Traumatic Brain Injury

A brain injury can change your life in an instant. It may affect how you think, how you feel, how you behave, how you move and what you remember. However, remarkable progress has been made in the treatment and rehabilitation of patients who have had a brain injury.

The multidisciplinary team at the Mischer Neuroscience Institute at Memorial Hermann-Texas Medical Center is dedicated to providing exceptional care to patients with brain injury.

In addition to the personalized care that you receive at the institute, please refer to this page to help you and your loved one navigate the journey to recovery. Along with learning about key milestones and expectations of brain injury patients, you will find important resources, clinical details and helpful suggestions for rehabilitation. We aim to be your partner as together we help you and your loved one recover from a brain injury.

What Is a Traumatic Brain Injury?

A traumatic brain injury (TBI) is usually the result of a sudden, violent blow to the head. Half of all traumatic brain injuries are caused by collisions involving cars, motorcycles and bicycles. TBI may also occur when a projectile, such as a bullet, rock or fragment of a fractured skull actually penetrates the brain.

According to the Centers for Disease Control and Prevention (CDC), 1.7 million persons sustain a traumatic brain injury annually. Of those, around 120,000 people will have long-term, substantial loss of function. For this reason, it is important to understand the risk factors and causes of brain injury.

To understand the types of brain injury, it is important to know the different functions of the brain.

Lobes of the Cerebral Cortex

• The brain stem is responsible for basic life functions such as breathing, arousal and consciousness, attention and concentration, heart rate, and sleep and wake cycles.
• The frontal lobes are responsible for problem-solving, judgment and motor function.
• The parietal lobes manage sensation, handwriting and body position.
• The temporal lobes are involved with memory and hearing.
• The occipital lobes contain the brain’s visual processing system.

Skull Fracture

A break in one or more bones that surround the brain. Many times theses fractures heal on their own.

Contusion

A mild bruise to the brain. Side effects of a contusion may include headaches, nausea, vomiting, dizziness, and problems with memory and concentration. Surgery is usually not indicated.

Epidural Hematoma

A collection of blood that forms between the dura (outer covering of the brain) and the skull. Due to possible increases in pressure inside the brain, surgery may be needed.

Subdural Hematoma

A collection of blood outside of the brain. An acute subdural hematoma occurs when there is rapid bleeding in the brain. A chronic subdural hematoma may occur days or weeks after a minor injury to the brain. Due to possible increases in intracranial pressure, surgery may be needed.

Anoxic Brain Injury

Occurs when there is a lack of oxygen supplied to the brain.

Many brain injury patients may continue to experience neurological or physical symptoms following hospitalization. These may include cognitive, physical, personality and behavioral changes. Below is a list of possible changes that may occur, depending on the severity and location of the brain injury.

Confusion following brain injury can be very common. This may cause some agitation which may be treated with medications. Supervision by family may be recommended.

Cognitive deficits that may occur after a brain injury include memory loss, impaired decision-making skills, impaired communication, lack of safety awareness, and attention deficits.

Physical deficits could include inability to walk, decreased balance, impaired speech, weakness, impaired hearing or vision, and increased fatigue. Sometimes the most difficult effects of a brain injury are the changes to the personality of the individual who may experience more stress, irritability, agitation, and may feel denial, lack of motivation, depression and anxiety. There may be a loss of emotional control accompanied by mood swings. Please be aware of these changes and talk to a physician with any concerns.

Please keep in mind that recovery from a brain injury continues after hospitalization.

Brain injury not only impacts the individual with the brain injury but also the family and friends who surround them. Below is a list of helpful tips for caregivers, family and friends of patients on how to cope and adjust to changes following a brain injury.

Acknowledge Your Feelings About the Brain Injury

A brain injury may bring about emotional, physical and financial stress for the caregiver. Other emotions that may arise are denial, anger, depression, guilt or responsibility. These feelings are normal and are expected.

Remember to Take Care of Yourself

It can be physically and emotionally exhausting caring for a loved one. It is important for caregivers to take moments out of the day to focus on other things and do things that are part of their daily routine (e.g., read a book, call a friend, exercise, take a bath, etc.).

Rely on Your Support Network

Prior to leaving the hospital, caregivers should think about family and friends who may be able to assist the patient with the brain injury. Rely on the support system to help with the patient’s care, and also to assist with everyday tasks such as grocery shopping, running errands, cooking meals, doing laundry or cleaning the house. Some brain injury patients may require some type of supervision after discharge, so it is important to work with family, friends or community resources to work out a supervision plan for the patient.

Educate Yourself

It is important to speak with the medical team, nursing staff and therapists about the needs of the patient following brain injury. Take time to read articles and attend support groups if possible.

Some brain injury patients may experience increased agitation following their injury. If the patient becomes agitated or refuses to follow instructions, please try the following:

• Re-direct: Change the topic or task by discussing topics of interest to the individual.
• Give the individual time to calm down: Move away and give them time to calm down.
• Notice any type of stimulation that might cause the agitation (lights, outside noises, etc.): Try to reduce the amount of stimulation by closing the door, go to a quiet room, etc.

The road to recovery following a brain injury will vary depending on the extent of the brain injury. During the hospital stay, patients may be evaluated by physical, occupational and speech therapists to determine their rehabilitation needs.

While the rate for emergency room visits for TBIs has increased over the past decade, the rates for long-term hospitalization and death have actually decreased. It is possible that this improvement in survivorship could be attributed to brain injury rehabilitation programs like those at TIRR Memorial Hermann.

For Physicians: Refer a patient here »