Brain injuries can range in scope from mild to severe. Traumatic brain injuries (TBI) result in permanent neurobiological damage that can produce lifelong deficits to varying degrees.
Moderate brain injury is defined as a brain injury resulting in a loss of consciousness from 20 minutes to 6 hours and a Glasgow Coma Scale of 9 to 12;
Severe brain injury is defined as a brain injury resulting in a loss of consciousness of greater than 6 hours and a Glasgow Coma Scale of 3 to 8.
The impact of a moderate to severe brain injury depends on the following:
- Severity of initial injury
- Rate/completeness of physiological recovery
- Functions affected
- Meaning of dysfunction to the individual
- Resources available to aid recovery
- Areas of function not affected by TBI
The impact of a moderate to severe brain injury can include cognitive deficits including difficulties with:
- Attention
- Concentration
- Distractibility
- Memory
- Speed of Processing
- Confusion
- Perseveration
- Impulsiveness
- Language Processing
- “Executive functions”
- Speech and Language
- Not understanding the spoken word (receptive aphasia)
- Difficulty speaking and being understood (expressive aphasia)
- Slurred speech
- Speaking very fast or very slow
- Problems reading
- Problems writing
- Sensory
- Difficulties with interpretation of touch, temperature, movement, limb position and fine Discrimination
- Perceptual
- Integration or patterning of sensory impressions into psychologically meaningful data
- Vision
- Partial or total loss of vision
- Weakness of eye muscles and double vision (diplopia)
- Blurred vision
- Problems judging distance
- Involuntary eye movements (nystagmus)
- Intolerance of light (photophobia)
- Hearing
- Decrease or loss of hearing
- Ringing in the ears (tinnitus)
- Increased sensitivity to sounds
- Smell
- Loss or diminished sense of smell (anosmia)
- Taste
- Loss or diminished sense of taste
- Seizures
- Convulsions associated with epilepsy that can be several types and can involve disruption in consciousness, sensory perception, or motor movements
- Physical Changes
- Physical paralysis/spasticity
- Chronic pain
- Control of bowel and bladder
- Sleep disorders
- Loss of stamina
- Appetite changes
- Regulation of body temperature
- Menstrual difficulties
- Social-Emotional
- Dependent behaviors
- Emotional ability
- Lack of motivation
- Irritability
- Aggression
- Depression
- Disinhibition
- Denial/lack of awareness