Can a Brain Injury Cause Disability?

Whether a mild concussion to a Traumatic Brain Injury (TBI), if you or someone you love has suffered a brain injury, there is a good chance that, in addition to the injury itself, other issues will occur. The most prominent issues that can occur as a result of a brain injury include physical and/or mental disabilities.

Brain Injury and Disability

The type of disability and the severity of the disability that a patient could potentially sustain as a result of a brain injury depends on several factors, including:

• The severity of the injury
• The location of the injury
• The age of the patient
• The general health of the patient

Some of the most common disabilities that are associated with brain injuries include issues with cognition (thinking, memory and recall, and reasoning), communication (understanding and expression), sensory processing (sense of sight, smell, taste, touch, and hearing), and behavioral or mental health problems (depression, anxiety, aggression, social inappropriateness, changes in personality, and acting out).

The disabilities that can be associated with a brain injury can be minor and short-term, or they can be severe and lifelong. The symptoms can appear immediately following a brain injury, though it can take several days to weeks after a brain injury for signs and symptoms of disability to appear. In any case, the disabilities that can be associated with brain injuries can impact every aspect of the patient’s life, as well as the lives of his or her loved ones. No matter the cause, the following are some of the most common disabilities that can occur as a result of blunt force trauma to the head.

Post-Concussion Syndrome

Nearly 50 percent of individuals that sustain a brain injury develop post-concussion syndrome (PCS) to some degree within days after the injury occurs. Post-concussion syndrome can last a few weeks to several months or more, depending on the severity. There are several symptoms that can be associated with PCS, such as:

• Headaches
• Memory recall issues
• Dizziness
• Difficulty concentrating
• Sleep disturbances
• Anxiety
• Depression
• Sadness
• Agitation
• Apathy
• Loss of interest

As mentioned, PCS can resolve within a few weeks or it can persist for several months or more, and while the condition is temporary, it can be severe enough that a patient’s ability to work or carry out normal activities can be affected. Three methods of treatment can be used to manage the symptoms that are associated with PCS: medication, psychotherapy, occupational therapy.

Sensory Issues

Sensory issues following a brain injury refer to problems that affect the five senses: the sense of sight, hearing, taste, touch, and smell. The brain is directly responsible for sensory processing, which is why it is common for some form of sensory disability to occur following a brain injury. Of the five senses that can be impaired as a result of a brain injury, the sense of sight is the most commonly affected. Often, a while a patient may still be able to see, he or she can begin to have difficulty recognizing people and items , as they are unable to process signals that are sent to the brain through the eyes. The severity of vision impairment can vary and range from mild to severe; however, regardless of the severity, should a patient experience vision disruption following a brain injury, he or she will not be able to drive a motor vehicle or operate heavy machinery until the symptoms have subsided.

Other sensory impairment issues that patients may experience following a brain injury may include:

• Tinnitus, which is characterized by hearing a ringing or roaring sound in the ears
• The inability to smell or smelling foul odors that don’t exist
• Disrupted sense of taste in that the patient may not be able to taste foods and beverages, or he or she may experience a constant bitter flavor
• A tingling, painful sensation in the skin, or non-stop itching

Sadly, there is little that can be done for sensory issues following a brain injury; however, in time, the symptoms tend to resolve.

Cognitive Impairment

Cognitive impairments can occur following a severe brain injury, or after repeated mild injuries to the brain. Patients who experience cognitive disabilities may find that they are having trouble thinking clearly, may have a difficult time recalling facts or events, may forget loved ones, or their ability for logical reasoning may be negatively impacted.

Memory loss is the cognitive disability that patients experience following a brain injury; typically, the symptom presents as an inability to recall some past events, as well as difficulty remembering new things. An individual who has suffered a brain injury may find that he or she is unable to successfully solve problems, organize schedules, complete simple tasks, or make proper judgements. The symptoms that are associated with cognitive disabilities post-brain injury can last for a period of six months or more.

Communication Difficulties

It’s common for brain injury patients to experience difficulties with their ability to communicate. As with all disabilities that are associated with brain injuries, communication difficulties can range in severity from mild to severe; for example, someone who experiences a minor impairment may find that they have a hard time reading body language or picking up on non-verbal cues, while in more serious cases, a patient may have difficulty understanding or expressing spoken and/or written words. To illustrate, a victim may have slurred speech, or he or she may speak gibberish.

Emotional and/or Behavioral Problems

It is not uncommon for brain injury patients to experience emotional and/or behavioral problems. Often, victims of brain injuries can feel depressed and anxious, they may become highly irritable and quick to anger, they may experience sever and unpredictable mood swings, they may become apathetic, they may have a hard time falling asleep and/or staying asleep, or they may act violently and impulsively. Though medication and psychotherapy may be able to help resolve emotional difficulties following a brain injury, unfortunately, patients can experience life-long complications and may revert to child-like behavior or may be unable to develop emotionally.

Can a Brain Injury Affect Personality?

Though the physical symptoms that can be associated with a brain injury, such as difficulty walking, slurred speech, inability to recall information, blurred vision, and extreme itching, are usually obvious, it’s important to understand that brain injuries can cause inward damage that is difficult to recognize. While every patient is different and the risk of personality changes varies and depends on several factors, such as the severity of the injury and the age of the patient, a large percentage of individuals do experience altered emotions, which can cause perceived changes to their personality related to mood, behaviors, feelings, and/or actions.

How Brain Injury Affects Personality

No matter the severity, brain injuries can damage the connections in the brain that are responsible for regulating both emotional and cognitive processes, which can present as difficulties with:

• Recall and memory
• Attention and concentration
• Decision making skills
• Emotional and behavioral regulations and expressions
• Self-awareness

Not only the disruption to the brain’s processing abilities alter a patient’s personality, an individual can also react emotionally to the hardships that they encounter while they are recovering from the injuries that have been sustained. As well as managing the ongoing symptoms that may be experienced, and to the changes in his or her ability to perform everyday functions.

Symptoms of Brain Injury-Related Personality Changes

No two brain injuries – or individuals – are the same, and therefore, the personality and/or mood alterations that a patient may experience can vary widely. With that said, patients who do experience personality changes following a brain injury may exhibit one or more of the following:

• Difficulties regulating emotions
• Rapid onset of anger and/or frustration
• Inappropriate and/or uncontrollable fits of laughter or crying
• “Flat affect”; a loss of emotional expression
• Aggressive behavior, which can come on suddenly and can be extreme and violent
• Obsessiveness and/or inflexibility

Treatment for Brain Injury-Related Personality Changes

If you or a loved one is displaying personality changes following a brain injury, it’s important to realize that these chances are common and should be expected. Additionally, with proper treatment, the symptoms can be managed. The human body is self-healing and therefore, over time, the symptoms that are associated with mood changes can improve naturally. Doctors and therapists can also work with patients to pinpoint and manage triggers that spark personality changes; for instance, some patients may find that when they are tired, stressed, or over-stimulated, emotional symptoms may manifest. In such a case, managing the patient’s environment and making changes to his or her lifestyle may help to minimize emotional responses.

What is the Difference Between a Head Injury and a Brain Injury?

All blows to the head should be considered serious; however, it’s a common misconception that head injuries and brain injuries are the same thing. They aren’t, and using the two terms (head injury and brain injury) interchangeably can cause lead to confusion, not only in regard to long-term ramifications of the injury and the type of medical treatment that a patient requires, but also in regard to potential legal ramifications that a patient may be entitled to, such as compensation for medical care and loss of income. As such, it is important to understand the differences between a brain injury and a head injury.

Head Injury

A head injury is defined as an injury that results in damage to the scalp, skill, and/or the interior layers of the skull that protect the brain. With a head injury, an individual’s brain tissue is not damaged. The following are some common examples of head injuries:

• Bruising to the skull
• Fractured skull bones
• Lacerations to the scalp or to the tissues that surround the head

Though brain damage does not occur, a head injury can be quite serious. Often, patients require surgery following a head injury in order to repair the damage; for example, if the skull is broken or to prevent pieces of the bone from breaking off and puncturing the brain tissue. Additionally, it is imperative for anyone who has sustained a head injury to also be checked for a brain injury, as head injuries and brain injuries can occur at the same time.

Head injuries usually occur when the scalp, skull, and tissues within the skill experience some type of traumatic force. Motor vehicle collisions are a common cause for head injuries; for example, when a patient’s head makes contact with a windshield, steering wheel, or dashboard. Head injuries can also occur when the head is struck against or by something; for instance, when a football player’s head makes contact with the ground or if a construction worker experiences blunt force trauma as a result of banging his head into a 2x4. Bullet wounds, explosions, slips and falls, and physical assaults can also result in a head injury.

Brain Injuries

A brain injury is classified as any injury to the brain tissue. Brain injuries are usually referred to as “Traumatic Brain Injuries” or “TBIs” and can result in several physical, mental, and emotional disabilities, including cognitive impairments, personality chances, emotional issues, motor skill deficits, and sensory issues. The human body is self-healing and over time, brain injuries can heal themselves; for instance, neurological complications can subside within a few months after a brain injury. Catastrophic brain injuries, however, are considered severe and the effects are long-term. A patient’s ability to eat, move, speak, and recall basic information can be impaired following a catastrophic brain injury. Additionally, severe brain injuries have the potential to cause long-term complications; seizures, post-traumatic dementia, coma, or a persistent vegetative state, for instance.

There are two types of brain injuries, which include:

• Acquired brain injury (ABI). Acquired brain injuries refer to any brain damage that a person experiences post-birth and is not the result of an external force; brain damage caused by drowning or chocking, or resulting from infection or a medical condition, such as an aneurysm or stroke.
• Traumatic brain injury (TBI). A TBI can be described as brain damage that occurs when an external force is placed on the brain or head. TBIs can be further categorized by the type and severity of trauma a patient experiences; a contusion, a concussion, or coup-contrecoup injuries, as well as diffuse axonal (shearing) injuries. Traumatic brain injuries can also occur as a result of an outside object penetrating through the skull, or can be closed and where the damage is contained within the skull.

Treatment for brain injuries varies and depends on the severity of the damage, as well as the cause of the injury. Examples of treatment options include the following:

• Medications.
  • Anti-seizure drugs have been proven to be effective for patients who suffer from moderate to severe TBIs and who are at risk of developing seizures.
  • Temporary coma may be induced in severe causes of TBI, as it can help to induce healing
  • Diuretics can help to minimize the amount of fluid in the tissues, and therefore, the brain, by increasing the amount and rate of urine output.
• Surgery.
  • Hematoma (clotted blood) removal via surgical procedure
  • Surgical skull fracture repair
  • Surgery to stop bleeding on the brain
  • Opening a window into the skill can drain accumulated cerebrospinal fluid, thereby relieving pressure within the skull
• Rehabilitation
  • Physiatrist
  • Occupational therapy
  • Physical therapy
  • Speech and language therapy
  • Neuropsychological therapy
  • Recreational therapy
  • Vocational therapy