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A brain injury is an injury to the brain. It can be caused in many ways, including:

• physical trauma – such as in many accidents if the head is hit
  
• strokes and other events which cut oxygen to the brain
  
• brain tumours
  
• certain infections (such as meningitis and encephalitis)
  
• chemicals which can produce toxic brain injury by physical or physiological harm to the brain

These are all called Acquired Brain Injuries (ABI), being “acquired” since birth. The most frequent type of Acquired Brain Injury is the first one listed above – from physical trauma to the head which is also called “Traumatic Brain Injury” (TBI).

What are the consequences? – Extremely varied, because

• people are different in personal mental characteristics
• every brain injury is unique in microscopic physical detail and in physiological impact
• brain injuries vary in severity and by type

All brain injuries can be extremely serious but symptoms are not uniform since brain injuries are varied and complex. People who have survived a Traumatic Brain Injury, TBI, commonly have symptoms such as –

• Cognition: Slowed processing and coordination of thoughts
• Concentration: Impaired ability to concentrate
• Reasoning: Difficulty in logical thinking
• Attention: Easy and agitated distractibility
• “Blinkered” mindset: Getting stuck in passing concerns single-mindedly
• Memory: Poor or jumbled recall
• Communicating: Difficulty with word-finding and expression
• Fatigue: Easily tired (but often unaware of being so),then sharply dropping mental performance
• Sleep: Long-term difficulty in getting restful sleep
• Headaches: Chronic and sometimes acutely painful
• Sensory: Confusing or painful effects from “ordinary” “overload” but overwhelming sensory stimuli, e.g. sound
• Anxiety:Becoming excessively anxious, whether for real or imagined causes
• Emotions: Emotional “roller coasting” with mood swings and/or unreactive emotional numbness
• Social difficulties: Behaving or talking in an awkward, embarrassing or socially     inappropriate way
• Depression: Stagnating unhappiness with low energy and low self-esteem

This list is only a selection of the common difficulties of people who have had Traumatic Brain Injuries (usually from accidents, making three-quarters of all brain injuries) and does not include varied difficulties of bodily movement and coordination, which are also common among accident and stroke survivors. People who survive the injuries might also have partial or complete paralysis, stiff or weak limbs, speech difficulties. There is a neuro cliché, proven true: “every brain injury is unique.”

Do people get better?

The brain is by far the most complex human organ. Brain injuries are not completely understood by medical and rehabilitation specialists.

People can make varied levels of progress back towards their pre-injury selves. The brain’s functioning can partly improve after injury, and people can also rehabilitate in ways to cope with their conditions.Tragically, many people with brain injuries can be undiagnosed, and many more do not obtain access to suitable neurological, psychological or rehabilitation services. Individuals can also have good days and bad, which lead to confusion about their continuing underlying conditions.

There is no “cure” concept for brain injury. People live with the consequences of brain injury all their lives.

The brain can partly heal; medical treatment can be a catalyst; rehabilitation can include neuropsychological training to restore or reorganise or compensate for varied mental tasks. All such “interventions” are complicated and there are no quick “fixes” which are analogous to having a “cure”, as for some physical illnesses and injuries.

FOR EVERYBODY WITH BRAIN INJURY, THE BIGGEST CHALLENGE CAN BE GETTING ACCESS TO REAL AND EFFECTIVE REHABILITATION.

Because –

• current medical and rehabilitation knowledge is incomplete
• current neurological and rehabilitation services are in extremely short supply, usually reserved for only the most manifestly serious cases
• there is little general public understanding of brain injury
• brain injuries are not necessarily externally visible but evident by aspects of mental performance, behaviour and how people feel

… so, consequently –

• people with brain injuries frequently feel underserved and misunderstood, and their conditions can be unrecognised
• their access to information and to specialist medical and rehab services is often extremely limited
• their families, friends and work colleagues are also often uninformed, under-supported themselves and/or under-supportive of people who have brain injuries

10,000 new Traumatic Brain Injuries occur in Ireland each year – they happen to people of all ages, backgrounds and personal circumstances.