The human brain has three major structural components: the large dome-shaped cerebrum (top), the smaller somewhat spherical cerebellum (lower right), and the brainstem (center). Prominent in the brainstem are the medulla oblongata (the egg-shaped enlargement at center) and the thalamus (between the medulla and the cerebrum). The cerebrum is responsible for intelligence and reasoning. The cerebellum helps to maintain balance and posture. The medulla is involved in maintaining involuntary functions such as respiration, and the thalamus acts as a relay center for electrical impulses traveling to and from the cerebral cortex

 
B. Brain Injury
 
Head injury can initiate a cascade of damaging events. After a blow to the head, a person may be stunned or may become unconscious for a moment. This injury, called a concussion, usually leaves no permanent damage. If the blow is more severe and hemorrhage (excessive bleeding) and swelling occur, however, severe headache, dizziness, paralysis, a convulsion, or temporary blindness may result, depending on the area of the brain affected. Damage to the cerebrum can also result in profound personality changes.

Damage to Broca's area in the frontal lobe causes difficulty in speaking and writing, a problem known as Broca's aphasia. Injury to Wernicke's area in the left temporal lobe results in an inability to comprehend spoken language, called Wernicke's aphasia.

An injury or disturbance to a part of the hypothalamus may cause a variety of different symptoms, such as loss of appetite with an extreme drop in body weight; increase in appetite leading to obesity; extraordinary thirst with excessive urination (diabetes insipidus); failure in body-temperature control, resulting in either low temperature (hypothermia) or high temperature (fever); excessive emotionality; and uncontrolled anger or aggression. If the relationship between the hypothalamus and the pituitary gland is damaged, other vital bodily functions may be disturbed, such as sexual function, metabolism, and cardiovascular activity.

Injury to the brain stem is even more serious because it houses the nerve centers that control breathing and heart action. Damage to the medulla oblongata usually results in immediate death.

REFERENCE (Stats & Facts)

Head Injury - The Facts

• Head injury is the No. 1 killer and disabler of persons under the age of 44.
• It is estimated that 55,000 Canadians incur a traumatic brain injury each year.
• In Saskatchewan, about 2,500 people incur a head injury each year. That's five persons injured a day!
• The majority of those who are brain injured are young adults. They will have a normal life expectancy but will require special care.
• Brain injuries affect a significant number of people each year and the numbers are reaching epidemic proportions. Head injury is the silent epidemic!

How do head injuries happen?

Brain injury occurs suddenly, without warning, and from that instant a normal life can be changed. Every day we participate in activities that leave endless possibilities of incurring a head injury!
• That drive to the grocery store which is so close you don't need to wear a seat belt.
• The backyard pool where you don't bother to check the depth of the water before you dive in.
• The harmless unorganized game of hockey where no one wears their helmet.
• The simple fall on ice or down the stairs.

Types of acquired brain injury (Acquired Brain Injury:The problem)

"Acquired brain injury is a term used for all people who have suffered neurophysica, cognitive, personality and behavioural changes due to diffuse, as opposed to focal, structural brain damage, whether it's from HEAD INJURY, BRAIN HAEMORRHAGE, DRUG TOXICITY, ENCEPHALITIS or NEAR-DROWNING. These other brain injury survivors frequently exhibit similar long-term problems as the head-injured do, and consequently have similar needs for rehabilitation services."

Can you recover?

The death toll from head injury is a major problem but the even bigger issue is surviving a severe brain injury. Many people survive those brain injuries which would have previously been fatal "because of improvements in cardiopulmonary resuscitation, and increasingly sophisticated life support treatment in intensive care units, many people now survive (Acquired Brain Injury : The Problem).
"The majority of head injuries are very mild requiring little medical attention and a short period of time to recover. However, the recovery process form a major head injury is long and difficult and filled with uncertainty. This uncertainty is frustrating for patients and relatives to cope with and to understand. It also poses difficult problems for those providing care." (Capp, Preface -Head Injury and the Family). 

The brain does not heal itself like a broken arm. It takes time, dedication, and a lot of patience. Recovery can take weeks, months, or years. Many spend the rest of their lives trying to regain what they once had. Once the damage is done, its effects may be irreversible. 

In brain injuries it is difficult to predict the extent and type of damage or the possible outcome . Each traumatic brain injury can be expected to produce a unique set of brain injuries and problems to be solved. 

The general effects of brain injury are losses in: motor function, sensory function, coordination, impaired speech, hearing, vision, smell and taste, personality/intellectual changes, consciousness. And sometimes DEATH. 

For the majority of survivors, the physical problems are usually regarded as less disabling or disruptive as the cognitive and behavioural problems.

Problems/disorders faced by survivors of head/brain injury:

• Physical problems
• Coma
• Movement Disorders
• Sensory Impairment
• Communication Disabilities
• Epilepsy
• Cognitive problems-Difficulty remembering/learning, inability to concentrate, understand complex issues, plan, make judgements or think quickly
• Behavioural problems/personality changes-Irritability, aggression, restlessness, lack of spontaneity, sexual inappropriateness, childishness, apathy, mood swings, depression, excessive emotions (ie laughing, swearing or crying excessively or other inappropriate behaviour), self-centredness, lack of ambition, changes in usual personality.

RECOVERY/REHAB

Recovery from any brain injury takes time and patience. Rehabilitation after a brain injury make include a team of specialists. The team may include:
• A neurosurgeon
• A neurologist
• A physiatrist
• A neuropsychologist
• An occupational therapist
• A speech therapist
• A recreation therapist
• Nurses
• Social workers

PREVENTION

What can you do to prevent a head injury?
Wear that seat belt...it's the only thing between you and the windshield. 

About 75% of all bicyclists who die each year die of head injuries. Statistics show 85% of head injuries in bicycle accidents can be prevented by wearing a helmet! 

Use common sense, don't take unnecessary chances. Remember: " A head injury is forever - prevention is the only cure".

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