Traumatic Brain Injury (tbi): Causes and Side Effects

Traumatic Brain Injury

Traumatic Brain Injury (TBI) is a major health concern to health-care professionals and to the public. Each brain injury is unique when it comes to its physiological, physical, social, and psychological complications. However, the literature provides an overview of brain injuries from different aspects. This paper presents information collected from previous research, peer-reviewed articles, and case studies that looked at TBI in various conditions.

TBI is defined as a “TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force” (Menon, Schwab, Wright, and Maas 2010). External forces such as car accidents, violence, and sports seem to be common causes of TBI, especially among young adults (Ruberts et al., 2011). The recent statistics on the epidemiology of TBI in the United States provides that “each year 235 000 Americans are hospitalized for nonfatal TBI, 1.1 million are treated in emergency departments, and 50 000 die” Corrigan, Selassie, & Orman (2010). The numbers are high and considerable; therefore, it is important to be knowledgeable about the different aspects and outcomes of brain injuries.

Each brain injury presents its symptoms, and causes dysfunctions, throughout the body depending on the severity and the location of the damage. For diagnosis purposes, clinician use medical advances such as MRI, CT scans and X-rays. They also collect information about the medical history of the individual, the level of consciousness during the injury and poet the injury. The symptoms should be relatable to the injury for a better diagnosis (Menon et al., 2010).

Some general symptoms of traumatic brain injuries include alteration in memory functions, physical abilities, mental status, and interpersonal behaviors. There is a high impact of brain injuries on the quality of life. Some people become physically disabled for the rest of their lives which without a doubt affect their emotional and psychological well-being. TBI may also cause a deterioration in mental functions such as not remembering people, things, or being aware of time which may result in poor self-care and dysfunctional relationships. It is obvious that brain traumas do affect not only the person who is injured but also the people around.

For instance, Family members of an injured person will need to change their lives and daily routines so they can fit this sudden issue, and that is usually challenging. Therefore, proper diagnosis, treatment, and rehabilitation plans for the patient and his/her social circles are crucial when dealing with brain traumas. Brain injury treatment includes pharmacological medications, physical rehabilitation, psychological rehabilitation, and presence of proper social support system.

Psychosocial Aspects

People respond to their brain injuries vary depending on their personalities, socio-economic status, social lives. The accessibility to medical facilities and advances is also important when dealing with brain traumas. Brain injuries are often traumatic and result in different forms of disabilities. Thus, post- traumatic stress and depression are expected to be parts of the major psychological outcomes to such conditions.

In mild traumatic brain injuries, for example, a study looked at 1167 individuals who were hospitalized and underwent different PTSD assessments. The study found that traumatic brain injuries result in PTSD and they attributed the level of the stress to the area of the brain damage. For instance, damage to the medial prefrontal cortex may lead to severe cases of stress as there will be deficits in emotion regulation (Bryant et al., 2009).

This finding supports the fact that the area of the damage constitutes to the outcomes of the injury. However, the factor data from a study suggest “that early depressive symptomatology is not comprised entirely of brain injury-related somatic and cognitive symptoms; rather, depressed affect, the lack of positive affect, and interpersonal problems also contribute” (Dikmen et al., 2004). That means, there are external factors that would affect the overall psychological well-being of a person with a history of TBI.

Physical disability caused by brain traumas leave people unsure about how to go about their daily lives activities and unsure about how would they manage their pain. They are worried about who will be taking care of them, how they are going to eat, get their groceries and communicate with other people in the society. There could also be a huge concern about the community and its stigma on a disabled person. All these worries can be ongoing sources of stress and depression if not dealt with in a healthy manner.

Vangel, Stephen Rapport, & Hanks found that poor caregiver’s well-being influence the outcomes of TBI (2011). Therefore, there is a need for well-prepared caregivers when it comes to supporting people with traumatic brain injuries. A family of an injured person would need to acknowledge the challenges that they will face, deal with them, and seek help if needed so they can minimize the distress on the disabled person as well as the whole family dynamic.

Stress, pain, and helplessness may lead a person to be aggressive. Aggression is found to be one of the consequences of TBI. A study examined aggression levels (verbal and physical) among individuals with TBI within three months’ period from the injury. Researchers in this study found that it is common for people with TBI to be verbally aggressive especially when it comes to allowing a caregiver to take care of their personal needs or when it comes to stopping them from childhood, or adulthood, maladaptive behaviors such as drug abuse (Rao et al., 2009).

Aggression can also be caused by uncontrollable pain. When an injured individual suffers from some internal pain, he/she could be easily irritated and therefore aggressive to their surroundings. Also, some people engage in substance abuse or alcohol over consumption to manage their physical and psychological pain. However, these behaviors could lead to further negative side effects in which aggression is one of them.

Social withdrawal is another essential element of a life of a disabled person. Without proper social and medical support, a person with a disability would highly prefer to be isolated from the society. Acquiring health coping strategies improves a person’s life quality even with the presence of a form of invalidity. One research found that there is a relation between the coping style and the outcomes. The escape and the avoidance techniques resulted in maladaptive behaviors and therefore deterioration in the overall psychological wellbeing including higher levels of depression and anxiety. On the other hand, “Strategies characterized as active, interpersonal, and problem-focused tend to be associated with higher self-esteem and positive affect following TBI” (Anson & Ponsford, 2006).

An injury could cause significant physical and psychological challenges towards going back to work and pursuing careers. Re-integration in society could be overwhelming and just impossible to some. However, some studies show that “TBI patient will successfully return to work is not feasible, with RTW rates in the 12 – 70% range” (Shames, Treger, Ring, & Giaquinto, 2007). Preparing and improving the outcomes of mildly and severely injured individuals requires a multidisciplinary approach that includes medical and psychosocial approaches.

Brain Injury Case

In this section, I provide details about the interview with a person who had a brain injury. The names I provide for this case are not real, and I am only using them for this case summary.

Copper is fifty years old male who had a brain injury in 1996 due to gang related violence and assaults. He got a shot in his forehead, while he was trying to kill someone else, and got hospitalized for it for 6-12 months. Doctors at that time were determined that Copper will never walk again and said that the pieces of metal in his head would kill him within five years. Copper did not die, but he lost the ability to talk at that time. He used to communicate with his surroundings by hands pressure.

Before the injury, Copper was an active man with a high sense of humor which resulted in him being sociable and likable by the people around him. He was always clean and smells nice. Socially, he had five kids with different women, and he used to be a drug dealer. His life may not seem as perfect, ordinary life of a man at his age, still, the injury did affect his overall lifestyle and negatively impacted it.

After the injury, Copper had to go to his physiotherapy sessions so it can help his physical limitation. After a while, Copper started walking with the assistance of a cane. In a later point, he got thoroughly drunk and decided to throw his cane away, and that’s when he walked on his own without any external aid. After he had been discharged from the hospital, he went to live with his mother for around a year. He used to have issues of involuntary urination while sleeping. He used to accuse his brother of doing it rather than admitting it. He also stopped taking care of himself and his overall hygiene. He smelled bad; he quit showering, his breath was ugly.

On a social level, Copper got more isolated from people and disliked getting in contact with others. However, he still had a couple of sexual relationships going with his different women. Copper was careless about the well-being of these women and the well-being of himself he just used others to find some shelter and a home. He smokes marijuana and abuse other drugs. He became a drug addict and often got in troubles and conflicts with drug dealers.

These experiences in the drugs mainstream put him into a threat of death for the second time, but he was still doing it. His primary caregiver, his cousin June, along with everybody else around Copper, lost hope in him. They gave up trying to help him to get back to a normal life. Copper refused to get proper help, and he ended up living in the streets. June is now helping Copper’s kids and taking care of them to replace their father’s absence and dysfunctional behavior.

Analysis of Copper’s case

The personal experiences of Copper represent some important aspects of Traumatic Brain Injury. It is apparent that the overall well-being of Copper got negatively impacted by his injury. Copper has had stressful times, and he might have had PTSD because of his experience with the violent attack. Copper’s life before the injury is also important to consider because it was not a safe or stress-free environment. Therefore, it is expected that the chances of him being severely depressed and aggressive after his injury are very high.

According to the research mentioned earlier in this paper, a person with a disability could turn to be aggressive when someone tries to help them. In copper’s case, he decided that he will throw away his cane when he was drunk. This action represents his aggressive and compulsive behavior that resulted from consuming a considerable amount of alcohol. At a point, he lost his ability to think and judge a situation; therefore, he went away from his cane. It is also evident that he engaged himself in dysfunctional behavior for the sake of avoidance and escaped from his pain and stress. Copper was involved in sexual relationships and had new babies from different women without being able to make healthy decisions about the kids that he already had before and not able to raise and be there with them.

The area of the injury might be one of the factors when assessing and evaluating Copper’s condition. He got shot in his forehead which may have had affected specific areas responsible for judgment and critical thinking. So, it is important to keep this in mind while comparing literature findings with his situation.

Copper also shows depressive symptoms by ignoring his physical appearance and overall cleanliness. He is not taking care of his body smell, bad breath and general health and well-being. He might be highly depressed and lost interest in regular daily activities. He is also socially withdrawn, which reflect that he is not interested and not engaged with the surroundings. He does not see a benefit from being in contact with other people.

Copper comes from a lower socio-economic status, and his life has always been affected by different factors whether personal or societal. Thus, brain injuries that occur within such a demographics are harder to manage and improve.

The literature shows that to improve an outcome of a TBI; there must be a multidisciplinary approach that takes place immediately after the injury. A system that includes well established medical care system, rehabilitation facilities, psychological intervention, and proper assistance to the family and caregivers is needed.

Conclusion

Traumatic brain injury is a broad topic that is hard to narrow down to a couple of papers. However, it is always crucial to understand different aspects of this injury. Brain injuries are different, and each one is unique when it comes to its etiologies, symptoms, and complications. However, the literature provides critical views on the topic from different perspectives. It also contains information and details about dealing and adjustment with various areas of the injury. As there are high numbers of victims of TBI, it is important to increase the awareness of such conditions and to involve the families, social circles, and all caregivers in such a topic.

The impact of TBI is huge on the individuals’ quality of lives, as well as the quality of life of the community. However, proper understandings and well-thought actions, bring tremendous benefits to the lives of the sufferers and the surroundings. It is also important to acknowledge that time plays a prominent role when rehabilitating disabilities. The immediate and the consistent treatments are, the better the outcomes.