Acquired brain injury (ABI)

Overview

Acquired Brain Injury (ABI) refers to any damage to the brain that occurs after birth, distinguishing it from congenital or genetic brain disorders present from birth. ABI can result from a wide range of causes, both traumatic and non-traumatic. Traumatic brain injuries often result from physical impacts, such as falls, car accidents, or sports injuries. At the same time, non-traumatic causes include conditions like strokes, brain tumours, infections (such as meningitis or encephalitis), or exposure to toxins, such as alcohol, drugs, or environmental pollutants. The effects of ABI can be broad and diverse, varying greatly depending on the severity, location, and type of injury. Some individuals may experience mild symptoms, such as headaches or memory issues, while others may face more severe impairments, including paralysis, cognitive deficits, speech difficulties, or personality changes. The impact of ABI can be temporary or long-lasting, and recovery often involves a combination of medical treatment, rehabilitation, and support for managing the physical, cognitive, and emotional effects of the injury¹. 

Causes of Acquired Brain Injury (ABI)

The most common causes of ABI include²:

• Traumatic brain injury (TBI): Traumatic brain injury (TBI) occurs when an external force causes damage to the brain, making it a leading cause of disability and death among adults³. Common causes of TBI include car accidents, falls, assaults, sports injuries, gunshot wounds, and violent shaking. While the term "head injury" is often used, "TBI" is more precise, as it specifically refers to injuries that impact brain function, distinguishing them from superficial injuries like cuts or bruises on the face or scalp that do not affect the brain.
• Stroke: Strokes are a frequent non-traumatic cause of acquired brain injuries. They occur when there is a blockage in the major blood vessels in the neck, which can result from a blood clot, artery hardening, or other factors. This blockage restricts blood flow to the brain, depriving it of the oxygen-rich blood essential for its function⁴.
• Hypoxia/anoxia: Hypoxic and anoxic brain injuries occur when brain cells do not receive sufficient oxygen. Just like the rest of the body, the brain requires oxygen to operate properly, and any interruption in its oxygen supply can result in serious health issues or even death.
• Infection: Bacterial or viral infections may cause inflammation of the brain coverings (meningitis) or brain tissue (encephalitis). This inflammation can lead to brain swelling, which can kill nerve cells or cause bleeding (haemorrhage), resulting in brain damage.
• Tumour: Brain tumours can harm the tissue where they develop and damage surrounding areas and neurological pathways as they grow.
• Alcohol and other toxins: Toxins, such as lead or mercury, can lead to brain damage either from a single exposure or through repeated exposure over time. Alcohol also acts as a toxin, and long-term abuse can harm the brain.
• Degenerative neurological diseases: Degenerative neurological diseases progressively disrupt brain function as they advance. The diseases include Multiple Sclerosis (MS), Huntington's disease, Parkinson's disease, Motor Neurone disease, and Alzheimer's disease (and other dementias).

Symptoms of Acquired Brain Injury (ABI)

Common symptoms of ABI include⁵:

• Medical difficulties: Medical difficulties like epilepsy can significantly impact a person's daily life due to unpredictable seizures, which may vary in frequency and severity. These seizures can lead to safety concerns and require ongoing medical management to control symptoms and reduce risks.
• Altered sensory abilities: Altered sensory abilities such as impaired vision, touch, or smell can affect how individuals interact with their environment. Vision impairment might make it difficult to read or navigate spaces, while changes in touch and smell can influence personal safety and quality of life by affecting balance and the ability to detect hazards like smoke or spoiled food.
• Impaired physical abilities: Impaired physical abilities, including weakness, tremors, and spasticity, can limit mobility and dexterity. This might make it challenging to perform everyday tasks, such as dressing, writing, or using tools, and can lead to increased reliance on assistive devices or caregivers.
• Impaired ability to think and learn: Impaired ability to think and learn often manifests as forgetfulness and poor attention, making it difficult to process information or complete tasks. This can affect academic performance, job responsibilities, and everyday decision-making, leading to frustration and a need for adaptive strategies or support.
• Altered behaviour and personality: Altered behaviour and personality changes, such as becoming short-tempered, lethargic, or experiencing flat or depressed moods, can strain relationships and social interactions. These changes may require psychological support or medication to manage effectively and maintain quality of life.
• Impaired ability to communicate: Impaired ability to communicate, including slow or slurred speech and difficulty following conversations, can hinder effective interaction. This may lead to misunderstandings and social isolation, necessitating speech therapy or alternative communication methods to improve engagement and expression.

Acquired Brain Injury (ABI) and TCIH Approaches

• Craniosacral therapy: Craniosacral therapy can be highly effective in reducing symptoms of acquired brain injuries, including concussions and traumatic brain injury (TBI). By improving the flow of cerebrospinal fluid, it helps remove waste around the brain, which can alleviate symptoms such as headaches, dizziness, confusion, irritability, and chronic pain. This therapy is especially beneficial for athletes, accident victims, and anyone recovering from brain injury, offering a valuable tool for post-injury recovery⁶.
• Neurofeedback: In the initial stages following a traumatic brain injury, neurofeedback can help alleviate common symptoms such as headache, nausea, irritability, mental confusion, and sleep disturbances. Over time, it can also support improvements in energy, alertness, fatigue, cognitive issues related to the injury, sensory sensitivity, and executive function. Additionally, memory function is likely to improve as recovery progresses⁷. 
• Sound therapy: A form of sound therapy which involves music has been shown to have been shown to improve mood, enhance quality of life, and support cognitive recovery for individuals with acquired brain injury (ABI). They can also boost physical performance, including walking, upper limb function, and speech while improving communication skills such as voice, speech, and language⁸.