Traumatic brain injury

Traumatic Brain Injury (TBI) is an injury to the brain caused by a trauma to the head (head injury). There are many possible causes, including road traffic accidents, assaults, falls and accidents at home or at work.

A brief period of unconsciousness, or just feeling sick and dizzy, may result from a person banging their head getting into the car, walking into the top of a low door way, or slipping over in the street. It is estimated that 95% of all head injuries fall into this category.

A moderate head injury is defined as loss of consciousness for between 15 minutes and six hours, or a period of post-traumatic amnesia of up to 24 hours. The patient can be kept in hospital overnight for observation, and then discharged if there are no further obvious medical injuries. Patients with moderate head injury are likely to suffer from a number of residual symptoms.

Severe head injury is usually defined as being a condition where the patient has been in an unconscious state for six hours or more, or a post-traumatic amnesia of 24 hours or more. These patients are likely to be hospitalised and receive rehabilitation once the acute phase has passed. Depending on the length of time in coma, these patients tend to have more serious physical deficits.

For further information, please visit the resources below:

Traumatic brain injury | Headway
Brain injury – Support for neurological conditions | The Brain Charity
Brain Injury Charity and Rehabilitation – Brainkind | Brainkind

Anoxic brain injury

What is hypoxic brain injury / anoxic brain injury?

Oxygen is needed for the brain to make use of glucose, its major energy source. If the oxygen supply is interrupted, consciousness will be lost within 15 seconds and damage to the brain begins to occur after about four minutes without oxygen.

A complete interruption of the supply of oxygen to the brain is referred to as cerebral anoxia. If there is still a partial supply of oxygen, but at a level which is inadequate to maintain normal brain function, this is known as cerebral hypoxia. In practice, these two terms tend to be used interchangeably.

For the purposes of consistency, this section of the website will use the terms anoxic brain injury or cerebral anoxia, unless hypoxic injury is specifically meant.

What causes hypoxic/anoxic brain injury?

There are many potential causes of cerebral anoxia, including:

  • Cardiac or respiratory arrest
  • Irregular heart rhythm or poor function of the heart muscle after a heart attack, resulting in inefficient supply of blood to the brain
  • Very low blood pressure (shock), resulting from blood loss (haemorrhage) or disturbed heart function
  • Suffocation
  • Choking
  • Strangulation
  • Very severe asthma attack
  • Complication of general anaesthesia (where there has been inadequate oxygen supply or cardiac arrest)
  • Near drowning
  • Exposure to high altitudes
  • Smoke inhalation
  • Carbon monoxide inhalation
  • Poisoning
  • Drug overdose
  • Electric shock

For further information, please visit the resources below:

Hypoxic and anoxic brain injury | Headway
Brain injury – Support for neurological conditions | The Brain Charity
Brain Injury Charity and Rehabilitation – Brainkind | Brainkind

Stroke/cerebrovascular accident & Cerebral Haemorrhage

What is a haemorrhagic stroke?

Haemorrhagic stroke is when you have bleeding in or around the brain. This can damage brain cells. Damage to brain cells can affect how the body works. It can also change how you think, communicate and feel.

It’s less common than ischaemic stroke, which is due to a blocked artery (blood vessel). Around 15% of strokes in the UK are haemorrhagic.
If you have a haemorrhagic stroke, you will have a brain scan and emergency treatment. Afterwards, you will have support for your recovery, including medical prevention treatment and rehabilitation.

There are two main types of haemorrhagic stroke.

Intracerebral haemorrhage (ICH) is where blood leaks out of a blood vessel into the brain tissue, sometimes deep inside the brain. ICH is the most common type of haemorrhagic stroke, and around two-thirds of all haemorrhagic strokes are ICH.

Subarachnoid haemorrhage

Subarachnoid haemorrhage (SAH) is where blood leaks out of a blood vessel on the surface of the brain and gets into the protective layer of fluid surrounding the brain. This layer is known as the subarachnoid space, and it helps to cushion the brain from injury. SAH is the least common type of stroke, causing about one in 20 of all strokes.

For further information, please visit the resources below:

Haemorrhagic stroke | Stroke Association

Subdural haemorrhage

Subdural haematoma

A subdural haematoma is bleeding inside the brain usually caused by a head injury. It can be very serious and usually has to be treated with surgery.

Symptoms of a subdural haematoma

A subdural haematoma can happen after a head injury.

The symptoms may start straight away, or come on gradually over a few weeks.

Symptoms of a subdural haematoma include:

  • a bad headache that does not get better after taking painkillers
  • feeling and being sick
  • confusion and memory problems
  • changes in personality, such as being unusually aggressive
  • drowsiness
  • slurred speech and problems with swallowing
  • problems with vision, like blurred or double vision
  • loss of balance and having falls
  • having problems moving one side of your body (paralysis)
  • seizures (fits)
  • loss of consciousness – the person affected may not respond when you talk to, or touch them; this may just last for a few moments or could be much longer

For further information, please visit the resources below:

Subdural haematoma – NHS
Brain injury – Support for neurological conditions | The Brain Charity
Brain Injury Charity and Rehabilitation – Brainkind | Brainkind

Encephalitis

Encephalitis is an uncommon but serious condition in which the brain becomes inflamed (swollen). It can be life threatening and requires urgent treatment in hospital. Anyone can be affected, but the very young and very old are most at risk.

Symptoms of encephalitis

Encephalitis usually starts off with flu-like symptoms, such as a high temperature and headache.

More serious symptoms come on over hours, days or weeks, including:

  • confusion or disorientation
  • seizures or fits
  • changes in personality and behaviour
  • difficulty speaking
  • weakness or loss of movement in some parts of the body
  • loss of consciousness

Dial 999 for an ambulance immediately if you or someone else has these serious symptoms.

Causes of encephalitis

It’s not always clear what causes encephalitis, but it can be caused by:

  • viral infections – very rarely, encephalitis may be caused by the common viruses that causes cold sores (herpes simplex) or chickenpox (herpes varicella) spreading to the brain
  • a problem with the immune system, the body’s defence against infection – sometimes something goes wrong with the immune system and it mistakenly attacks the brain, causing it to become inflamed
  • bacterial or fungal infections – these are much rarer causes of encephalitis than viral infections

Some types of encephalitis are spread by mosquitoes (such as Japanese encephalitis), ticks (such as tick-borne encephalitis) and mammals (such as rabies). You cannot catch encephalitis from someone else.

For further information, please visit the resources below:

Encephalitis – NHS
Encephalitis International | The brain inflammation non-profit
Encephalitis – Support for neurological conditions | The Brain Charity

Brain injury secondary to tumours

What is a tumour? Our bodies are made from building blocks called cells, each with its own structure and function. Cells grow and multiply naturally and normally as you grow and when your body repairs tissue damage (for example, when your skin heals after a cut or graze). A tumour is a swelling or lump that forms when certain cells grow and multiply abnormally. What is a spinal tumour? A spinal tumour is an abnormal growth of cells in the spine.

For further information, please visit the resources below:

BSF_Spinal-tumour.pdf
Brain injury – Support for neurological conditions | The Brain Charity
Headway – the brain injury association | Headway