Causes of Brain Damage

The basic definition of brain damage is an injury to the brain caused by various conditions such as head trauma, inadequate oxygen supply, infections, or intracranial hemorrhage. This damage may be associated with a behavioral or functional abnormality. The brain can be damaged in many ways and severity. Depending upon the type, location, and severity of any damage to the brain, the outcome can range from a complete recovery to some amount of disability or even death.

Some causes of brain damage can be:

Genetics - where a gene passed down to a child may prevent proper development of the brain

Trauma - where a physical blow from an object or fall causes physical damage to the brain

Loss of Blood Flow - where a blood clot from a stroke or loss of flow from a heart attack stops the flow of blood. Damage begins 4 minutes without oxygen

Tumors - where any abnormal growth invaded the brain causing pressure and pushing it aside, as well as taking needed oxygen away from it

All traumatic brain injuries are head injuries, but a head injury isn't necessarily brain injury. There are two types of brain injury that both the brain’s normal functioning:

Traumatic brain injury (TBI)

Typically caused by an external force, such as a blow to the head, that causes the brain to move inside the skull or damages the skull. This in turn damages the brain.

Acquired brain injury (ABI)

Typically occurs at the cellular level. It's most often associated with pressure on the brain such as from a tumor. It may also result from neurological illness such as multiple sclerosis (MS).

Both traumatic brain injury and acquired brain injury occur after birth. Neither is degenerative and sometimes the two terms are used interchangeably.

There is a kind of brain damage that results from genetics or birth trauma called congenital brain damage. It's not included in our discussion, but it's within the standard definition of brain damage or traumatic brain injury.

Most brain injuries cause focal (localized) brain damage, such as the damage caused when a bullet enters the brain. This typically means that the damage is confined to a small area. Closed head injuries frequently cause diffuse brain damage, or damage to several areas of the brain, such as both major speech and language areas might be involved.

The severity of brain damage can vary with the type of brain injury. A mild brain injury is usually temporary and causes such symptoms as headaches, confusion, memory problems, and nausea. In a moderate brain injury, symptoms can last longer and be more pronounced. In both cases, most patients make a good recovery.

With a serious brain injury, the person may suffer life-changing and debilitating problems. One may think of someone is in a coma or "vegetative" state if a serious brain injury occurs. MS, however, causes life-changing and debilitating problems that are caused by permanent brain damage.

Examples of Brain Damage

When the brain is starved of oxygen for a prolonged period of time, brain damage may occur. Brain damage can also occur as a result of a wide range of injuries, illnesses, or conditions. Because of high-risk behaviors, males between the ages of 15 and 24 are most vulnerable. Young children and the elderly also have a higher risk.

Causes of traumatic brain injury include:

•	blows to the head
•	car accidents
•	sports injuries
•	falls or accidents
•	physical violence

Causes of acquired brain injury include:

•	poisoning or exposure to toxic substances
•	infection
•	strangulation, choking, or drowning
•	stroke
•	heart attacks
•	tumors
•	aneurysms
•	neurological illnesses
•	abuse of illegal drugs

Symptoms of Brain Damage

There are numerous symptoms of brain damage, whether traumatic or acquired. They fall into four major categories: Cognitive, perceptual, physical, and behavioral/emotional.

Cognitive symptoms of brain damage include:

•	difficulty processing information
•	difficulty in expressing thoughts
•	difficulty understanding others
•	shortened attention span
•	inability to understand abstract concepts
•	impaired decision-making ability
•	memory loss

Perceptual symptoms of brain damage include:

•	change in vision, hearing, or sense of touch
•	spatial disorientation
•	inability to sense time
•	disorders of smell and taste
•	balance issues
•	heightened sensitivity to pain

Physical symptoms of brain damage include:

•	persistent headaches
•	extreme mental fatigue
•	extreme physical fatigue
•	paralysis
•	tremors
•	seizures
•	sensitivity to light
•	sleep disorders
•	slurred speech
•	loss of consciousness

Behavioral/emotional symptoms of brain damage include:

•	irritability and impatience
•	reduced tolerance for stress
•	sluggishness
•	flattened or heightened emotions or reactions
•	denial of disability
•	increased aggressiveness

Acquired Brain Injury

The term acquired brain injury (ABI) is used to describe all types of brain injury that occur after birth. The brain can be injured as a result of:

•	traumatic brain injury (TBI)
•	stroke
•	brain tumor
•	poisoning
•	infection and disease
•	near drowning or other anoxic episodes
•	alcohol and drug abuse
•	other disorders such as Parkinson's disease, MS, and Alzheimer's disease

Changes after ABI

Changes as a result of an acquired brain injury can include:

•	Medical difficulties (epilepsy)
•	Altered sensory abilities (impaired vision, touch, smell)
•	Impaired physical abilities (weakness, tremor, spasticity)
•	Impaired ability to think and learn (forgetful, poor attention)
•	Altered behavior and personality (short tempered, lethargic, depressed)
•	Impaired ability to communicate (slow or slurred speech, difficulty following conversation)

Recovery after brain injury differs from person to person because of the variations in where the brain is injured and extent of the brain injury. Impairments can be either temporary or permanent, and can cause either specific or more widespread disability. Individuals may also find that the nature of their problems may vary over time.

In the longer term most people with ABI report changes in learning, thinking and behavior while only 25% of people with a severe ABI will experience ongoing physical disabilities. These changes in learning, thinking and behavior are hard for other people to recognize. People who do not understand the difficulties associated with acquired brain injury may believe the person is lazy or being difficult.

Any changes, from mild to severe, require a period of adjustment, both physically and emotionally. Adjustment to these changes will not only affect the person who has had the brain injury but also the family, friends and caregivers who are supporting the person

How Are Brain Damage and Brain Injuries Treated?

Anyone who has a head or brain injury needs immediate medical attention.

A typical brain injury that seems mild (concussion) can be as dangerous as clearly severe injuries. The key factor is the extent and location of the damage. Brain injury doesn't necessarily result in long-term disability or impairment. But the correct diagnosis and treatment is needed to contain or minimize the damage.

The extent and effect of brain damage is determined by a neurological exam, neuroimaging testing such as X-rays or CT scans, and neuropsychological assessment such as checking reflexes. Doctors will stabilize the patient to prevent further injury, ensure blood and oxygen are flowing properly to the brain, and ensure that blood pressure is controlled.

About half of severely injured patients require surgery to repair a ruptured blood vessel or to relieve pressure on the brain.

If a patient is severely injured, rehabilitation may be ordered to assist in long-term recovery. That may include:

•	physical therapy
•	occupational therapy
•	speech and language therapy
•	psychological support

This may seem over-simplified and unrelated to MS, however, this simplified approach is basically what happens when one is being diagnosed. There isn't a ruptured blood vessel or an obvious direct trauma, but there is a direct attach within the brain that can be just as devastating.