Traumatic brain injury is an ever-increasing issue in the U.S. For example, our war veterans often come home with brain injury, and thanks to the ever-increasing ability of medicine to save lives after severe trauma, more of our non-military citizens survive devastating injuries as well. Children playing contact sports are also at risk of concussion and more severe brain injury.
After the arduous experience of getting through hospitalization and surgery or whatever other treatment is required, it may seem that the battle is over, but this is not the case. There are often permanent changes in the person who suffers a traumatic brain injury (TBI), and they can be difficult to deal with for both the injured person and the people around her.
One of problems with traumatic brain injury is that even moderate injury can leave cognitive deficits that become chronic. The number and severity of deficits can be hard to predict, and they can be subtle. The sufferer may not realize the full extent of the changes or issues, leaving those around her to cope with her neurological dysfunction.
According to the American Association of Neuroscience Nurses, “Compared to mild TBI patients who recover by 3 months, moderate TBI recovery takes more than a year. Though studies that specifically define moderate TBI report a 38-82% good recovery rate on the GOS (Glasgow Outcome Scale), they also report that more than 80% still reported cognitive and behavioral problems at 1 year after injury with only 73% returning to work.”
Patients can experience hormone dysregulation after brain injury related to pituitary dysfunction that requires treatment. The cranial nerve responsible for sense of smell can shear off during trauma and permanently decrease or eliminate the sense of smell, which can also affect sense of taste. Other chronic issues after brain injury can include:
• Impaired judgment
• Poor impulse control
• Short-term memory changes
• Emotional lability
• Chronic headache including cluster headaches
• Personality changes
• Inappropriate anger
• Balance/vestibular issues
It is crucial to be evaluated regularly after TBI to manage new or continuing issues as they arise. It may be necessary to see a neuropsychologist for evaluation and treatment. Physical and occupational therapy, cognitive therapy, and counseling can help patients go back to work and cope with the changes in their cognition.
Resources:
Brain Injury Association of America
http://www.biausa.org/
Brain Trauma Foundation
http://www.braintrauma.org/
Sources:
Bader MK & Littlejohns LR. (2004). AANN Core Curriculum for Neuroscience Nursing (4th Ed.). St. Louis, Saunders.
NINDS Traumatic Brain Injury Information Page
http://www.ninds.nih.gov/disorders/tbi/tbi.htm