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Meeting Special Needs of Individuals with Brain Injury Part I: How the Brain Works Training for 211

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Acquired Brain Injury ... The brain injury may produce a diminished or altered state of consciousness, ... Traumatic Brain Injury (TBI) - External forces ... – PowerPoint PPT presentation

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Title: Meeting Special Needs of Individuals with Brain Injury Part I: How the Brain Works Training for 211


1
Meeting Special Needs of Individuals with Brain
InjuryPart IHow the Brain WorksTraining for
2-1-1 Specialists
2
Brain Works
  • Definition
  • Causes of Brain Injury
  • Basic Brain
  • How the Brain is Hurt
  • Course of Recovery
  • Changes After Brain Injury
  • Severity of Injury
  • Common Myths
  • Prevention
  • Q A

3
FACT
  • TBI is the leading cause of death and disability
    among children and young adults, and those over
    75.

4
Congenital / Developmental Disorders vs.
Acquired Brain Injury
  • Congenital or developmental disorders result from
    a basic organic cause that manifests as an
    alteration in the developmental process, as
    opposed to being the result of an acquired brain
    injury. Examples include mental retardation,
    learning disability, ADHD, fetal alcohol
    syndrome, etc.

5
Congenital / Developmental Disorders vs.
Acquired Brain Injury
  • An acquired brain injury is an injury to the
    brain that has occurred after birth. The injury
    generally results in a change in the physical
    integrity, the metabolic activity, or the
    functional ability of the neuron.

6
Definition Acquired Brain Injury Contd.
  • The brain injury may produce a diminished or
    altered state of consciousness, which results in
    impairment of cognitive abilities or physical
    functioning. It can also result in disturbance of
    behavioral or emotional functioning. These
    impairments may be either temporary or permanent
    and cause partial or total functional disability
    or psychological maladjustment.

7
vs. Traumatic Brain Injury (TBI)
  • Traumatic brain injury (TBI) is an insult to the
    brain, not of a degenerative or congenital nature
    but caused by an external physical force, that
    may produce a diminished or altered state of
    consciousness, which results in an impairment of
    cognitive abilities or physical functioning. It
    can also result in the disturbance of behavioral
    or emotional functioning. These impairments may
    be either temporary or permanent and cause
    partial or total functional disability or
    psychosocial maladjustment.

8
QUESTIONWere you born with the disability or
did it occur due to birth trauma?
  • REASON
  • Eligibility for many state services depends upon
    whether the disability is congenital or acquired
    during or after the birth process.

9
QUESTIONWas the brain injury due to a trauma or
other cause?
REASON Eligibility for many state services
depends upon whether the disability is due to a
TBI vs. other cause.
10
FACT
  • 144,000 Texans sustain a TBI each year, one every
    4 minutes.

11
Causes of Acquired Brain Injury
  • Traumatic Brain Injury (TBI) - External forces
    applied to the head and/or neck (most common)
  • Stroke (2nd most common)
  • Anoxic/hypoxic injury (shortage of O2)
  • Brain surgery

12
Causes of Acquired Brain Injury, Contd.
  • Infectious diseases
  • Brain tumor
  • Metabolic disorders (e.g., diabetic coma)
  • Seizure disorders
  • Toxic exposure

13
QUESTIONWhat was the cause of the injury?
REASON Some state services may exclude brain
injury due to causes other than TBI.
14
Causes of TBI
15
FACT
  • The annual incidence of TBI is more than that of
    MS, spinal cord injury, HIV/AIDS, and breast
    cancer
  • COMBINED.

16
Basic Brain
  • Brainstem
  • Cerebellum
  • Cerebrum

17
Brain Stem
  • Cardiac
  • Respiratory
  • Arousal
  • Movement touch sensation in body

18
Cerebellum
  • Balance of the body
  • Coordination of body movement

19
Cerebrum
  • Four lobes in each hemisphere
  • Frontal
  • Temporal
  • Occipital
  • Parietal

20
Frontal Lobe
  • Located under forehead
  • Largest part of brain
  • Last section to evolve
  • Executive functioning

21
Frontal Lobe Injuries
  • Problems with
  • Attention
  • Planning and organization
  • Initiation
  • Problem solving/flexibility
  • Judgment
  • Impulse control
  • Personality changes/inappropriate emotional
    expression and behavior
  • Speaking
  • Muscle weakness paralysis

22
Temporal Lobe
  • Hearing
  • Understanding Speech
  • Memory
  • Music/ Sound
  • Comprehension

23
Occipital Lobe
  • Located at the rear
  • of the brain
  • Interpretation of
  • visual information

24
Parietal Lobe
  • Located at the top of brain
  • Perception of touch/body
  • orientation
  • Face and shape
  • recognition
  • Awareness of spatial
  • relationships
  • Arithmetic calculations

25
Subcortical Areas
  • Limbic System-memory and emotions
  • Thalamus-relay of incoming sensory information
  • Basal Ganglia-control of voluntary movement

26
How the Brain is Hurt TBINormal Neuron Firing
27
How the Brain is Hurt TBI
  • PRIMARY INJURY
  • Skull fracture
  • Contusion (Coup/Contracoup injury)
  • Diffuse axonal injury (DAI)
  • Focal Shear Injury

28
(No Transcript)
29
Diffuse Axonal Injury (DAI)Rotational forces on
the brain cause stretching and snapping of axons.
30
Focal Shear Injury
31
How the Brain is Hurt TBI, Contd.
  • SECONDARY INJURY
  • Cerebral edema
  • Hydrocephalus
  • Hematomas
  • Neurotoxic cascade of events

32
Secondary Injuries
Edema (swollen brain tissue)
Hydrocephalus (enlarged ventricles)
33
Hematoma
34
Neurotoxic Cascade of Events
35
How the Brain is Hurt STROKE
  • Caused by vascular disruption to a region of the
    brain leading to death of neurons in the affected
    area

36
How the Brain is Hurt STROKE, Contd.
  • Ischemic Stroke
  • Blood flow to a region of the brain is blocked by
    plaque in the vessels, or a blood clot from the
    heart, starving brain cells in the area of the
    affected vessel of oxygen and nutrients.

37
How the Brain is Hurt STROKE, Contd.
  • Hemorrhagic Stroke Bleeding into the brain
    caused by rupture of an aneurysm, malformation of
    a blood vessel, or a weakened blood vessel
    disrupts normal flow of nutrients and oxygen into
    the affected region

38
STROKE vs. TBI
  • TBI
  • Injury is usually to the entire brain (diffuse or
    global injury).
  • In addition to diffuse injury due to damage to
    scattered neurons, there are focal injuries due
    to bruising and bleeding in localized areas.
  • STROKE
  • A single discrete area of the brain is affected,
    but the damage to the area is complete.

39
STROKE vs. TBI
  • TBI
  • In TBI, diffuse injury varies greatly in severity
    from one patient to another.
  • No two TBI survivors are exactly alike.
  • Similarities may be related to the frequency of
    frontal lobe injury due to the impact of brain
    tissue on the frontal skull during an accident.
  • STROKE
  • Patients whose stroke was due to damage to the
    same blood vessel will have similar deficits.

40
FACT
  • More than 381,000 Texans are living with a
    disability from TBI (about 2 of the population).

41
Course of Recovery Acute Stage
  • Coma or Loss of Consciousness (LOC)
  • Medical stabilization
  • May last from minutes to months

42
Course of Recovery Post-Acute Stage
  • Post-Traumatic Amnesia (PTA)-no memory for events
    despite increased awareness
  • Increased rate of recovery during first 1.5 to 2
    years post-injury
  • Rehabilitation
  • May last from days to years

43
TOP TEN CHANGESAFTER BRAIN INJURY
  • Memory
  • Attention
  • Communication
  • Speed of thought action
  • Problem solving/planning
  • Mobility
  • Fatigue
  • Judgment
  • Emotional/behavioral control
  • Initiation

44
Possible Behavioral / Social Effects
IMPAIRED ABILITY TO PERCEIVE, EVALUATE, OR USE
SOCIAL CUES/ CONTEXT
VERBAL / PHYSICAL AGGRESSION
MOOD SWINGS OR EMOTIONAL LABILITY
IMPULSIVITY
IMPAIRED ABILITY TO COPE WITH OVER-STIMULATING
ENVIRONMENTS
LOW FRUSTRATION TOLERANCE
LACK OF AWARENESS OF DEFICITS
45
QUESTIONDo you have something to write with?
REASON The individual may need to refer to their
notes later for follow-through.
46
QUESTIONWhat problems are you having?
REASON To identify needs as they relate to
available services.
47
QUESTIONIs there someone who helps you that
you would want me to talk to?
REASON Individual may have problems
communicating their needs or following up.
48
FACT
TBI accounts for more years of lost productivity
than any other injury.
49
Severity of Injury MILD
  • 75-90 of all brain injuries
  • LOC less than 20-30 minutes
  • A concussion is a mild brain injury
  • Most recover within hours or days
  • May have subtle problems over time (e.g.,
    headache, attention, memory, fatigue, emotional
    problems)

50
Severity of Injury MODERATE
  • 8-10 of all brain injuries
  • LOC less than about 6 hours
  • 3 months post-injury 2/3 have not returned to
    work
  • 33-50 have residual problems (e.g., initiation
    including sexual, memory, temper, poor planning)

51
Severity of Injury SEVERE
  • Less than 10 of all brain injuries
  • LOC more than 6 hours
  • Cognitive, emotional/behavioral, physical
    problems
  • Socially isolated/psychiatric problems
  • Likely greater long-term impairment

52
FACT
More than 5,700 Texans are permanently disabled
by TBI each year.
53
FACT
Males sustain BI twice as often as females.
54
MYTHS ABOUT BRAIN INJURY
REALITY The cognitive and behavioral effects of a
brain injury can last long after the person heals
on the outside.
MYTH Visible, physical recovery is a sign that
the brain is healed.
55
MYTHS ABOUT BRAIN INJURY, CONT.
REALITY It may just take longer for the effects
of a brain injury to show up in a growing and
developing brain.
MYTH Younger children are more resilient and can
therefore bounce back easier and more quickly
from a brain injury.
56
MYTHS ABOUT BRAIN INJURY, CONT.
REALITY Even a 60 second loss of consciousness
has resulted in DAI (as seen on autopsy).
MYTH Mild brain injury has no long term effects.
57
MYTHS ABOUT BRAIN INJURY, CONT.
REALITY There is no cure for a brain injury.
MYTH Time heals.
58
Related Issues
  • Age at injury/ Stage of development
  • Substance abuse problems pre- and post-injury
  • Psychiatric problems pre- and post-injury
  • Family support and expectations

59
Prevention
  • Common sense
  • Seatbelts
  • Use child safety seats
  • Helmets
  • Education
  • Home Safety Check
  • Dont drive under influence
  • of any substance
  • Dont drink to excess
  • No drugs of abuse
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