Traumatic Brain Injury

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AASEP's Comprehensive Overview of Traumatic Brain Injury (TBI)

Click Here to go to AASEP's comprehensive overview of Traumatic Brain Injury. For numerous other links related to this topic, refer to the variety of topics below. 


Accommodations/Modifications

  • Excellent list - This list of classroom modifications and strategies may assist the student as he/she returns to school following an acquired injury to the brain.
  • Related to residential life - Upon request, a paid student guide is provided to help establish paths and locate classrooms in the early days of the new semester. It is the responsibility of the student and her family to ensure that she has acquired training in mobility techniques by a professional mobility instructor prior to her arrival on campus...
  • On college campus - The mission of the Disablility Support Service is to coordinate services that ensure individuals with disabilities equal access to University of Maryland College Park programs.

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Adults with TBI

  • For spouses - When a husband sustains a brain injury, the family's life is forever changed. In the efforts to rehabilitate the survivor, the devastating effect on the spouse is often overlooked.
  • For spouses - September 19, 1989, a date I will never forget, is the day my whole life changed. I am the spouse of a severe brain-injury survivor. The past eighteen months have been a time that is most difficult to put into words. No one (except for another spouse) can fully understand the pain, frustration, loneliness, isolation and exhaustion that I have felt.
  • Sexuality and brain injury - Relationships are in progress when brain injury happens. We get through the immediate crisis by default because of the many players in the incomprehensible medical drama that is unfolding. We are all numb temporarily. The brain-injured person seems protected by coma and post traumatic amnesia.
  • Survivor’s view - It is called head injury, traumatic brain injury, and acquired brain injury. But it all essentially means the same thing-- a person has sustained an injury to his/her brain that may change his/her life forever.

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Advocacy Information

  • Advocacy defined - Advocacy is a type of problem solving designed to protect personal, and legal rights, and to insure a dignified existence.  There are many types of advocacy.  For example, system advocacy, is useful for changing "the system;" additionally, it is used to promote causes. Legal advocacy is what lawyers are paid to do, and  legislative advocacy is designed to change laws.

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Assessment

  • Assessment scales - Information on brain injury assessment and evaluation rating scales, including the diability rating scale, glasgow coma scale, and rancho los amigos.
  • Assessment sites - A condensed list of assessment sites.

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Assistive Technology

  • Good site for technology solutions - Brain injury is a thief. Whether caused by stroke, cerebral aneurysm, brain tumor, anoxia, apoxia, or other disease or trauma, it steals freedom from all it touches.  However freedoms lost to brain injury can be regained, at least in part. You can do it, we can help - with information, support, and (our specialty) assistive products.
  • Good overview of sites - Assistive technology can mean anything from simple devices such as Post-it Notes to sophisticated computerized equipment, PDAs, computers, reminder tools, and much more. Below are links to articles to help start exploring possibilities.
  • Brief explanation - Assistive technology can sometimes be the key to a loved one's independence, self-confidence and overall happiness. Assistive Technology is any device, resource or service, which aids the patient to improve any skill, which is hindering his/her functional ability. These devices may vary from a simple hearing aid, to a more high tech augmentative communication board as used in speech therapy.
  • List of devices and distributors - A long and detailed list of devices, distributors of assistive devices, and resources related to TBI.

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Audio/Video Tapes

  • Selected topics - A moderately extensive list of videos related to TBI

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Books and Publications

  • Extensive list of articles - Articles related to TBI
  • Selected books - The internet's largest online traumatic brain injury bookstore. The TBI Resource Guide - in association with Amazon.com - has compiled over 200 books specializing in the field of neurological injury, treatment and outcome. You can browse the bookstore by keyword, alphabetically or by category.
  • Bibliographies up to 1998 - While dated may contain interesting topics for further research
  • Extensive list on TBI resources - Journal articles, books, and other publications related to TBI

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Causes

  • Overview of causes - Brain injury is unpredictable in its consequences. Brain injury affects who we are, the way we think, act, and feel. It can change everything about us in a matter of seconds.

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Characteristics

  • Symptoms - After an impact to the head, a person with a brain injury can experience a variety of symptoms but not necessarily all of the following symptoms. This information is not intended to be a substitute for medical advice or examination.

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Classifications or Types of

  • Good list - The brain can receive several different types of injuries depending on the type of force and amount of force that impacts the head. The type of injury the brain receives may effect just one functional area of the brain, various areas, or all areas of the brain.

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Classroom Management

  • Educator’s guide to the brain- The brain, our brain, is quite elegantly the supreme organ of learning. All that we do, all that we are, emanates from our brain. Yet, few educators in their undergraduate or graduate work receive detailed information on the brain and how the brain learns or what is happening (or not happening) when the brain does not learn well.
  • Memory process - Improving one's memory after a brain injury seems to be a life-long struggle. Books and audiotapes available on improving memory skills most readily apply to the non-injured population, and the additional steps involved only seem to make the memory process even more difficult.
  • Case study - At the Hospital Jimmy was seen by a team of pediatric specialists. He was operated on to remove a large subdural hematoma. Jimmy was in the PICU for 3 weeks until he began to regain consciousness. During that time he was followed by neurosurgery, neurology and internal medicine. He was evaluated by physical medicine and a core of rehabilitation therapies were started to improve his range of motion, feeding and swallowing, and his ability to attend and respond to his environment.
  • Attention skills - Attention skills are an important factor in the recovery from traumatic brain injury for two reasons. First, attention disorders are seen in the majority of traumatic brain injuries.
  • Functional IEP’s - The Individual Education Plan (IEP) is the driving force that supports the entire educational program planning for students with special needs. For the student, the IEP is the educational map we use to guide what we do with the student. For the family members, the IEP is the contract between the family and school for the delivery of educational services to their child. As each student is different, each IEP needs to be different to meet the unique needs of the student.
  • Understanding inclusion - Inclusion is the practice of educating students with disabilities in "regular" education classrooms, classes which they would attend if they did not have a disability. Special instruction is delivered by a special education teacher within the classroom. This article will attempt to clarify the issues surrounding inclusion, define terminology associated with inclusion, and help the reader to understand several placement options related to inclusion.
  • Recovery strategy-back to school - About a year after my brain injury, I was told to do something about community re-entry. This meant finding a place to go where people wouldn't notice my difficulties. I decided to attend a continuing education certificate program in holistic health two nights a week for one school year. My limp toes were admired as "so relaxed." I heard people talking about a lot of interesting things. My silence was viewed as composure. I couldn't study for the tests but I was assured that tests were not used to eliminate people...
  • Communicating needs to instructors and professionals - I'm sitting in a huge, so it seems, classroom among many unfamiliar faces. Everything is different, these people, surroundings, and circumstances. I'm further away from the security I know, my home, from the people I know. And now, further away from myself, since my brain injury. But my dreams are still very close, I want to finish school.
  • Victim’s perspective of school - A few years after my injury, the Texas Rehabilitation Commission agreed to give me a shot at returning to school. What they neglected to do was assign a counselor to me that knew brain injury and was able to be involved in the process. Instead, I was on my own with the clock running. As horrible as it was, I can't imagine what it must be like for someone who doesn't have some awareness of what they need or, atleast, have someone available to help them figure it out.
  • A model of TBI peer support- The Traumatic Brain Injury Model System of Care at Santa Clara Valley Medical Center in San Jose, California is providing a unique new peer support service for individuals with a brain injury and their families, based on the investigated needs of the community of individuals with a traumatic brain injury (TBI) and their families.
  • Adolescents with TBI - Adolescence is a time of growth, freedom, adjustment, and, unfortunately, injury. During adolescence the rate of traumatic brain injury increases dramatically, with the number of severe injuries sustained between ages 15 and 19 equal to all the previous 14 years combined. Most traumatic brain injuries during adolescence are related to motor vehicle accidents. This is the time when adolescents are beginning to get their driver's licenses and are spending much of their time "on the move."
  • Helpful glossary of terms associated with TBI - Terms in this section were drawn from Taber's Cyclopedic Medical Dictionary, 14th edition, 1981, Mosby's Medical and Nursing Dictionary, 2nd edition, 1986, The Merck Manual, 13th edition, 1977, DSM-IV.

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Definition

  • Brain injury glossary - The Brain Injury Glossarywas edited by L. Don Lehmkuhl, PhD, of the Texas Medical Center. Copyright 1992, by HDI Publishers.
  • Excellent overview of brain injury-legal perspective - Here at new york city personal injury lawyers are knowledgeable in a wide range of personal injury cases and have numerous strategies to use while representing you. State law usually governs personal injury lawsuits but federal law under certain circumstances could apply. The brainstem controls your eyes for one of specific drugs may cause hallucinations and sleeping!

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Diagnosis

  • Diagnosis and management - The in-hospital guidelines have been accepted by the American Association of Neurological Surgeons (AANS), the first such protocols ever accepted by the Association.  These guidelines are also endorsed by the World Health Organization's (WHO) Committee on Neurotraumatology.

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Frequently Asked Questions

  • Good selection of questions - What is an Acquired Brain Injury?  Is it only an ABI if there has been coma?  What are the symptoms of an ABI?...
  • Head injury - Ruth Hutchison, M.S. and Terry Hutchison, M.D., Ph.D., and The Texas Head Injury Association State Chapter of the National Head Injury Foundation, in collaboration with members of the Texas Head Injury Association, provide the following answers to questions frequently asked by head injured people, their families and friends, and professionals.

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Medical Issues/Medications

  • Pharmacology guide - Carbidopa/L-Dopa (Sinemet) | Levodopa (L-Dopa) | Bromocriptine (Parlodel) Baclofen (Lioresal) | Dantrolene (Dantrium) | General References...
  • Excellent coverage - Just as no two people are alike, no two brain injuries are alike. Appropriate treatment and rehabilitation will vary from individual to individual. Programs and treatments change, as a person's needs change. It is important to recognize that "more therapy" does not make a person "better", but that "appropriate" therapy may.
  • Hypothermia treatment - The University of Cincinnati Department of Neurosurgery is seeking public input before it launches federally funded research aimed at improving the odds that patients who suffer severe traumatic brain injury will go on to live a normal life.
  • Treatment protocol and mild TBI - Review pain medications to avoid medications which can cause dependence or rebound headache. Avoid over the counter medications that contain caffeine such as Excedrin, Anacin. Gradually reduce caffeine intake, in particular, for individuals with irritability or sleep disruption...
  • National Institutes of Health - Although studies are relatively limited, available evidence supports the use of certain cognitive and behavioral rehabilitation strategies for individuals with TBI. This research needs to be replicated in larger, more definitive clinical trials.

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Organizations

  • Brain Injury Association of America - The Brain Injury Association of America was founded in 1980 by a group of individuals who wanted to improve the quality of life for their family members who had sustained brain injuries. Despite phenomenal growth over the past two decades, the Association remains committed to its grassroots. The Brain Injury Association of America encompasses a national network of more than 40 chartered state affiliates across the country, as well as hundreds of local chapters and support groups.
  • Good list of TBI resources - From AbleData systems.
  • National and worldwide associations - There are many, many organization sites out there including those of various BIA State Chapters and Affiliates. However, we are only including those sites that are actually hosted by the organization itself and even then we are limiting inclusion to those who have specific, pertinent and unique information available (more than just membership information only. We apologize if this inconveniences anyone.)
  • Coma Recovery Association - CRA is a non-profit support organization for coma and brain injury survivors, family members, friends and professionals.
  • International Brain Injury Association - The International Brain Injury Association (IBIA) is dedicated to the development and support of multidisciplinary medical and clinical professionals, advocates, policy makers, consumers and others who work to improve outcomes and opportunities for persons with brain injury.
  • Brain Injury Society - The Brain Injury Society is a federally-exempt 501(c)(3) corporation committed to empowering persons living with conditions caused by a brain injury. The organization works with clients, families and caregivers to identify strategies and techniques to maximize the new found potentials for a stronger recovery. In this way individuals recovering from brain injuries are better able to lead active, productive and meaningful lives while becoming as independent as possible in a rarely given second chance.

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Overview and General Information

  • Excellent overview - Traumatic brain injury (TBI) is damage to the brain caused by an external physical force. The damage may occur from the movement of the brain within the skull or from penetration of an object into the skull, contacting the brain directly. TBI can result in cognitive dysfunction, physical impairment, or psychological disturbance.
  • Children and adolescents with TBI - It is called head injury, traumatic brain injury, and acquired brain injury. But it all essentially means the same thing-- a person has sustained an injury to his/her brain that may change his/her life forever. In fact, the largest killer and disabler of our children is not AIDS nor cancer, it is brain injuries. When one considers the schoolage population of survivors, those survivors under age 21 outnumber all other ages combined (NHIF, 1994). Yet, children and adolescents with brain injuries have not received the same recognition nor services as have adults with brain injuries.
  • The Perspective Network - The Perspectives Network, Inc.'s  primary focus is positive communication between persons with brain injury, family members/ caregivers/friends of persons with brain injury, those many professionals who treat persons with brain injury and community members in order to create positive changes and enhance public awareness and knowledge of acquired/traumatic brain injury.
  • Good overview - The number of children and adolescents in this country sustaining traumatic brain injuries is staggering.  Each year one million youngsters are taken into emergency rooms with brain injuries resulting from motor vehicle accidents, falls, sports, and abuse (National Head Injury Foundation, Inc., 1992).  Approximately 165,000 of these children will be hospitalized, with 20,000 suffering moderate to severe symptoms.
  • Interesting overview - Traumatic brain injury (TBI) is one of the leading causes of death and lifelong disability in the United States today. According to statistics from the Centers for Disease Control and Prevention (CDC), out of the estimated 1.5 million yearly survivors of TBI in the United States, approximately 90,000 are left with permanent disabilities. As a result, more than 5 million people are living with TBI-related disabilities. Men are affected 3 times as often as women, with the leading causes of TBI being motor vehicle accidents (MVAs), falls, and violence (CDC, 1999).
  • General overview- Traumatic brain injury (TBI) is damage to the brain caused by a blow to the head. The severity of the injury may range from minor, with few or no lasting consequences, to major, resulting in profound disability or death.
  • Legal overview - The purpose of the Traumatic Brain Injury (TBI) Update is to inform those lawyers interested in TBI cases about recent developments in the neurobehavioural literature. The first Update (The Verdict, December/94) reviewed the literature in the field of mild traumatic brain injury (MTBI).

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Parent Information

  • Roles of the family - The role of the family in the rehabilitation process is paramount to the child's continued recovery and changing needs. Professionals need to recognize the omnipotent role that families have as "partners" in the care of their children.
  • Guidelines for parents - Your child has sustained an injury to his/her brain. The brain controls how we think and communicate, how we act and feel, and how we move about our world.  The following tips may help you guide your child through the "confusion" that is common in the early stages of recovery.
  • About siblings and peers - Siblings and peers need to be part of the information loop concerning their brother/sister/friend. The ideas that follow will help parents, relatives, friends, and teachers enable the sibling or peers understand TBI and the injury itself and provide continuity as their brother/sister/friend recovers and returns home.
  • Self esteem, empowerment and social action - Those who have experienced "serious medicine" have seen that model in action and experienced its effects on the mind and soul. It starts in white coats (uniforms of intimidation?), is driven by a faux expertise and believes that the worst thing that can happen is death. It steals dignity from customers by calling them "patients." Remember that Webster defines "patient" as: "one who is acted upon."
  • Disability benefits - If a brain injury has permanently or temporarily prevented you from working, you may be eligible for Social Security disability benefits. The time between applying for and receiving benefits, however, can be a very lengthy one. By knowing what to expect from the application process, you can spare yourself some of the frustration many applicant's experience. You should also be aware of when you should contact a lawyer to help you pursue disability benefits.
  • Stress management - We all know that caring for a TBI survivor is stressful. Many studies have shown that TBI caregivers have very high levels of stress, anxiety, and depression. At the same time, studies also show that due to the isolating nature of being a caregiver, TBI caregivers have very low levels of social support. This creates a situation which could be detrimental to your health and also make it harder for you to be a caregiver for your loved one.
  • Sports and recreation resources - A nice list of sport and recreation resources for individuals suffering from traumatic brain injury.

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Prevalence

  • Overview - Head injury is the No. 1 killer and disabler of persons under the age of 44. It is estimated that 55,000 Canadians incur a traumatic brain injury each year. In Saskatchewan, about 2,500 people incur a head injury each year. That's five persons injured a day!
  • Charts and statistics - On an annual basis in the United States: 1.5 million people will sustain a TBI annually; 50,000 people will die annually as a result of TBI...
  • Facts and stats - This Annual Incidence Comparisons Charts are now available for download. To view full image please click on the thumbnail. To download right click on the file name and choose file save as. Files are very large, please allow time for download.

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Transition Services

  • AASEP's comprehensive overview of 18 types of transition services

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