Brain Damage

The term brain injury or brain damage refers to damage to the brain caused by illness or accident. The consequences of injuries are similar, regardless of their cause. They are complex, varied and not always visible. Brain damage is very common, but often poorly understood.

Brain injury or brain damage is often manifested by physical disabilities: affected people can no longer walk or speak properly, or they have hemiplegia. However, the consequences go much further: they also affect behavior, intellect and personality. However, a brain injury is neither a mental handicap nor a psychological handicap. What is it then?

Most common causes of brain damage

Numerous causes of brain injury are:

• stroke
• cerebral hemorrhage
• traumatic brain injury
• brain tumor
• lack of oxygen in the brain, for example following cardiac arrest,
• drowning or asphyxiation other illnesses, such as meningitis, encephalitis, borreliosis, hydrocephalus.
• Brain tumors
• Head trauma
• Stroke
• Dementias
• Frontotemporal dementia
• Lewy body dementia
• Neurodegenerative diseases
• Alzheimer’s disease
• Parkinson’s disease
• Creutzfeldt-Jakob disease
• Huntington’s chorea
• Amyotrophic lateral sclerosis
• Progressive supranuclear palsy

Different types of brain damage

During hospitalization, doctors may tell you about different brain injuries. Here are a few simply described brain damages:

Extra-dural hematoma
It is an accumulation of blood between the dura (outer meninges of the brain) and the bone of the skull following a fracture. Its direct and immediate consequence is lateral compression of the brain with the risk of death if the hematoma is large. In the vast majority of cases, however, these bruises are small and do not require surgery. If there is an operation, you will have to do a bone flap to remove the hematoma, then put the bone back.

Subdural hematoma
It is the accumulation of blood between the dura (the outer meninges of the brain) and the brain itself. Sometimes there may be an associated brain injury (hematoma, edema for example). The immediate and immediate consequence is lateral compression of the brain with a risk of death if the hematoma is large.

Hematoma and brain contusions
Head trauma can also result in the appearance of one or more bruises in the brain. Sometimes in this case too, an operation is necessary if the hematoma is large and the patient is in a coma, for example. It is done under general anesthesia and consists of emptying the hematoma through a cranial flap. If the hematoma is too large and the patient’s clinical condition too severe, an operation cannot be performed. When there are small bruises and edema in an area of ​​the brain, it is said to be bruised in the brain.

Diffuse brain damage
Sometimes there is no hematoma in the brain, but diffuse lesions. The neurons and the connections between the different brain areas are affected, which sometimes causes a very deep coma with a risk of very serious sequelae. These diffuse lesions are sometimes difficult to see on a CT scan and are better visible on MRI.

Acute cerebral swelling
After trauma (sometimes seemingly mild), an acute increase in brain size can occur within minutes. The patient’s clinical situation may gradually worsen. This acute reaction of brain swelling, often serious and often fatal, due to the acute intracranial hypertension it generates, that is, the brain swells and breaks down because the skull is inextensible. It is common in children and adolescents. It is often referred to as “diffuse cerebral edema”. These swellings can sometimes be treated with what is called a decompressive craniectomy, which involves removing a piece of bone from the skull to allow the swelling brain not to be damaged. This piece of bone is temporarily placed in a tissue bank at the hospital. Then, it will be put back in place afterwards, when the edema is gone.

Similar disabilities that vary from person to person

Brain injury is a disability that has many facets. Despite the similarities, the disorders vary greatly from person to person. Because of the brain damage, the brain does not function as before. There is partial or complete failure of functions depending on the area where the lesion is located.

Some people can only perceive half of their body, others can still speak, but no longer understand what is being said to them or can no longer organize and plan what to do.

What no one sees

No brain injury is the same, although the disabilities have similarities and often remain invisible. “My handicap is hardly visible,” says Meret H. “People often think that I am as good as the others.” The reality is different. Meret needs to write lots of reminders and needs to take breaks more often. “I work part-time, in a protected environment. You might think I have a cool little job, but it’s not at all”.

Brain exploits

Brain injury poses a real challenge to the brain. Our nervous system remains able to recover even as we age. Cells and nerve connections that are not dead can regenerate. Functions where the tissue has been destroyed are taken over by other areas of the brain. Intensive therapy can encourage him to make new connections – which takes time. Plus, new connections are never as good or as fast as the original connections.

This process is demanding, tiring and tedious for people with brain injuries. They are reaching their limits faster than ever before. However, they sometimes manage to fully recover their capacities – this is especially the case when the lesions are relatively mild and people are still young.

Effects / Consequences of brain injury

Often a brain injury turns life dramatically. This observation is true, both for those directly affected and for those close to them. Nothing is like it used to be. The brain is no longer working as it used to. Some consequences are visible, but the injury also causes many invisible disabilities.

Physical disabilities

Paralysis
Total (plegia) or incomplete (flaccid or spastic paresis) paralysis of certain parts of the body
Hemiparesis or hemiplegia: incomplete or total paralysis on one side of the body.
Paralysis of the face, corner of the lips lowered (facial palsy)
Swallowing disorders (dysphagia)
Locked-in syndrome
Mobility disorders
Slow movements
Loss of skill
Decreased strength
Tremor of the limbs
Balance disturbances, staggering walking
Language disorders (aphasias)
Difficulty finding words
Confusion of terms, invention of words, inversely of syllables (Wernicke’s aphasia)
Slow, labored speech, articulation difficulties (Broca’s aphasia)
Sensory disturbances, perception disturbances
Disruption of hearing and sight
Loss of taste or smell
Problems affecting self-perception and body orientation
Perception of only one side of the body and of space (one-sided spatial neglect)
Sensitivity to noise and light
Headache
Epilepsy, convulsions
Sleeping troubles

Deficits affecting the cognitive sphere…

Attention, concentration
The person has difficulty concentrating, cannot do two things at the same time, gets distracted quickly and needs more time for a lot of things.

Resistance

The person gets tired quickly, they need many breaks and more sleep than before.

Orientation and memory

The person does not know what time it is or where they are.
She forgets passwords and phone numbers.
She has memory problems, forgets names and dates, loses or misplaces her things.

Organization and execution

The person makes decisions without thinking about their consequences.
She can’t tell the difference between what’s important and what isn’t; she dwells on details and has difficulty completing tasks through and through.
She struggles to start or finish an activity. She has to do it over and over and needs a lot more time.

Thinking ability

The person has difficulty making inferences and analogies, and weighing various solutions.
She doesn’t understand methaphora or irony.

Data processing

The person works and reacts more slowly.
She has difficulty learning, adapting to a new situation.
She has difficulty understanding the opinions of others.

Communication

The person has difficulty understanding the words, context, metaphors, tone, emphasis of what is being said, and non-verbal communication.
She cannot follow a discussion.
She has difficulty formulating her thoughts.
While writing, she reverses or forgets letters and words.

Social and emotional disabilities…

Awareness of disease
The person overestimates himself and does not perceive his limits.
The person does not realize that they have changed because of the brain injury.

Impulse control

The person behaves inappropriately, he does not know how to keep his distance, he is uninhibited, irritable and aggressive; his mood is changeable.
She has a hard time following the rules.

Emotions

The person has feelings of inferiority, he feels frustrated and sad that he has lost some of his faculties.
The person is bored, agitated or uncomfortable.
Her emotions are dull – she no longer feels the emotions as before.

Solitude

The person feels different and has the impression that they are not understood.
The person loses contact with his friends.

Sources: PinterPandai, WebMD, HealthLine, Mayo Clinic

Photo credit: Max Pixel (CC0 Public Domain)