Traumatic brain injury is sudden physical damage to the brain. The head forcefully hitting an object, a closed head injury, may cause the damage or by something passing through the skull and piercing the brain, like a gunshot wound, penetrating head injury. The major cause of traumatic brain injury is from motor vehicle accidents. Other causes include falls, sports injuries, violent crimes, and child abuse.
Physical, behavioral, or mental changes are dependent upon which areas of the brain are injured. Most often focal brain damage is done, which is damage confined to just a small area of the brain. This point is usually where the head has hit an object. Closed head injuries often times causes scattered brain injuries or damage to other areas of the brain. Diffuse damage is the result of an impact causing the brain to move back and forth against the skull. Frontal and temporal lobes, responsible for speech and language, are often the most affected because they sit in the areas of the skull that allows more room for the brain to shift and sustain injury. Speech and language is therefore affected, as well as voice, swallowing, walking, balancing, and coordination difficulties and changes in the ability to smell and in memory and cognitive skills.
The effects of the brain damage are generally greatest immediately following the injury. However, long-term problems are difficult to assess because some damage may be caused by contusion, bruising of the brain that is usually temporary. Focal damage may result in long-term and permanent difficulties. Other areas of the brain can learn to take over the functions of the damaged areas over time and can improve the condition. When a traumatic brain injury occurs in a child they may progress better than an adult because their brain has a greater capability to be flexible.
The brain stem regulates basic arousal and regulatory functions, as well as being involved in attention and short-term memory. When a traumatic brain injury occurs and affects this area disorientation, frustration and anger can result. In moderate to severe injuries swelling can cause pressure on the brainstem. Consciousness or wakefulness can be affected so a person may fall into a coma.
Higher up in the brain, than the brain stem, is the limbic system, which helps regulate emotions. The temporal lobes are connected to the limbic system and are involved in many different cognitive skills, including memory and language. Behavioral disorders have resulted from damage to the temporal lobes, or seizures in this area. Almost always, the frontal lobe is injured in traumatic brain injuries because it is so large in size and is located near the front of the cranium. The frontal lobe is considered the emotional and personality control center, as well as many cognitive functions. Damage to the frontal lobe can lead to decreased judgment and increased impulsivity.
Traumatic brain injury can cause cognitive impairments, like trouble concentrating, trouble organizing thoughts, and becoming easily confused or forgetful, may occur in conscious people. Learning new information may be difficult and interpreting actions of others will lead to social problems, like making inappropriate statements. Problem solving, decision-making, and planning could be difficult as well as judgment.
Speech issues like articulating words and forming sentences may become difficult after TBI. Frustration and anger can be directed at the other person because of the difficulties a person with TBI can experience when trying to carry on a conversation or others may not even be aware of their errors. Reading and writing becomes a problem also. Mathematical abilities, simple or complex, are also often affected.
A traumatic brain injury can cause conditions, such as dysarthia, which starts to slow, slur, and make speech difficult to understand if the speech mechanism muscles become damaged. Swallowing can become problematic brought on by dysphagia, and a condition called apraxia can make repeating words in a consistent manner difficult.