acquired brain injury

n Acquired Brain Injury (ABI) is a disorder that occurs after birth as a consequence of certain events and is non-genetic, non-degenerative and non-congenital. It results in brain damage that leads to temporary or permanent changes in the body functions. ABI can result in impairments of the cognitive, physical, emotional and behavioural functions, which in turn, may lead to specific or widespread disabilities. However, it does not include brain damage as a consequence of neurodegenerative diseases.

Since ABI involves damage to some portion of the brain, the patient’s life is adversely affected. The changes due to ABI may include –

  • Health issues like epilepsy
  • Deteriorated sensory abilities  like impaired vision, touch and smell
  • Impaired physical capabilities including general weakness, tremor and spasticity
  • Diminished thinking and learning abilities like forgetfulness and poor attention span
  • Altered behaviour and personality changes like  being short-tempered, lethargic, stressed   or depressed
  • Communication difficulties like   slow or slurred speech and  difficulty in speech comprehension

Causes of ABI

  • Traumatic Brain Injury (TBI) which implies physical trauma caused by accidents, assaults, neurosurgery and head injury.
  • Non-Traumatic Injury caused by various external and internal factors including
  • Stroke
  • Brain Tumours
  • Infections and diseases
  • Poisoning
  • Near drowning or other related anoxic events(total depletion of oxygen)
  • Hypoxia(deprivation of oxygen levels at tissue level)
  • Ischemia(inadequate blood supply to organs)
  • Encephalopathy(brain dysfunction)
  • Substance abuse including alcohol and drugs

Types of ABI

  • Cerebral Hypoxic Brain Injury – This happens when the brain receives only a partial amount of the oxygen that is needed for functioning efficiently. It may be a result of choking, electric shocks, high altitudes, severe attacks of asthma or complications arising from general anaesthesia. The oxygen dearth and limited blood circulation in the brain cause the injury. The impact may vary depending on the duration of oxygen deprivation or the way the oxygen supply was hampered. Treatment of cerebral hypoxia primarily involves removal of the source that hinders the oxygen supply. Other remedies include preventive drugs, antibiotics for infections, surgical procedures for blockage removal, usage of assistive devices and psychotherapy for patients and their family.
  • Cerebral Anoxic Brain Injury – This is caused when the brain is completely deprived of oxygen supply. Brain tumours, electric shock impulses, very low blood pressure and other related trauma can cause anoxic brain injuries. In severe cases, the hypothalamus and pituitary gland in the brain responsible for hormone production is affected. It may also result in various physical, cognitive and emotional changes in the patient. Treatment targets identification of the injury cause and preventing it. Other cure strategies include speech, occupational and physical therapies, patient health education sessions, support group activities and counselling on nutrition, exercise and mental health.

Impact of ABI

The outcome of ABI and timescales for recovery are completely dependent on the nature of the injury and the extent of its severity and damage. Consequences involve making crucial life adjustments which have a significant impact on patient recovery and rehabilitation.ABI patients, particularly seniors, may face emotional problems such as depression, loss of self-control, difficulty in managing anger and problem-solving challenges leading to social isolation issues. Hence elderly care at home  should address these psychosocial aspects to prevent low self-esteem and dejection. Additionally, such patients are likely to experience memory loss and disorders due to the decline of cognitive functioning. So there may be partial or permanent memory lapses.

Rehabilitation procedures for ABI, therefore, vary due to injury type and organs impaired. Rather than pre-defined protocols, treatment involves a customized multi-disciplinary approach by doctors, nurses and therapists.

Deploying Home Healthcare Services can support ABI rehabilitation substantially with a patient- centred approach outlined by personal needs and goals to achieve functional independence.

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