A serious brain injury – from whatever cause – can be life-changing for the individual and their family and friends.
TBI mainly affects young people, particularly in the age range 16 – 29 (and more men than women. Stroke tends to affect older populations, although, importantly, about 25% will be under 65 and 10% under 50.
The Health Select Committee in 2001 commented that “Head injury is the foremost cause of death and disability in young people. In an age of increased motorisation and violence, head injury is a healthcare problem which is not going to go away. There is a growing population of head-injured people in this country, as improved medical techniques have led to many head-injured people now surviving their accident and living into old age, with a normal life expectancy. However, a head-injured person is likely to require long term rehabilitation to live his or her life in society.” Health Select Committee report: HEAD INJURY : REHABILITATION (2001)
After TBI (and, for example, encephalitis), people may become mobile again fairly quickly, but there will still be long term effects, such as a complex mixture of physical, cognitive, emotional and behavioural problems. Some people also have a change in personality and a lack of awareness of how the brain injury has affected them.
Every brain injury is different and the effects will depend, for example, on the extent of the injury and part of the brain that has been damaged. Fatigue is a common experience after a brain injury from many causes.
In many cases after ABI, there is limited physical or sensory disability. The residual effects are largely “hidden” – being of a cognitive, emotional and behavioural nature – and thus less easy to observe. This can result in misunderstandings, and often lead to loss of employment, relationship breakdown, low self-esteem, and social isolation for the person, as well as their family.
It can also result in homelessness, alcohol and drug dependency, or the person finding themself in the criminal justice system.
The process of adjustment is very difficult for all. The affected person will in most cases have a normal life expectancy.
Stroke survivors, however, commonly have problems with physical mobility, sensation, vision and personal care, as well as communication, swallowing and spatial orientation. There can also be cognitive difficulties, for example, problems with short-term memory, concentration, reasoning and planning.
The vast majority of traumatic brain injuries will be classified as moderate or mild, and the people affected will not in general have in-patient rehabilitation, and are currently badly catered for in the community. Around 20% of people with mild TBI (post-concussion syndrome) will have ongoing problems.
There is a need for adequate early assessment, so that they and their families and employers – and their GPs – can get the advice and guidance they need to help the person cope with the early effects of the injury, and for specialist community rehabilitation where necessary (see also Why rehabilitation?).
A significant number of people will need ongoing – in some cases lifelong – care and support.
For more information on ABI and its effects see, for example:
The Stroke Association
The Encephalitis Society
Brain Injury Association of America