Acquired Brain Injury (ABI) is damage to the brain acquired after birth. It includes traumatic brain injury as well as tumour, stroke, brain haemorrhage and encephalitis, to name a few causes. The effects are often very similar to those of a traumatic brain injury (TBI), but the key differences that make treating and coping with acquired brain injury are quite different.
Traumatic Brain Injury (TBI)
Traumatic Brain Injury occurs when sudden trauma causes damage to the brain. Traumatic Brain Injury can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a traumatic brain injury can be mild, moderate, or severe, depending on the extent of the damage to the brain.
You are the same person, just different.
This can be hard to remember at times, but it’s important to keep this in mind during tough days. Brain injuries affect different people in different ways, but many brain injury survivors will experience at least one of the issues below:
Fatigue. Even the small, straight forward tasks can leave you completely drained.
Memory. You may find that your short term memory worsens. While you might well recall childhood memories with clarity, you may now find it hard to remember names, faces and more recent events.
Planning. Leaving home can feel intimidating, even if you were a confident traveler, pre-injury. Noise, traffic, crowds or unfamiliar places can leave you feeling daunted and unsettled. You may find that nowadays, you need to plan trips carefully, allowing more time than you used to and feel better writing details down about your destination and route.
Concentration. You can find it hard to concentrate, so may be unable to last through a movie, finish a book, or follow a conversation.
Slower Responses. You may find that your body reacts more slowly to things
Changes in Character. Personality changes are very often linked to head injury/brain trauma. Formerly mild-mannered people may now find themselves more short-tempered, or anxious, for example. Dealing with these changes can be emotionally draining.
Physical issues. There are of course many, but these may include issues with balance, speech, hearing, noise-sensitivity, muscle spasms, etc.
Relationship changes. Family dynamics can often change after brain injury. Everyone is put under strain and spouses may find themselves in more of a carer-type of role. If you are a spouse or family member, and need to talk, do bear in mind our Peer Group. Running every week in complete confidentiality, it offers the opportunity to talk openly and honestly in a safe, quiet and above all, non-judgmental environment. Simply talking through your concerns, frustrations and feelings can be a real help.
Above all, remember – you are not alone.
Caring for someone with a brain injury
If you are caring for someone with a brain injury, or have a relative being treated in hospital, we understand that you’ll feel as if you’re on both a practical and emotional rollercoaster. It can be hard even knowing where to start.
For example, you may need to work out financial entitlements (and then manage the related paperwork), figure out practical arrangements, deal with your loved ones’ employer, and book seemingly endless medical appointments (not to mention continuing to try and run the house and manage the rest of the family, children’s schooling, your own work commitments, etc).
It is very hard seeing a loved one go through such a tough time – you may at times feel that your relationship has changed. You might also face unexpected personality or behavioural changes the injury has brought about in your loved one. This can be a very upsetting, stressful time for everyone involved. We understand that 100%.
About the Brain
Your brain weighs about 3lbs (that’s just under 1.5kg), and it has the texture of blancmange.
Your brain is connected to your spinal cord by the brain stem.
Behind your brain is the cerebellum. This part of the brain coordinates movement, posture, balance and speech.
60% of the brain is made up of fat. That’s why a diet rich in ‘healthy’ fats like Omega 3 and 6 is so beneficial to brain performance.
The Cerebral Cortex is the largest part of your brain. It contains the frontal lobes, the motor cortex, sensory cortex and parietal lobes. These lobes process different types of sensory information.
The brain is made up of around 100 billion nerve cells and even more support cells, which provide nourishment to the nerve cells. Every time a new memory is formulated, new brain connections are made. When you’re awake, the human brain can produce enough electricity to power a small lightbulb.
The storage capacity of the human brain is almost limitless.
If your brain were to be flattened out, its surface would cover four sheets of A4 paper.
Glossary of Terms
ACQUIRED BRAIN INJURY (ABI) - Acquired brain injury. This covers all situations in which brain injury has occurred since birth
ABIFN - Acquired Brain Injury Forum Northants
AMNESIA - Loss of memory that can happen after a person has a head injury.
ANEURISM/ ANEURYSM - Swelling or dilation of an artery due to a weakened wall.
ANOSMIA - Loss of sense of smell.
ANOXIA - Complete oxygen starvation. A condition in which the oxygen supply to the tissues is cut off completely. Partial loss of oxygen supply to the tissues is known as HYPOXIA.
APATHY - A direct result of brain injury to frontal lobe structures which concern emotion, motivation and forward planning.
APHASIA/ DYSPHASIA - Difficulty understanding or expressing language as a result of damage to the brain.
APRAXIA/ DYSPRAXIA - Inability to plan and perform purposeful movements, while still having the ability to move and be aware of movements.
ARTERAL LINE - A very thin tube (catheter) inserted into an artery to allow direct measurement of the blood pressure, the amount of oxygen and carbon dioxide in the blood.
ARACHNOID - The middle of the three membranes covering and protecting the brain and spinal cord. The arachnoid membrane lies below the DURA mater and directly above the SUBARACHNOID space.
ATAXIA - Abnormal movements due to loss of muscle coordination.
ATHETOSIS - Abnormal writhing movements, particularly of the hands, seen in a number of brain disorders, and following brain injury.
AXON/DENDRITES - Parts of nerve cells in the brain which look like small hair tentacles. The cells receive information via the dentrites and communicate with each other by passing electrical signals down the axons and releasing chemical signals at their ends.
BASAL GANGLIA - Collections of grey matter in the deep areas of the brain, below the cerebral cortex. They are involved in the control of movement and injury may produce a disturbance resemblance to Parkinson’s disease.
BLINDSIGHT - A phenomenon in which people who are perceptually blind in a certain area of their visual field demonstrate some response to visual stimuli.
BRAIN STEM - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brain stem include those necessary for survival (breathing, heart rate) and for arousal (being awake and alert).
BRAIN PLASTICITY - The ability of intact brain nerve cells (neurones) to make new connections and, in some cases, take over functions of damaged cells. Neuronal plasticity plays a crucial role in memory and diminishes as a person gets older.
BROCA’S AREA - An area of the brain crucial to language processing, speech production and understanding.
CARDIAC ARREST - The heart stops beating and there is no effective circulation of blood to the body, so that the brain and other organs rapidly become starved of oxygen.
CATHETER - A tube which is inserted into any body part to withdraw or introduce fluids.
CEREBELLUM - Area at the back of the brain, below the cerebral hemispheres, involved in the control of movement, co-ordination, posture and balance.
CEREBRAL - Concerning the brain.
CEREBRAL ANGIOGRAM - An X-ray picture of the blood vessels inside the head. A drug is injected via the groin artery to outline those cerebral vessels.
CEREBRAL ANOXIA - A complete interruption of the supply of oxygen to the brain.
CEREBRAL CORTEX - The folded layer of grey matter (made up of nerve cell bodies) on the surface of the brain. It is involved in higher brain functions such as sensation and perception, the control of voluntary movement, thought and reasoning, language and memory.
CEREBRAL HEMISPHERES - The right and left halves of the cerebrum. When a brain is examined in the laboratory, most of what can be seen is the cerebral cortex covering the surface of the two cerebral hemispheres.
CEREBRAL HYPOXIA - A partial interruption of the supply of oxygen to the brain, which becomes inadequate to maintain normal brain function.
CEREBRAL ISCHAEMIA - A deficiency of blood supply to brain tissue, due to an interruption or reduction of arterial blood flow.
CEREBRO-SPINAL FLUID (CSF) - Liquid which fills the ventricles of the brain and surrounds the brain and spinal cord.
CEREBRUM - This is the largest part of the human brain, which occupies most of the skull cavity. It is made up of the two cerebral hemispheres.
CEREBELLUM - Located at the back of the head between the cerebrum and the brain stem, the cerebellum is responsible for the coordination of movement and balance and is thought to play a role in emotion.
CHOREA - Brief, involuntary jerky movements involving the limbs and face, seen in a number of brain disorders and following brain injury.
CLOSED HEAD INJURY - Damage to the brain where there is no penetration from the scalp or skull through to brain tissue. Often there is no injury to scalp or skull.
COGNITION - General term used to cover all areas of intellectual functioning. Includes skills such as thinking, remembering, planning, understanding, concentrating and using language.
COMA - A state of unconsciousness from which a person can’t be roused.
COMPLICATION- Problem that happens as a result of the injury.
CONCUSSION - Loss of consciousness for a short time followed by an apparent return to normal.
CONFABULATION - Verbalisations about people, places or events with no basis in reality.
CONTRA COUP - Bruising of the brain tissue in the side opposite to where the impact occurred.
CONTRACTURES - Joints and muscles which are not used regularly quickly becoming stiff, and rendering them resistant to stretching.
CONVULSION - A fit or a seizure.
CORTICAL BLINDNESS - Loss of visual function resulting from damage to the main visual areas of the brain, which are located in the occipital lobes at the back of the brain.
CRANIOTOMY - Surgical removal of the skull in small pieces.
CRANIUM - The bony skull which completely encases the brain for protection.
CRANIAL NERVES - A set of 12 pairs of nerves originating in the brainstem, the oldest part of the brain. Functions of the cranial nerves include control of eye movement and blinking.
CT SCAN - CT stands for computed tomography. A CT scan is a computeraided X-ray used to provide clear pictures of the brain.
CYANOSIS - A bluish tinge to the skin, caused by a deficiency of oxygen in the blood, and often most apparent around the lips and mouth and in the fingertips.
DEMYELINATION - Loss of the fatty insulating sheath (myelin) surrounding nerve axons, which impairs their function by interfering with their ability to conduct electrical nerve impulses normally.
DENTRITE - See AXON.
DEPRESSED SKULL FRACTURE - A break in the skull where a piece or pieces of bone are pushed in towards the brain.
DIFFUSE BRAIN INJURY - In jury to cells in many areas of the brain rather than in one specific location.
DIENCEPHALON - The mid brain. This contains discrete nerve centres including the hypothalamus, which controls appetite regulation, sexual arousal, thirst and temperature control, and some aspects of memory. The diencephalon also contains the thalamus, the body’s sensory gateway to the brain.
DIFFUSE AXONAL INJURY (DAI) - Widespread tearing of nerve fibres across the whole of the brain.
DIPLOPIA - Double Vision.
DISINHIBITION - Difficulty in controlling urges and impulses to speak, act or show emotions.
DURA - Outermost of the three membranes protecting the brain and spinal cord.
DYSARTHRIA - Difficulty speaking because of weakness and lack of co-ordination of the muscles for speech.
DYSHAGIA - Difficulty with swallowing.
DYSPRAXIA - Inability to plan and perform purposeful movements, while still having the ability to move and be aware of the movement.
ECHOLALIA - Limitation of sounds or words without comprehension. This is a normal stage of language development in infants but is abnormal for adults.
ELECTROENCEPHALOGRAM (EEG) - EEG is a test used to record any changes of electrical activity in the brain by placing electrodes on the scalp.
EMOTIONAL LIABILITY - Rapid and drastic changes in emotional state (such as laughing, crying or anger) that are inappropriate.
EVOKED POTENTIALS - Electrical responses of the brain to stimulation, recorded from the scalp.
EXECUTIVE FUNCTIONS - The ability to think and reason, to synthesize and integrate complex information and make considered judgements and decisions about what to do in a particular situation.
EPILEPSY - There are many varied presentations. Seizure or fit activity involving parts of or the complete body.
EXTRADURAL HAEMATOMA - A collection of blood on the surface of the brain similar to a subdural haematoma.
FOCAL BRAIN INJURY - Injury restricted to one region (as opposed to diffuse).
FRONTAL LOBES - The largest lobes of the brain, occupying the front part of the cerebral hemispheres. As well as containing the areas controlling voluntary movement and speech production, the frontal lobes are involved in the executive functions of thinking and reasoning, the integration of complex information, judgement, decision-making and planning for the future. They also have an important role in social behaviour, personality and emotion.
GASTRSTOMY - The creation of an opening into the stomach for the administration of foods and fluids when swallowing is impossible.
GLASGOW COMA SCALE - Scale used to assess consciousness after a head injury
GLUTAMATE - The major excitatory neurotransmitter in the brain. Excessive glutamate release (or cascade) following TBI can be a major cause of nerve cell death in the second injury.
GREY MATTER - Nerve cell bodies in the brain, which have a greyish appearance and make up the cerebral cortex.
GYRUS (pl. GYRI) - A ridge of the cerebral cortex (also see SULCUS).
HAEMATOMIA - A collection of blood forming a definite swelling which compresses and damages the brain around it.
HAEMOGLOBIN - A substance in the red blood cells, which takes up oxygen in the lungs and transports it to the tissues of the body.
HAEMORRHAGE - Blood loss, bleeding.
HEAD INJURY- MILD/MINOR - Causes brief loss of consciousness for 15 minutes or less with a period of post-traumatic amnesia of less than 1 hour.
HEAD INJURY – MODERATE - Defined as being a condition where the patient has been in a coma for up to 6 hours, and a period of post-traumatic amnesia of up to 24 hours.
HEAD INJURY – SEVERE - Defined as being a condition where the patient has been in a coma for 6 hours or more, or a post-traumatic amnesia of 24 hours or more.
HEN - Headway East Northants.
HIPPOCAMPUS - A structure on the inner surface of the temporal lobes, which is made up mainly of grey matter and has an important role in memory processes. Damage to the hippocampus may lead to memory problems.
HOMEOSTASIS - The ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes. For example, sweating when hot in order to keep the core body temperature at 98.6 degrees Celsius maintains homeostasis.
HWUK - Headway UK
HYPERBARIC OXYGEN THERAPY - A specialized treatment sometimes used in severe anoxic states – particularly after carbon monoxide poisoning – which involves giving pure oxygen at increased pressure in a hyperbaric chamber.
HYPOTHALAMUS - A small structure just above the brain stem. The hypothalamus detects levels of hormones in the blood and controls the pituitary gland’s release of hormones in order to keep the levels stable (also see pituitary gland).
HYPOPITUITARISM - The condition in which the pituitary gland doesn’t produce adequate levels of one or more hormones.
HYPOXIA -A term applied to that state in which the body tissues have an adequate supply of oxygen. This may be because the blood in the lungs does now receive enough oxygen, or because there is not enough blood to receive oxygen, or because the blood stagnates in the body.
HYPOXIC-ISCHAEMIC INJURY - Damage caused by an interruption of oxygen supply (hypoxia) linked with a reduction in the blood flow to the brain (ischaemia), such as occurs when the heart stops beating in a cardiac arrest.
IMPULSIVITY - A tendency to rush into something without reflecting or thinking first.
INFACTION - Death of cells resulting from an interruption of their blood supply, e.g. as occurs in a stroke.
INTRACRANIAL HAEMORRHAGE - Bleeding inside the skull. If it happens, it will usually occur within the first few hours after the injury. The bleeding puts pressure on the brain and is very serious unless treated quickly. This includes extradural and subdural haematomas as well as bleeding into the brain itself.
INTRACRANIAL PRESSURE (ICP) MONITOR - A monitoring device to determine the pressure within the brain. It consists of a small tube (catheter) in contact with the brain or the fluid cavity within it. ICP is measured by means of a metal screw or a plastic catheter connected to an electronic measuring device.
LIMBIC SYSTEM - A group of deep cortical structures connected to the hypothalamus, governing memory, emotions and basic drives, including sex drive.
LOCKED IN SYNDROME - A condition in which the patient is awake and retains the ability to sense and perceive, but is unable to communicate except by limited eye movements. This is due to the motor nervous system being paralysed. It can sometimes be confused with persistent vegetative state.
MANNITOL - A solution which removes water from the brain by accelerating urinary excretion and thus reduces raised intracranial pressure.
MINIMUMALLY CONSCIOUS STATE - A state of profoundly altered consciousness seen following a severe brain injury, in which there is some evidence of minimal awareness, although this is far removed from anything approaching normal appreciation of the surroundings or of what is happening.
MOTOR CORTEX - The part of the brain involved in planning and executing voluntary movements. The primary motor cortex lies directly in front of the primary SENSORY CORTEX on the upper surface of the brain.
MRI - MRI stands for magnetic resonance imaging, which is a method of producing sophisticated pictures of any part of the body. It uses magnetic fields and radio waves, not X-rays.
MYELIN - A fatty insulating sheath, which surrounds nerve axons and improves the efficiency of transmission of the electrical nerve impulses along them.
MYOCLONUS - Sudden, shock-like muscle twitches or jerks, seen in various brain disorders and quite common following severe cerebral anoxia.
NERVE CELL BODIES - The largest part of a nerve cell. The cell body holds all of the general parts of a cell as well as the nucleus, which is the control centre.
NASOGASTRIC - This is the very thin tube that is threaded through the nose and throat into the stomach for giving liquid food and pureed meals. Used if there are swallowing difficulties.
NEUROGENIC DIABETES INSIPIDUS - A condition which causes thirst and excessive production of dilute urine due to the pituitary gland not producing enough of the hormone vasopressin (anti-diuretic hormone).
NEURALOGICAL PROBLEMS - Neurological problems happen because the nervous system is not controlling a set of actions in the normal way. They can be a sign that the brain has been damaged. The signs to watch for in a person with a head injury include: problems understanding, speaking, reading or writing (since the injury); loss of feeling in part of the body; problems with balance or walking (since the injury); general weakness (since the injury); any changes in eyesight.
NEUROSURGEON - A brain surgeon.
NEUROSURGERY - Operations on the brain
NEURON - This is a nerve cell.
NEURO-TRANSMITTERS - Chemicals made in the nervous system that serve as messengers, aiding or interfering with the functions of the nerve cells.
ODEMA - Increased water content in specific tissues, causing swelling.
OCCIPITAL LOBES - A region in the back of the brain which processes visual information.
OPEN HEAD INJURY - An injury where there is penetration of the scalp and skull through to brain tissue.
OPEN SKULL FRACTURE - Where an area of the skull has fractured as a result of the injury and there is a deep cut in the skin over the fracture through the bone which can be seen.
PARIETAL LOBES - The part of each cerebral hemisphere primarily concerned with the perception and interpretation of sensation and movement.
PERSEVERATION - Uncontrollable repetition of a particular response such as word, phrase or gesture. May also be a tendency to continue or repeat an act or activity after the original stimulus has stopped.
PERSISTENT VEGETATIVE STATE (PVS) - A persistent vegetative state (commonly, but incorrectly, referred to as “brain-death”) sometimes follows a coma. Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. They may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands. It is a long-standing condition in which the patients utters no words and does not follow commands or make any response that is meaningful. Also called MINIMUM CONSCIOUS STATE.
PIA - One of the three membranes holding the brain together.
POST- CONCUSSION SYNDROME - A group of symptoms occurring after mild head injury that may persist for days, weeks or months.
POST- TRAUMATIC AMNESIA (PTA) - The period after being unconscious when there may be confused behaviour and no continuous memory of day to day events.
PROPRIOCEPTION - The sensory awareness of the position of body parts with or without movement.
REFLEX - An involuntary movement that shows that the nerves are working normally.
RIGIDITY - This simply means stiffness, resistance to movement.
RETROGRADE AMNESIA - The loss of memory of events for a period prior to the injury.
SENSORY CORTEX - The sensory cortex is situated in the cerebrum. Different parts of the sensory cortex deal with the sensations experienced in different parts of the body.
SHUNT - A device to draw off excess fluid in the brain. A surgically placed tube runs from the ventricles and deposits fluid into either the abdominal cavity, heart or large veins in the neck. An ‘external shunt’ is a similar device and this drains from the ventricles through a tube into an external reservoir where the drainage may then be measured.
SPASTICITY - An involuntary increase in muscle tone (tension).
SUBDURAL HAEMATOMA - A build-up of blood and fluid on the surface of the brain. A subdural haematoma may be discovered immediately after a head injury but occasionally it can develop more slowly, for example within several days or weeks. The pressure on the brain causes headaches, drowsiness, confusion, speech problems or problems down one side of the body. People with any of these symptoms should return to hospital quickly so they can be treated.
TEMPORAL LOBES - The part of each cerebral hemisphere concerned with sound and language interpretation, and important in memory function.
TRACHEOSTOMY - An operation to insert a tube in the neck. Through this tube an adequate air passage can be maintained. It may be necessary to leave the tube in the windpipe for a prolonged period.
TREMOR - Regular repetitive movements which may be worse either at rest or on attempted movement.
TRIAGE - A system to prioritise patients according to the seriousness of their injuries.
UK ABIF - United Kingdom Acquired Brain Injury Forum
VENTILATOR - A machine that does the breathing work for the unresponsive patient. It delivers moistened (humidified) air with the appropriate percentage of oxygen and at the appropriate rate and pressure.
VENTRICLES - Cavities (spaces) inside the brain which contain cerebro-spinal fluid.
VESTIBULAR - System in the middle of the ear which senses movement. Injury can lead to dizziness.
WERNICKE’S AREA - An area of the brain concerned with producing speech.
Headway UK Headway UK – the brain injury association. This is the national charity to whom we are affiliated, that works to improve life after brain injury. Free 24 hour helpline- 0808 800 2244 Email firstname.lastname@example.org
I'm Calling About Chris The Headway support website, I'm calling about Chris is a useful free resource. It's designed to help ease the burden of keeping friends and family members informed about the condition of a loved one in the acute stage of care following an acquired brain injury.
It’s a way of updating those who care, without having to spend hours on the phone each night, exhausted after spending 15 hours at the hospital bedside. And it’s a chance to connect with those who may be able to offer practical help or support.
Brain and Spine Foundation This organisation offers information and education regarding a wide range of neurological symptoms and conditions, with the helpline being staffed by neuroscience nurses. Fourth Floor, CAN Mezzanine, 7-14 Great Dover Street, London, SE1 4YR Helpline: 0808 808 1000
BRAKE The road safety charityRaising awareness of road safety and offering support to accident victims BRAKE, PO Box 548, Huddersfield, Yorkshire, HD1 2XZ Switchboard: 01484 559909 Victim Support Line: 0808 800 0401 Email: email@example.com Website: www.brake.org.uk
Child Brain Injury Trust The Child Brain Injury Trust (CBIT) supports children, young people and families affected by an acquired brain injury, to support them in achieving their potential. Unit 1, The Great Barn, Baynards Green Farm, Nr Bicester, Oxfordshire, OX27 7SG Helpline: 0845 601 4939 Contact number: 01869 341075 Email: firstname.lastname@example.org Website: www.childbraininjurytrust.org.uk
Community Brain Injury Team A specialist service staffed by clinical psychologists, specialist occupational therapists, a head injury co-ordinator and a consultant in rehabilitation medicine. Community Brain Injury Service, Abbey Block, Isebrook Hospital, Irthlingborough Rd, Wellingborough, NN8 1LP Tel: 01933 235829 Email: CBIService@nhft.nhs.uk
Community Law Service An independent and confidential service offering a team of highly experienced caseworkers and solicitors. They provide a comprehensive casework service and advice from beginning to conclusion, including representation at social security appeal tribunals, immigration appeals, housing repossession hearings, bankruptcy hearings and other debt related matters at the Crown and County Court. Northampton Offices: 01604 621038 Rushden Offices: 01933 313020 Wellingborough Offices: 01933 278248 Website: www.communitylawservice.org.uk
NHS Direct National helpline providing 24-hour medical information, advice and reassurance. Contact Number: 0845 4647 Website: www.nhsdirect.nhs.uk
Northamptonshire Social Services Adult Care Team A Northamptonshire County Council provision for specialist social care and help towards community living. John Dryden House, Northampton, NN4 7YD Tel: 0300 126 1000
Northamptonshire Carers A comprehensive support service to the unpaid carers of Northamptonshire. Open 9-5pm, Mondays to Fridays inclusive. 123 Midland Road, Wellingborough, Northants, NN8 1LU General Enquiries: 01933 677837 Carer’s Support Line: 01933 677907 Email: email@example.com Website: www.northamptonshire-carers.org
ABI Relatives Group Providing help and information for those living and caring for someone with an Acquired Brain Injury. The group meets every 3rd Thursday of the month.