Brain Injury and Concussion
What is a Brain Injury?
A brain injury occurs when the brain has been damaged. From a neurological perspective, damage may be comparatively minimal (concussion), or extensive (moderate to severe brain injury). It is important to remember, however, that the true impact of the brain injury is realized when we measure the impact of the symptoms on your life.
It is very difficult to predict brain injury recovery and the exact symptoms you will experience, because symptoms vary depending, not only on the part of the brain that was injured, but the parts of the brain that the injured area works with.
Even a mild concussion may have far-reaching effects depending on several factors including the health of the brain at the time of injury, past injuries, the part of the brain that has been injured, and the impact of your specific symptoms on your life.
A brain injury can be sustained in many different ways. These include sport concussion, blast injury (military), lack of oxygen to the brain (anoxic brain injury), stroke, traumatic brain injury due to a car accident, fall, or being struck with an object.
What are the Symptoms of Brain Injury?
The range of possible symptoms following brain injury is broad. Although brain injury classification ranges from mild traumatic brain injury/post concussive syndrome to moderate and severe brain injury, it is important to note the symptoms that may be experienced at any point along the spectrum. For example, an individual with post concussive syndrome may experience significant attention issues, and an individual with severe traumatic brain injury may experience severe sound sensitivity.
Some of the impact of symptoms must be measured against life demand. For example, someone who works at a fast food restaurant will struggle if they experience visual and sound sensitivity, and may not be able to return to their pre-injury job. On the other hand, someone who works alone in a quiet office may be able to manage their environment enough that they are able to return to what they were doing before the injury.
- Cognitive: Impaired attention, concentration, distractibility, memory, processing speed, confusion, perseveration (stuck points), impulsiveness, language processing, executive function (organization, emotion regulation, planning, decision making)
- Speech and Language: Slurred speech, problems reading or writing, receptive aphasia (difficulty understanding language), expressive aphasia (difficulty speaking language)
- Sensory: Difficulty interpreting sensory information (smell, vision, touch, temperature, etc.)
- Perception: The brain’s interpretation of sensory information
- Vision: Partial or total loss of vision, decreased colour vision, weakness of eye muscles, double vision, blurred vision, difficulty judging distance and contrast, involuntary eyes movements, light sensitivity.
- Hearing: Change in hearing, tinnitus, sound sensitivity
- Physical Changes: Paralysis or spasticity, chronic pain, bowel and bladder control, body temperature regulation
- Sleep disorders: Excessive sleepiness, insomnia, disrupted circadian clock
- Social-emotional: Impaired motivation, emotion regulation, irritability, anxiety, depression, aggression, lack of awareness or understanding of the impact of injury
Mild TBI Symptoms:
- Sensitivity to light or noise
- Behavioural or emotional dysregulation
- Fatigue or lethargy
- Blurred or double vision
- Seeing stars or lights
- Balance problems
- Sleeping more than usual
- Difficulty falling asleep
- Feeling “slowed down”
- Feeling “in a fog” or “dazed”
- Difficulty concentrating
- Difficulty remembering
How Can Renew Neurotherapy Help?
After an injury, the brain’s ability to think can become slowed or ‘foggy.’ The speed of organizing and using information can be decreased (information processing); skills such as planning, setting goals and achieving them, making decisions, finding the motivation to complete daily activities, paying attention, remembering, and even resuming previously learned skills such as math, reading and writing can become overwhelming.
Renew therapists can help you find and integrate the best techniques to promote recovery. For example, many clients comment on difficulty both deciding what to pay attention to, and then focusing and sustaining attention. These functions are managed in different parts of the brain, so the same rehabilitation strategy won’t work for both of them. A skilled therapist can guide you through the rehabilitation process.
Cognitive rehabilitation is beneficial throughout the range of recovery. Early following injury, you may require support for activities such as dressing (picking and organizing clothes). As you recover, support may be needed to help plan meals and coordinate grocery shopping. Once you are ready to return to work, you may need support to help organize and plan your day, learn new ways of reading and remembering information, planning out phone calls, etc.
Mental Health Support
Many people don’t realize that symptoms related to anxiety and depression are very common following a brain injury, and directly linked to the injury. It was previously thought that all mental health symptoms were due to life changes after the injury. We now know that is not the case. When a brain injury occurs and cells in the brain are damaged, this impacts the delicate chemical balance that helps maintain efficient thinking and mood management.
Beyond the chemical changes that impact mental health is the challenge of accepting the ‘new you.’ The life changes that follow a brain injury are difficult and can contribute to mental health issues and life satisfaction.
Renew therapists incorporate mental health support into brain injury rehabilitation.
Just like you would if you broke a leg, it is important to alternate between periods of activity and rest to ensure that you give your brain the exercises it needs to resume function; but not so much that you become completely exhausted. When you walk too much on an injured leg, you begin to feel pain. The pain tells you that it’s time to stop moving and rest. It’s a bit more complicated that that when it comes to the brain! Our brain doesn’t give us a pain signal. Instead, it become bogged down and tired. It struggles to keep up with all of the information coming at you (sight, sound, smell) and becomes overwhelmed. Many clients report that all of their symptoms increase. Learning how to balance activity and rest in a way that allows your brain the right amount of learning is very difficult. Although the concept seems very easy, it is extremely difficult to put into practice!
Lifestyle Modification to Optimize Brain Health
We all know that our bodies function best when eating healthy, sleeping well, exercising, and practicing self-care (rest, enjoyable time with family and friends, breathing and other activities to support mental health).
The same principles apply to our brains.
It’s important to remember that scientific research has taught us that happiness results in improved healing.
You Renew clinician will work with you to help establish a rehabilitation routine that takes your brain health into account. Your brain’s ability to heal is compromised when it is not in its healthiest state.
One of the most important factors impacting brain injury rehabilitation is support and environment! If you live in a calm, supportive and organized home with enough time to rest when required and daily support to work on your rehabilitation, you are well set up for recovery.
Family and Caregiver Support
Brain injury is not easy. Although most medical and rehabilitation attention is paid to the injured person, we must remember that family members and caregivers experience the injury too. Family and friendship dynamics change overnight. It can be overwhelming and devastating for all parties. Research tells us that both the family and caregivers and the brain injured client can expect better life satisfaction and recovery when they are supported and establish an open and supportive communication style.
Renew therapists support families and caregivers through the process of rehabilitation and recovery.
Neurofeedback therapy begins with a brain map that can show your therapist the patterns of brain function that may contribute to your symptoms. Once the patterns are identified, brain training sessions can be completed to help ‘normalize’ and/or reorganize the brain activity to improve its ability to function more efficiently and flexibly. Once the brain is better able to regulate itself, symptoms are better managed.
Screening and Referrals
As you have seen there are many, many possible brain injury symptoms, including visual disturbances, vestibular issues (balance, nausea), headache, movement disorders, speech and language disorders, and more.
Renew therapists are trained to screen for these issues of concern and will refer you to providers who are able to help