Long Term Problems
Traumatic brain injury damage is usually the greatest directly following the injury. Long-term problems are often difficult to assess because temporary bruising of the brain, known as a contusion, may cause some damage. Focal damage may result in long-term and permanent difficulties. Other areas of the brain can learn to take over the functions damaged by the TBI over time and can improve the condition. When a traumatic brain injury occurs in a child their progression is often better than an adult because their brain has a greater capability to be flexible.
Function of the Brain Stem
The brain stem regulates basic arousal and regulatory functions, as well as being involved in attention and short-term memory. When a traumatic brain injury damages this area, disorientation, frustration and anger can result. In moderate to severe injuries swelling can cause pressure on the brainstem. Consciousness or wakefulness can be affected so a person may fall into a coma.
Higher up than the brain stem is the limbic system, which helps regulate emotions. The temporal lobes are connected to the limbic system and are involved in many different cognitive skills, including memory and language. A traumatic brain injury to the temporal lobe can cause behavioral disorders or seizures in this area. The frontal lobe is almost always injured in a traumatic brain injury because it is so large in size and is located near the front of the cranium. The frontal lobe is associated to the emotional and personality control center, as well as many cognitive functions. A traumatic brain injury to the frontal lobe can lead to decreased judgment and increased impulsivity.
Cognitive impairments can occur as a result from a traumatic brain injury, like trouble concentrating, trouble organizing thoughts, and becoming easily confused or forgetful. The damage from the traumatic brain injury can result in learning new information to become difficult and interpreting other’s actions will lead to social problems, like making inappropriate statements. The TBI damage can also cause problem solving, decision-making, and planning to become difficult, in addition to judgment.
Traumatic brain injuries often affect language issues like articulating words and forming sentences. When language areas are affected because of a traumatic brain injury, frustration and anger can occur because the person with the TBI trying to carry on a conversation, or others, may not even be aware of their problems communicating. Words in writing and reading situations can also become difficult when the traumatic brain injury has affected the part of the brain responsible for language. Mathematical abilities, simple or complex, are also often affected.
A traumatic brain injury can cause conditions, such as dysarthia, which starts to slow, slur, and make speech difficult to understand if the speech mechanism muscles become damaged. Swallowing can become problematic brought on by dysphagia, and a condition called apraxia can make repeating words in a consistent manner difficult.
Every year 70,000- 90,000 Americans will develop long-term disabilities from a traumatic brain injury experienced. The damage that the TBI causes can severely affect every aspect of an individual’s life, causing extreme obstacles, as well as pain and suffering. Treating traumatic brain injuries can result in high financial costs because of hospital bills, doctor’s visits, ongoing treatment, and lifestyle adjustments. The Brain Injury Association estimates hospital and fatal injury costs relating to traumatic brain injuries in the U.S. exceed $48 billion.
The Department of Defense (DoD) at the request of the Institute of Medicine recently issued a report on the efficacy of treating brain injured troops, but its conclusions are not firm because they lack strenuous scientific support, the report said.
Traumatic brain injury (TBI) is among the most common injuries sustained by troops fighting in Iraq and Afghanistan. About 20 percent of armed service members who are wounded in Iraq and Afghanistan have had forceful injuries to the face, neck or head. The number of brain injuries in the last ten years has gone from 11,000 to over 30,000
Dr. Ira Shoulson, professor of neurology at Georgetown University Medical Center and chairman of the panel that prepared the report told the New York Times on Oct. 11, 2011, that the evidence for the report’s conclusions was not firm enough because:
- Causes and severity of the injuries vary greatly
- Treatment techniques are usually individualized
- Veterans have a number of related problems such as chronic pain, depression, and post-traumatic distress syndrome
- Caregivers (including family members) and their methods varied widely
DoD spokeswoman Cynthia O. Smith told the Times that more than 71,000 hours of cognitive rehabilitation have been provided by the Pentagon, and the insurer Tricare has paid for about 54,000 hours of such care in private clinics for active duty, National Guard, and retired members of the service.
Family members of the injured have closely questioned the rehabilitation methods used to treat TBI. These include nonpenetrating blasts, blows to the head and wounds from bombs and bullets.
Dr. Nicholas Schiff, a neuroscientist at Weill Cornell Medical College in New York, told the Times, “because there’s no infrastructure, no organized plan of attack for what happens after a brain injury at all stages, you’re simply not going to find many large, well-designed studies that compare treatment options and outcomes.”
There are 5.3 Million Americans living with a traumatic brain injury, the fastest growing injury in the nation. Yet those who suffer from a traumatic brain injury often fail to get assistance other disabled people receive. A traumatic brain injury can affect people on varying levels, such as attention, memory and many other aspects. The Brain Injury Association and community members wish to address the desire to improve health care services and funding to help people suffering from brain injury.