them with rehabilitation have better recovery rates.