Acquired brain injury (ABI), also called traumatic brain injury (TBI), represents one of the leading causes of death and disability in adults and affects more than one million Americans annually. As the name implies, ABI is an acquired, as opposed to an inborn, condition occurring as a result of a sudden, physical jolt that damages the brain. Depending on the circumstances surrounding the incident, injuries can range from mild to severe and affect one or more areas of the brain. In all cases, however, ABI is devastating to those who suffer its effects.
More than 50,000 Americans die every year because of ABI. Millions more live with ABI-related disabilities. Fortunately, the law enables those who suffer from ABI as a result of the negligence, wrongdoing, or inaction of another to seek compensation for their losses.
Types of Acquired Brain Injury
- Closed – This type of brain injury frequently occurs as a result of the rapid movement of the brain inside the cranial cavity and is marked by the bruising and/or tearing of blood vessels and tissues. More specifically, a closed brain injury is one in which the injuries are completely internal and do not penetrate the skull bone. Falls, car accidents, or any incident involving excessive shaking often causes closed brain injuries.
- Penetrating or Open – A penetrating brain injury, also called an open brain injury, is characterized by a break in the skull bone. Bullet wounds are a primary example of a penetrating brain injury.
- Diffuse Axonal – Commonly referred to as DAI, this type of injury involves the tearing of nerve fibers caused by the shifting and rotating of the brain inside the skull. DAI often causes injury to multiple areas of the brain and coma.
- Primary – This type of brain injury refers to one that is sudden but complete, meaning the injury is non-progressive. Examples of primary brain injuries include those sustained as a result of gunshot wounds, car accidents, and falls.
- Secondary – Unlike primary brain injuries, secondary brain injuries are those that continue to evolve or progress after the injury is sustained. These continued changes – which can be cellular, chemical, tissue, and/or blood-related –contribute to further brain damage.
ABI Treatment and Rehabilitation Programs
The vast majority of those who suffer from ABI require some kind of medical treatment. ABI treatment and rehabilitation generally has two goals with regard to the patient: to maximize cognitive functioning and to improve overall quality of life. Treatment and rehabilitation for acquired brain injury victims depends on various factors including the type of injury and its severity as well as patient health and family/community support. ABI treatment and rehabilitation programs are individualized based on a thorough assessment of these factors, but may include any of the following:
- Physical care – such as nutritional and medication needs
- Pain management – medication and other methods for alleviating the pain associated with ABI
- Psychological care – includes the administration of various tests to identify any behavioral and/or emotional problems as well as necessary counseling
- Self-care skills – such as bathing, grooming, and feeding
- Communication skills – speech therapy and alternative modes of communication
- Mobility skills – may include wheelchair use or walking device
- Socialization skills – focuses on interactions with family and community
- Cognitive skills – to enhance memory, problem solving, concentration, and other areas of cognitive functioning affected by the injury
- Vocational skills – work-related training
- Family support – includes patient/family education and training on the numerous issues relevant to living with ABI
Acquired Brain Injury Coma
In some severe cases of acquired brain injury (ABI), also referred to as traumatic brain injury (TBI), patients may lapse into a coma. A coma is an altered state of consciousness in which a patient is either completely unconscious and does not respond to any amount of stimulation or has a reduced consciousness and responds only to certain stimuli. The depth and time a patient is comatose depends on the location and seriousness of the acquired brain injury. While some patients wake up and fully recover from a coma, many will suffer significant life-long disabilities.
Measuring a Coma
In emergency and intensive care settings, the depth or severity of a coma is typically measured on the Glascow coma scale, which evaluates eye, verbal, and motor responses on a scale from three to 15. A lower score indicates a lower level of consciousness and awareness.
In ABI treatment and rehabilitation settings, a coma is measured on a different scale – called the Rancho scale – that is used to determine the patient’s response level and ability to function. This scale is based on the patient’s reaction to his/her environment and outside stimuli and measures this reaction according to the following eight levels:
- Level I – Complete absence of any response to stimuli.
- Level II – General, mild response to pain or repeated stimuli.
- Level III – Response to stimuli is more localized (following a command), but is inconsistent and often delayed.
- Level IV – Heightened level of response, but patient is confused and agitated.
- Level V – Responses are more alert, but patient is confused, non-purposeful, and usually inappropriate. Impaired memory.
- Level VI – Behaviors and response are purposeful, but direction is required. Improved memory.
- Level VII – Patient is performing daily tasks with little confusion, but actions seem “robot-like.” Problem solving, thinking, and judgment are still impaired.
- Level VIII – Memory and basic skills are highly improved, however, patient may still need to be supervised because of impaired cognitive abilities.
Causes and Consequences of Acquired Brain Injury
There are numerous causes of ABI—the most common being motor vehicle accidents. Approximately 28 percent of ABI cases occur as a result of motor vehicle accidents and usually lead to severe injury and even death. Another common cause of acquired brain injury is from firearms. Ninety percent of all ABI cases stemming from firearms are fatal. Slip and fall accidents are the leading cause of ABI in adults over 65 and physical abuse or violent shaking is the leading cause of brain injury in infants and young children. Other catastrophic incidents such as sporting accidents and medical malpractice can also cause severe damage to the brain.
The effects of an acquired brain injury can vary depending on the severity of the injury. In some cases, the symptoms are mild and go away with proper treatment. Mild symptoms include headache, confusion, dizziness, fatigue, blurred vision, change in sleep and behavioral patterns, and more.
Some more serious consequences of acquired brain injury include:
- Cognitive Defects – Coma, amnesia, shortened attention span, problem solving and judgment deficits, loss of space and time perception
- Motor Sensory Complications – Weakness, paralysis, poor balance and coordination, spasticity, reduced endurance, tremors, problems swallowing
- Perceptual and Sensory Defects – Loss or change in sensations, tastes, hearing, touch, and smell, and vision problems
- Language and Communication Problems – Difficulty speaking, writing, reading, or identifying objects
- Functional Complications – Difficulty with daily activities such as bathing and dressing, organizational problems
- Social and Psychiatric Changes – Problems understanding or interacting in social situations, irritability, decreased motivation, depression, anxiety
- Traumatic Epilepsy – Two to five percent of ABI victims experience seizures
- Death – Many cases of ABI result in death
The costs associated with treating an acquired brain injury can be substantial and vary on an individual basis. Some victims of ABI require long-term care and rehabilitation while others short-term or less intensive treatment.
If you or someone you love is suffering from ABI, you probably feel overwhelmed—emotionally, physically, and financially. We may be able to help. Please contact us today for a FREE case evaluation with a caring and competent personal injury lawyer who can help you understand your legal rights and options.