What is Brain Injury?

Brain injury occurs suddenly, without warning. In an instant life is changed, forever. Everyday we participate in activities that produce endless risks for sustaining a brain injury; events include a car accident while driving to the grocery store, a fall from a bike, or a blow to the head.

Brain injury has become a significant medical and societal concern within the last 30 years. With advances in medical technology, many people who would have died are now surviving severe brain injuries. At times the cost is astronomical: financially, socially and emotionally.

It is estimated that thousands of Canadians incur a traumatic brain injury each year the majority being young adults. They will have a normal life expectancy but will require special care. A majority of bicyclists who die each year die of brain injuries. Most of the serious brain injuries can be prevented by wearing a helmet. Brain injury affects a significant number of people each year and the numbers are reaching epidemic proportions.[1]

Statistics indicate that the incidence of brain injury is two times greater in men.

Effects of Brain Injury
Although each individual is unique, the sequels resulting from a brain injury often have similarities. Some of the sequels can include difficulty with memory loss, impaired reasoning skills, and tendency toward “one track thinking.”

Imagine not remembering names and faces of lifelong friends or turning on a burner with a pot and not remembering having done so. Many persons with brain injuries will also have physical disabilities such as paralysis of the limbs or loss of vision and/or hearing. Some people experience varying degrees of speech impairment. Others may be able to speak, but due to cognitive impairments, have difficulty organizing their thoughts into meaningful speech. Some people lose their sense of smell, suffer from headaches or have to cope with having seizures. It is quite difficult to rely on others to plan your day.

Emotional effects vary as well as the person with a brain injury will see changes in emotional control. This may be related to the brain injury or to the frustrations that the person feels as he tries to adapt to his new self.

Realization of the effects of the injury combined with the increased dependence on others and/or a loss of control over one’s life may be cause for depression.

The social consequences of a brain injury can be devastating. Many people report losing friends and having difficulty cultivating and maintaining new friendships. These difficulties may result from the person experiencing problems with communication. Imagine the frustration of having difficulty remembering ideas and communicating them coherently and logically during a conversation. Loudness of the speech and knowing when it is appropriate to speak are examples of social skills that we all take for granted. In addition, subtle social skills may have been lost.

It is important to note the strength and character of these people. Once again all persons are unique, with varying injuries, personalities and supports available. Although there may be tremendous amount of loss to cope with, many people with brain injuries remain determined, sensitive and positive to their approach to life.

Although the effects of brain injury may make it necessary for the injured person to have assistance for up to 24 hours in a day, families often remain or become the primary caregiver and support person. Many families are left to cope on their own, with little understanding of the effects of the injury and the demands of living with an injured family member. Families need support of others who understand the stress within these family systems.

Just as no two people are alike, no two brain injuries are alike. Appropriate treatment and rehabilitation will vary according to the needs of the individual. Programs and treatments change, as a person’s needs change. It is important to recognize that “more therapy” does not make a person “better”, but that “appropriate” therapy may. A person with a brain injury may transfer to different facilities throughout the recovery process. A rehabilitation program would generally look at the following components: cognitive, behavioral, vocational, educational, community re-entry and recreation. The active involvement of family members and friends throughout the rehabilitation process is a key component to achieve maximum success. Some province have a “continuum of services” where the person with a brain injury will go through the hospital, rehabilitation centre, back home and will then use the services of specific community programs.

What Can You Do?
The effects of a brain injury can be varied and unique as the individuals who sustain them. Since brain injuries occur in different areas of the brain with varying degrees of severity, no two people will be affected in the same way. An injury to the brain may affect a person in several ways including his personality, thinking, communication, or mobility.

We cannot see many of the changes that a survivor of a brain injury experiences. It is often difficult for others to understand and accept changes in personality and thought processes, as these changes are not visible.

Some of the more common effects of a brain injury are changes in memory, concentration, response time, planning and problem solving, initiative, flexibility, insight, impulsivity, control of anger, talking, behavior, dependence, emotional stability, depression.

Following a brain injury, the person may experience any number of these effects in varying degrees. Individuals working with a person with a brain injury will need to be particularly sensitive, observant and flexible.

Survivors Of Brain Injury Are Saying:
· Courage is what it takes to keep going after a brain injury.
· Treat us with dignity, respect and love in spite of our challenges.
· We rely on your good advice.
· Tell us when improvement will take a long time.
· Get to know us as a person and learn to communicate with us.
· Find out what motivate and keep us going.
· We need your encouragement to do our best.
· Positive feedback is far better than patronization .
· We need to take a risk sometimes.
· It is difficult for our old friends to “handle” the injury and it is hard for us to make new friends.

Canadian Motor Vehicle Traffic Collision Statistics for 2003* indicates that there were 222,260 victims[2]. Detailed statistics on the number of neurological disease, disorders and injuries[3] are not readily available and requires more research. Being a new organization, we will work closely with provincial organizations, medical institutions and governments to collect data to be converted into reliable statistics for Canada in the future.

Transport Canada – Road Safety Statistics and Reports
Saskatchewan Brain Injury Association – Description on website: www.sbia.ca
[1]Ref: Saskatchewan Brain Injury Association – Description on website. Received authorization to use and adapt their text.
[2] Data for Nunavut are not reported for 2001 and 2003 except for fatalities. Data for Ontario are preliminary for 2003.
[3] “injuries” include all those who suffered any visible injury or complained of pain following a road accident.

Severe Brain Injury, Interview with Dr. Rolf B. Gainer, Ph.D.