Therapy for Traumatic Brain Injury

Traumatic Brain Injury

The brain is arguably the most complex organ in the body, and protecting it is extremely important for survival. However, there are times a traumatic brain injury (TBI) can occur regardless of safety measures taken.

While not all head injuries affect the brain, the severity of injury when a TBI does occur can range from mild to severe. Most are mild and commonly referred to as concussions, but moderate or severe injuries can lead to permanent brain damage, disabilities, and behavioral changes. 

What Is Traumatic Brain Injury?

A traumatic brain injury is a type of acquired brain damage. It occurs when harm, such as a bludgeoning or concussive explosion, happens to the brain. A TBI will most likely occur when something violently hits the head or an object penetrates the brain tissue itself. 

The Center for Disease Control and Prevention reports that since 2001, there has been a slow but steady rise in the number of people who experience traumatic brain injury in the United States, with over 2.5 million people affected each year. For men, the spike was as much as 40%, while women saw a 20% increase overall.

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A significant portion of the population, around 4%, dies each year from preventable TBIs, such as those caused by automobile accidents, blunt force trauma, and dangerous lifestyle habits. Because a TBI can ultimately lead to decreased mental capacity, monitoring healthy brain activity after such an event is crucial.

Diagnosis and Symptoms

Recognizing a traumatic brain injury is not always easy, as symptoms may not appear until days or weeks after the injury and can range from mild to severe. Symptoms of a mild TBI include:

  • Loss of consciousness for a few minutes only
  • Headache and/or neck pain
  • Lightheadedness
  • Blurred vision
  • Dizziness 
  • Ringing in the ears
  • Fatigue
  • Bad taste in mouth
  • Trouble with memory and concentrating
  • Changes in sleep patterns
  • Behavioral changes

A person with a moderate to severe TBI will typically exhibit some symptoms of a mild brain injury in addition to some of the following:

  • Persistent headache
  • Seizures
  • Nausea and/or vomiting 
  • Dilated pupils
  • Weakness or numbness in extremities
  • Slurred speech
  • Inability to awaken from sleep
  • Loss of coordination
  • Restlessness or agitation

Anyone who experiences a head injury and shows signs of a moderate or severe injury should seek medical attention as soon as possible. Imaging tests are used to confirm diagnosis and prognosis of traumatic brain injury. Health care professionals may conduct a neurological exam, skull and neck X-rays, or a CT scan to determine the extent and severity of any injury. 

Treatments and Therapies for TBI

Research on the causes and effects of traumatic brain injury in the U.S. is increasing as these injuries rise. Researchers are focused on discovering effective treatments for TBIs, and at this time, treatment for moderate to severe TBIs can include medical procedures, medications, speech or physical therapy, or psychotherapy.

Emergency care is recommended for people with moderate to severe injuries. The sooner a person with a TBI seeks treatment, the better their prognosis is likely to be. Although little can be done to reverse the effects of the injury, medical professionals will try to stabilize the patient and prevent further injury and inflammation. Medications such as diuretics, anti-seizure drugs, and coma-inducing medicines can be administered to prevent secondary injuries. 

There are several recommended therapy choices when it comes to traumatic brain injuries. One of the most effective methods is psychotherapy without the use of surgeries or psychotropic medications. However, this is usually only possible when the traumatic brain injury is mild to moderately severe. Cognitive behavioral therapy (CBT), insight oriented therapy, relaxation training, development of social skills, and anger management can also be useful in helping a person understand and accept the injury as well as adjust relationships and roles after the injury, when necessary.

Although there are many avenues for treatment, one constant is the importance of good health care providers. Lisa Danylchuck, LMFT, E-RYT, a psychotherapist who specializes in trauma, adds, “Neuroimaging can help, but often people come away from this treatment with as many questions as answers. For this reason, having providers who are empathetic and committed to seeking solutions for clients' challenges is an important aspect of recovery.” 

Living with a Traumatic Brain Injury

When a traumatic brain injury occurs, the functioning of neurons, nerve tracts, and entire sections of the brain can be affected, depending on the location and severity of the injury. When neurons and nerve tracts are impacted, the brain is often unable to function as usual. This can lead to changes in the way a person thinks, feels, and behaves. According to Danylchuck, “The challenge for people coping with TBI is that the brain plays a significant and complicated role in mood stability. It can be difficult to differentiate the source of mental and emotional challenges.” 

Brain injury can cause mild impairment or complete inability to function that may be temporary or permanent. Injuries to the brain can also affect other bodily system functioning including blood pressure, temperature regulation, bladder control, and bowel movements. Common disabilities due to TBI include:

Having a solid personal support network is equally important for those living with a traumatic brain injury. When someone is affected by a TBI, their entire family is also often impacted. Depending on the severity of the injury, a person’s interpersonal relationships and social life may also be impacted. It is not uncommon to develop difficulty processing emotions, remembering loved ones, and be unable to engage in basic daily living activities such as bathing, eating, and cleaning. Family and friends are an important part of the ongoing rehabilitation process. Support groups are available for those suffering from TBI as well as their impacted loved ones. 

Traumatic Brain Injuries and Veterans

Traumatic brain injuries gained mainstream interest due in large part to the service members returning home after sustaining wounds from improvised explosive devices, or IEDs, while serving in Iraq and Afghanistan. At the height of the wars, 78% of all combat injuries reported were the result of explosive munitions. The concussive effects of these blasts made a mild TBI or concussion one of the most common combat-related injuries. In fact, approximately 15% of all U.S. troops who engaged in active combat in Iraq or Afghanistan may have suffered some level of traumatic brain injury.

Case Examples of Traumatic Brain Injury

  • Traumatic Brian Injury from vehicular accident: Albert, 31, is an experienced police officer who recently endured a tragic motor vehicle crash while on duty. Albert hit his head on the steering wheel during the crash and lost consciousness. Albert was airlifted after the accident to a hospital where he had an MRI conducted to scan for internal damage. The MRI determined that Albert suffered a severe traumatic brain injury as part of the crash. Albert was transferred to a rehabilitation facility for the traumatic brain injury where physical therapists helped him work on regaining speech capability and motor function. He also sees a psychologist who is working to help him assess and regain some of his short-term memory functions. Albert will be on a structured treatment plan for a few months to assess his progress and what, if any, changes occur in his behavior.
  • Traumatic Brain Injury from explosive munitions: Jessica, 23, is a former U.S. soldier who served time in Iraq. During a convoy escorting relief supplies to a village in Anbar province, she was injured in a roadside bomb attack. Jessica only suffered minor abrasions, but she was knocked unconscious by the improvised explosive device. Several months later, she returned home to Texas after being discharged from the military. She begins experiencing severe headaches and feels like no matter how much she sleeps, she still wakes up tired. Confused and angered by the conditions she is experiencing, Jessica starts feeling depressed and hopeless as her headaches grow more severe. Jessica finds it extremely difficult to get out of bed some days and has decided to make an appointment with her VA mental health counselor, who suspects her conditions are related the attack in Iraq, to schedule an MRI.

References:

  1. Beatty, C. (2009, June 22). Interventions for behavioral problems after brain injury. Brainline.org. Retrieved from https://www.brainline.org/article/interventions-behavioral-problems-after-brain-injury
  2. Living with brain injury. (n.d.). Brain Injury Association of America. Retrieved from http://www.biausa.org/living-with-brain-injury.htm
  3. Rates of TBI-related emergency department visits, hospitalizations, and deaths by sex — United States, 2001–2010. (February 2014). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/traumaticbraininjury/data/rates_bysex.html
  4. Traumatic brain injury and PTSD. (n.d.). National Center for PTSD. Retrieved from http://www.ptsd.va.gov/public/problems/traumatic_brain_injury_and_ptsd.asp
  5. Traumatic brain injury information page. (n.d.). National Institute of Neurological Disorders and Stroke. Retrieved from http://www.ninds.nih.gov/disorders/tbi/tbi.htm
  6. Traumatic brain injury. (2014, May 15). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/basics/treatment/con-20029302 
  7. Traumatic brain injury. (n.d.). S. Department of Veterans Affairs. Retrieved from http://www.publichealth.va.gov/docs/vhi/traumatic-brain-injury-vhi.pdf
  8. Traumatic brain injury. (2017, October 3). U.S. National Library of Medicine. Retrieved from https://www.nlm.nih.gov/medlineplus/traumaticbraininjury.html

 

Last updated: 12-21-2017

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