Rehabilitation For Brain Injuries

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Rehabilitation For Brain Injuries Essay

Traumatic brain injury (TBI), or intracranial injury, is a medical diagnosis which refers to closed or penetrative damage to the brain that is caused by an external source. Every year, TBIs affect approximately 150-250 people in a population of 100,000 (León-Carrión, Domínguez-Morales, Martín, & Murillo-Cabezas, 2005). The leading causes of TBI are traffic accidents, work injuries, sports injuries, and extreme violence (León-Carrión et al., 2005). TBI is most often fatal when the cause is an injury due to the use of firearms, a traffic accident, or a long fall (León-Carrión et al., 2005). However, fatality rates and rates of occurrence differ in various countries Rehabilitation For Brain Injuries Essay


Patients who suffer from a mild TBI often require little rehabilitation and function normally over the course of a week or so (León-Carrión et al., 2005). Patients with a moderate TBI often suffer psychological and physical stressors, but they have an 80% chance of being high-functioning after a certain amount of time (León-Carrión et al., 2005). However, patients with moderate to severe TBI often suffer long-term physical and cognitive problems as a result of their injury. The disabilities that result from moderate to severe TBI differ depending on the area of injury, but they may include difficulties in speech, coordination, bilateral function, memory, complex thinking, and other areas (Murrey, 2006). Emotional and social areas are also affected by TBI due to changes in familial roles, lowered self-esteem, and hopelessness brought on by the injury (Murrey, 2006). Because of this, suicide rates in these patients are remarkably high, with 33% of patients at risk (León-Carriòn et al., 2005). Recovery in TBI patients may occur spontaneously throughout the two years following the trauma (León-Carrión et al., 2005). Beyond this point, remaining disabilities are usually permanent (León-Carrión et al., 2005). Implications for Music Therapy Because both TBI and music therapy have such broad definitions, music therapy has the capability to affect patients in several ways. In the case of a mild TBI, music therapy may not be necessary. However,Rehabilitation For Brain Injuries Essay

Traumatic brain injury (TBI), which is defined as a physical injury to brain tissue that temporarily
or permanently impairs brain function, is a global health concern and a growing socioeconomic
problem. TBI is the leading cause of mortality and disability among individuals under the age of 45,
with young adult males accounting for approximately 75% of cases. Due to the complex
pathophysiology associated with TBI, there is currently no effective pharmaceutical treatment
available for widespread clinical use. Consequently, individuals who suffer debilitating TBI often
require lifelong medical care and support.
TBI is commonly classified based on the clinical severity of the injury, ranging from mild to severe.
The Glasgow Coma Scale (GCS) has become the universally accepted severity classification system
for TBI. Based on scores (ranging from 3-15) from eye, motor, and verbal tests, the GCS classifies
TBI cases as mild (GCS 14-15), moderate (GCS 9-13), or severe (GCS 3-8). In addition to clinical Rehabilitation For Brain Injuries Essay
severity, TBI has also been traditionally classified based on the mechanism of injury. Mechanismbased classification usually categorizes TBI as either closed or open head injuries. Closed head
injury, also called blunt or non-penetrating brain injury, does not involve a breach of the brain’s
dura mater; however, skull fractures may occur. Closed head injury is the most common type of
TBI in the general population, and is typically caused by sports injuries, motor vehicle accidents,
and physical assault. In contrast, open head injury involves the penetration of the scalp, skull,
meninges, and often brain tissue itself. Such penetration injuries are more common amongst
military personnel, and are usually caused by foreign objects such as bullets.
TBI might involve various types of gross or microscopic brain damage depending on the
mechanism and severity of injury. Despite this heterogeneity, the associated damage of TBI is often
categorized as resulting from either primary or secondary injuries. Primary injuries are induced at
the moment of impact, when mechanical forces are applied to the brain. These forces most
commonly affect the frontal, parietal, and temporal lobes, and result in focal and/or diffuse injury
patterns. A focal injury pattern typically occurs following a direct blow to the head and may result
in contusion, hemorrhage, and ischemic infarct. Diffuse injury patterns are typically a result of the
stretching and/or shearing of white-matter tracts due to the differential motion of the brain within
the skull. The severity of this diffuse pattern ranges from a brief disruption and misalignment of
axonal neurofilaments to widespread axonal tearing. Secondary injuries result from processes that
are initiated by the primary insult, and may develop over the hours, days, or weeks that follow.
While different variations of TBI may initiate a range of secondary mechanisms, with variable
extent and duration, these processes most commonly involve increased excitatory neurotransmitter
release, calcium-mediated damage, mitochondrial dysfunction, free radical generation, Rehabilitation For Brain Injuries Essay
hyperphosphorylated tau, amyloid plaques, and a neuroinflammatory response.
Depending on the severity and brain structures affected, various signs and symptoms may appear
within the seconds to weeks following TBI. These might include a loss of consciousness, headache,
vomiting or nausea, convulsions or seizures, dilation of one or both pupils, clear fluid draining from
ears or nose, loss of bladder or bowel control, slurred speech, confusion, dizziness, sensory
problems, sleeping abnormalities, memory loss, cognitive impairments, agitation, irritability,
combativeness, disinhibition, impulsivity, anxiety, depression, mood swings, motor problems, and
other unusual behaviors like paranoia or mania.
To date, improvements in TBI patient outcomes have resulted from advances in intensive care
management, neurosurgical techniques, and rehabilitation. Unfortunately, these strategies often
result in limited benefits after TBI. Given that TBI is an international health concern with limited
treatment options and no effective pharmaceutical intervention, it is imperative that research is
conducted to better understand the underlying pathophysiological mechanisms of TBI and improve
TBI treatment strategies.

There are many misconceptions about traumatic brain injuries, their recovery and outcome; misconceptions that have their origin in a lack of information influenced by the image that the media show of the brain damage. Development. Based on clinical experience, the authors of this essay sets out his personal view on some of the most frequent misconceptions in the field of neuropsychological rehabilitation of traumatic brain injury: 1) All deficits are evident; 2) The recovery depends mainly on the involvement of the patient: more effort, more rapid recovery; 3) Two years after traumatic brain injury there is no possibility of improvement and recovery; and 4) The “miracle” of recovery will occur when is found the appropriate professional or treatment. These and other beliefs may influence directly or indirectly on the recovery process and the expectations placed on it by the families and patients. Conclusions. Provide accurate, clear and honest information, at the right time, helps patients and their families to better understand the deficits, the course of recovery and to adapt to the new reality resulting from a traumatic brain injury.Rehabilitation For Brain Injuries Essay


Causes of acquired brain injury (ABI)

Acquired brain injury is any damage to the brain that happens after birth. The specific symptoms or losses of functioning depend on which brain areas are affected.

Some of the causes include:
alcohol or drugs – which can poison the brain
disease – such as AIDS, Alzheimer’s disease, cancer, multiple sclerosis or Parkinson’s disease
lack of oxygen – called anoxic brain injury (for example, injury caused by a near drowning)
physical injury – such as an impact (or blow) to the head, which may occur in vehicle or sporting accidents, fights or falls
stroke – when a blood vessel inside the brain breaks or is blocked, destroying the local brain tissue.
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How ABI affects a person Rehabilitation For Brain Injuries Essay

The long-term effects of brain injury are difficult to predict. They will be different for each person and can range from mild to profound.

It is common for many people with ABI to experience increased fatigue (mental and physical) and some slowing down in how fast they can process information, plan and solve problems. They may experience changes to their behaviour and personality, physical and sensory abilities, or thinking and learning.Rehabilitation For Brain Injuries Essay

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How the brain works

The brain is the powerhouse of the body, even though it only makes up two per cent of the body’s weight. This soft, jelly-like organ has countless billions of neural cross-connections. It functions using a combination of electrical and chemical means.

The brain oversees the workings of the body, and gives us consciousness and personality. It is divided into two halves; the left hemisphere and the right hemisphere. Each hemisphere is further subdivided into lobes.

Different functions happen in different parts of the brain, which is suspended in a chemical ‘soup’ called cerebrospinal fluid. This fluid nourishes the brain and serves as a shock absorber. The brain is connected to the rest of the body through the spinal cord. Together, the brain and spinal cord make up the central nervous system.Rehabilitation For Brain Injuries Essay

Traumatic brain injury

Traumatic brain injury (TBI) is not the same as head injury, since a person can sustain damage to the face, scalp and skull without necessarily injuring their brain. TBI is considered a form of acquired brain injury, and refers to brain damage caused by an impact to the head.

When the head is struck hard, the brain slams against the inside of the skull, causing physical injuries such as bruising, swelling, bleeding, twisting or tearing of tissue. There are degrees of injury, ranging from a momentary loss of consciousness (which can happen from a punch to the face, for example) to a long-term bout of unconsciousness or coma.Rehabilitation For Brain Injuries Essay

Treatment for brain injury

A range of tests, including x-rays and CT brain scans, can help pinpoint the exact areas of damage. In some cases, surgery may be needed. Recovery depends on the extent and location of the brain damage, the age and general health of the person, the speed of first aid received and the quality of treatment.

The consequences of a person having an ABI are far reaching. Coping with any loss of functioning and going through rehabilitation can be difficult. The person with an ABI will have great distress. Family, friends and partners will also experience difficulties as they deal with emotional and practical challenges, interruptions to family life and role changes.Rehabilitation For Brain Injuries Essay

An ABI can affect intimate relationships, friendships, social networks, recreational and vocational activities. It may force the person and their immediate family to adapt to a completely new way of life and new kinds of relationships.

Caring for someone who has had a brain injury may bond a family closer together. It can also mean enormous burdens for the family, which may tear it apart.

It will help if family members:
have good information about the effects of ABI
appreciate the difficulties that might be encountered
understand that recovery is a slow process.
For carers to cope with the situation, it helps to:
stay with the present, rather than brooding about how catastrophic the future may be
highlight strengths and daily achievements, rather than the weaknesses
make time to care for themselves
be wise enough to ask for help when it is needed. Rehabilitation For Brain Injuries Essay