Physical Changes
A brain injury can cause physical changes that may be temporary or permanent.
Some people will experience a number of these changes. Some people may not experience any. It depends on the type of injury, where it is in the brain, and how serious it is.
A person with a brain injury may have difficulty with:
Alertness
In the early stages of recovery, the person may not be very alert or their level of alertness may change throughout the day. This usually improves as the person recovers, allowing them to better participate in rehabilitation.
Movement/mobility
A person with an ABI may experience:
- Paralysis or weakness in one or both sides of the body
- Poor balance
- Poor coordination
- Low endurance (becomes easily tired with activity)
- Difficulty planning movements
- Muscle stiffness or trembling
- Contractures (Muscles or tendons become permanently shortened and cause a limb to be deformed. Surgery or splints can help.)
- Slow reaction time.
Speech and language
Some people have difficulties communicating after a brain injury. Sometimes the problem can be physical in nature (e.g., not being able to make sounds). Sometimes the problem can appear more cognitive in nature. For example, someone can make sounds and words but cannot find the right words to say what they want to say or they cannot understand what is being said to them.
Swallowing
A person may not be able to chew or swallow regular foods or drink liquids after a brain injury. Sometimes they will require a change in diet (e.g., pureed food or thickened fluids). Sometimes a person may not be able to eat enough to meet their needs. They will have a tube put in their nose or stomach to give them proper nutrition. These difficulties are usually temporary (in the early stages of recovery) but can continue for someone with a more severe brain injury.
Bladder/bowel control
Following a brain injury, the person may not be able to control their bladder or bowel. The bladder or bowel may be overactive or underactive. Or, the person may not feel the urge to go to the bathroom or know how to respond if they do. People are often at increased risk for bladder infections because the bladder is not emptied regularly and completely.
Pain
Pain and headaches are common after a brain injury. Sometimes they go away as the person improves physically. Sometimes they can be more chronic and require ongoing pain management. Pain can make it difficult for people to concentrate and it can also affect the person’s mood and sleep.
Sleep
Sleep patterns can be changed after a brain injury. Sometimes people have trouble getting to sleep, staying asleep or getting the right level of sleep. A referral to a sleep clinic may be necessary if the issue is ongoing.
Fatigue
Fatigue is common. Recovering from a serious injury takes a lot of energy. Rehabilitation is hard work and can drain a person physically and mentally. If the person has difficulty paying attention, remembering or thinking, doing simple things will take more work.
The person may only be able to do activities for short periods of time and may need to be reminded to rest if they don’t realize they are getting tired. Fatigue often gets better as someone improves, but for some people it will be an ongoing problem. They will have to schedule their activities and appointments accordingly.
Seizures
Seizures can occur after brain injury. They can cause a part of the body or the whole body to shake, or they can cause the person to appear to black-out (be non-responsive for a few seconds). Seizures can occur soon after the injury or not until months or years later. Doctors may prescribe anti-seizure medication to help control the seizures. Sometimes doctors do this as a precaution after a brain injury. If a person has had seizures, it is unsafe to drive a car and the doctor may recommend that their driver’s license be taken away.
Senses
A person’s ability to hear, see, smell, touch or taste may be affected by a brain injury. Someone may experience:
- Oversensitivity to touch
- Inability to feel pain, touch, hot or cold
- Loss of vision, double vision or blurry vision
- Visual neglect (seem unable to see things on one side of their body or room)
- Changes in sense of smell or taste
- Ringing in ears
- Oversensitivity to noise.