They may stick to a task too long, being unable to switch to different task when having difficulties. On the other hand, they may jump at the first solution they see without thinking it through. They may have speech and language problems, such as trouble finding the right word or understanding others.
After brain injury, a person may have trouble with all the complex cognitive activities necessary to be independent and competent in our complex world. The brain processes large amounts of complex information all the time that allows us to function independently in our daily lives.
This activity is called executive function because it means being the executive or being in charge of one's own life. This is especially true for injuries to the frontal lobe, which controls emotion and behavior.
Second, cognitive problems may lead to emotional changes or make them worse. For example, a person who cannot pay attention well enough to follow a conversation may become very frustrated and upset in those situations.
Third, it is understandable for people with TBI to have strong emotional reactions to the major life changes that are caused by the injury. For example, loss of job and income, changes in family roles, and needing supervision for the first time in one's adult life can cause frustration and depression.
These behaviors may include: Restlessness Acting more dependent on others Emotional or mood swings Lack of motivation Irritability Aggression Lethargy Acting inappropriately in different situations Lack of self-awareness. Injured individuals may be unaware that they have changed or have problems. This can be due to the brain damage itself or to a denial of what's really going on in order to avoid fully facing the seriousness of their condition.
Suggest a topic, leave a comment or share your thoughts. I am willing to participate in surveys. Keep up on Model Systems news! Sign up for our monthly newsletter! Breathing Heart Rate Swallowing Reflexes for seeing and hearing Controls sweating, blood pressure, digestion, temperature Affects level of alertness Ability to sleep Sense of balance. Coordination of voluntary movement Balance and equilibrium Some memory for reflex motor acts. How we know what we are doing within our environment How we initiate activity in response to our environment Judgments we make about what occurs in our daily activities Controls our emotional response Controls our expressive language Assigns meaning to the words we choose Involves word associations Memory for habits and motor activities Flexibility of thought, planning and organizing Understanding abstract concepts Reasoning and problem solving.
Visual attention Touch perception Goal directed voluntary movements Manipulation of objects Integration of different senses. Health Conditions Discover Plan Connect. Medically reviewed by Seunggu Han, M. This article will examine common types, causes, symptoms, and treatments for brain injury. What are the types of injury that cause brain damage? What are the causes? What are the symptoms? How is brain damage diagnosed?
What are the treatment options? Where to find help. What is the outlook for people with brain injury? Read this next. Brain Disorders. Concussion Recovery Medically reviewed by Sachin S. Kapur, MD, MS. Medically reviewed by Karen Gill, M.
Medically reviewed by Judith Marcin, M. Medically reviewed by Ann Marie Griff, O. In many cases, surgery is performed to remove a large hematoma or contusion that is significantly compressing the brain or raising the pressure within the skull. After surgery, these patients are under observation in the intensive care unit ICU. Other head-injured patients may not head to the operating room immediately, instead are taken from the emergency room to the ICU.
Since contusions or hematomas may enlarge over the first hours or days after head injury, immediate surgery is not recommended on these patients until several days after their injury. Delayed hematomas may be discovered when a patient's neurological exam worsens or when their ICP increases. On other occasions, a routine follow-up CT scanto determine whether a small lesion has changed in size indicates that the hematoma or contusion has enlarged significantly.
In these cases, the safest approach is to remove the lesion before it enlarges and causes neurological damage. During surgery, the hair over the affected part of the head is usually shaved.
After the scalp incision, the removed bone is extracted in a single piece or flap, then replaced after surgery unless contaminated. The dura mater is carefully cut to reveal the underlying brain. After any hematoma or contusion is removed, the neurosurgeon ensures the area is not bleeding. He or she then closes the dura, replaces the bone and closes the scalp. If the brain is very swollen, some neurosurgeons may decide not to replace the bone until the swelling decreases, which may take up to several weeks.
The neurosurgeon may elect to place an ICP monitor or other types of monitors if these were not already in place. The patient is returned to the ICU for observation and additional care. At present, medication administered to prevent nerve damage or promote nerve healing after TBI not available. The primary goal in the ICU is to prevent any secondary injury to the brain. The "primary insult" refers to the initial trauma to the brain, whereas the "secondary insult" is any subsequent development that may contribute to neurological injury.
For example, an injured brain is especially sensitive and vulnerable to decreases in blood pressure otherwise well tolerated. One way to avoid secondary insults is to attempt normal or slightly elevated blood pressure levels. Likewise, increases in ICP, decreases in blood oxygenation, increases in body temperature, increases in blood glucose and many other disturbances can potentially worsen neurological damage.
The major role of ICU management is the prevention of secondary insults in head-injured patients. Various monitoring devices may assist health care personnel in caring for the patient. Placement of an ICP monitor into the brain can help detect excessive swelling.
One commonly used type of ICP monitor is a ventriculostomy, a narrow, flexible, hollow catheter that is passed into the ventricles, or fluid spaces in the center of the brain, to monitor ICP and drain CSF if ICP increases.
Another commonly used type of intracranial pressure monitoring device involves placement of a small fiberoptic catheter directly into the brain tissue. Additional catheters may be added to measure brain temperature and brain tissue oxygenation. Placement of an oxygen sensor into the jugular vein can detect how much oxygen the brain is using. This may be related to the degree of brain damage. Many other monitoring techniques currently under investigation to determine whether they can help improve outcome after head injury or provide additional information about caring for TBI patients.
Patients with mild head injury usually defined as GCS score on admission of tend to do well. They may experience headaches, dizziness, irritability or similar symptoms, but these gradually improve in most cases. Patients with moderate head injuries fare less well. Approximately 60 percent will make a positive recovery and an estimated 25 percent left with a moderate degree of disability.
Death or a persistent vegetative state will be the outcome in about 7 to 10 percent of cases. The remainder of patients will have a severe degree of disability. The group comprised of severely head-injured patients has the worst outcomes. Only 25 to 33 percent of these patients have positive outcomes. Moderate disability and severe disability each occur in about a sixth of patients, with moderate disability being slightly more common.
About 33 percent of these patients do not survive. The remaining few percent remain persistently vegetative.
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