A brain injury can be the result of damage caused to the brain. It can be something that you are born with or can be acquired after birth. A traumatic brain injury may be caused by a fall, accident, or assault that results in a head injury. A non-traumatic brain injury may also be caused by a stroke, tumour or lack of oxygen to the brain.

Effects of a Brain Injury

All brain injuries are different, and people are affected to varying degrees depending on the severity of the injury and the area of the brain which is injured. An injury can impact various brain functions.

The main effects of a brain injury can be grouped into 3 categories:

• Physical: how the body works
• Cognitive: ability to think, learn and remember
• Emotional: feelings and how we act

Physical Effects

Fatigue

A common effect experienced after the majority of brain injuries is fatigue. Tasks require much more effort, and even simple tasks can be exhausting. More time is needed to complete tasks, and regular breaks are required between them. Concentration and memory are often impacted by fatigue. A person with a brain injury may need to sleep a lot more or perhaps have an irregular sleep pattern. 

Sensory Impairment

The sensation of touch on the skin can be reduced, lost, or even exaggerated. Without looking at limbs, one can lose the ability to know how/where they are positioned. Eyesight and hearing can be affected, as can the sense of smell and taste. Due to sensory overload and the brain's ability to process this information, people with this symptom after an injury may want to avoid loud noises or busy places. It is common for people with a brain injury to become intoxicated by alcohol quicker than before they were injured.

Speech

Slow, rapid, or indistinct speech is common after brain injury, and can make it difficult to understand what the person is saying. Speech can also be lost completely.

Headaches, Dizzy Spells, and Blood Clots

Headaches and dizzy spells are common symptoms of head injuries, and can vary in severity and duration.

Epilepsy

A brain injury can increase the likelihood of epileptic seizures and/or absences due to damage to brain tissue. If a person has an episode after a brain injury, they may be prescribed a drug to reduce the chance of it happening again. These drugs can have a ‘dampening’ effect on someone’s ability to undertake everyday tasks, which can prove problematic when combined with excessive fatigue.

Mobility

Movement can become slow and balance can be impaired. A wheelchair or other mobility aid may be required to help get around as walking may be difficult due to poor coordination and balance.

Spasticity

Muscle spasms can cause limbs to become weak or stiff and limit range of motion. Depending on which side of the brain is affected, one side of the body can be more affected than the other.

Paralysis or Weakness

This is a common symptom following a stroke and usually affects one side of the body more than the other. Depending on the extent of the weakness or paralysis, help with dressing or personal care may be required.

Sexual Function

Numerous parts of the brain control the skills required for sexual activity and when they are damaged it can affect sexual function. This can have an impact on current or future relationships and how the person feels about themselves.  This may also have an impact on the ability to have children.

Cognitive Effects

Memory

A brain injury can cause problems with memory, particularly short-term and ‘working’ memory. Some people struggle to remember names or faces, and details of what someone has said to them or what they have read. 

Language

A person might find it difficult to find the right words to express themselves or be understood. This can be particularly frustrating for the person and for others around them, so patience is required on both sides.

Visual Perception Skills

This might manifest as an inability to recognise common shapes, objects or people’s faces. It can also result in someone ignoring the stimuli from one side of their visual field or neglecting one half of their bodies, when dressing or shaving for example.

Concentration

This is very common after brain injury and can also affect memory. Completing even simple tasks can be a problem, expressed enthusiasm at the outset can quickly wane and tasks are left unfinished.

Information Processing

It can be difficult for the person to arrange and weigh up information in their minds, especially if they are also experiencing memory loss. They can feel ‘overloaded’ with information which can quickly lead to feeling overwhelmed, angry and frustrated.  This can also cause difficulties with organising, problem-solving, multitasking and the ability to make decisions.

Motivation

The person may express an interest in doing something, such as an activity outside of the home or doing something to maintain their personal hygiene and appearance. However, when the time comes to act, they withdraw and no longer want to do it. To counter this lack of motivation, people will need to prompt and encourage the injured person so that the activity can take place.       

Repetition

The person might find it difficult to move on to another subject in a conversation, and repeatedly return to the same topic. They may also repeat the same action or become fixed on a specific issue and feel unable to break the cycle.

Impaired Reasoning

The person might struggle to understand rules, think ‘logically’, or follow discussions. Due to this lack of understanding, they can become argumentative.

Impaired Insight, Empathy, and Self Awareness

It can be impossible for the person to see things from someone else’s perspective, and struggle to interpret their own, and others’, behaviour and feelings. They may also have an unrealistic view of themselves and others, which often leads to them setting unattainable goals, which in turn can result in frustration. This lack of insight is often accompanied by a reduced level of self-awareness that makes it difficult for the person to self-monitor and self-correct their behaviour.

Emotional and Behavioural Effects

Personality changes

Many people experience changes in their personality. These changes can be subtle, but in some cases, they result in dramatic transformations. In severe cases, individuals may progress from a vegetative state to a minimally conscious state, indicating some level of awareness and responsiveness despite significant brain damage. For friends and family, this can be extremely difficult to deal with as it is like being around a different person. The injured person can also struggle with this as it feels like they have lost a sense of who they are.

Mood swings

The person may have a tendency to laugh or cry easily, or suddenly move from one end of the emotional spectrum to the other.

Anxiety

The future can look frightening when a person’s life has suddenly changed. The magnitude of living with a brain injury can easily make someone anxious.

Frustration and anger

Being unable to do things that came easily before injury can lead to frustration building up and manifesting into angry outbursts that are difficult to control.

Depression

Depression can result from damage to certain areas of the brain but can also be caused by the injured person gaining some understanding of their injury and the impact it is having on their life. A sense of loss can bring sadness, grief, anger and confusion.

Disinhibition

A loss of control over social etiquette can mean the person is overly familiar with people, resulting in inappropriate behaviour. They may also be unable to inhibit offensive outbursts, which can lead to embarrassing and upsetting situations for loved ones.

Obscene or abusive language

Often spontaneous and uncontrollable, this can be an outlet for the person’s anger and frustration.

Obsessive-compulsive behaviour

Recurrent thoughts and impulses can cause high levels of distress and anxiety that the person is unable to dismiss. Repetitive behaviours have to be carried out in response to the obsession in order to reduce stress.

Impulsiveness

An inability to weigh up information before making a decision can lead an injured person to act impulsively without thought for the consequences of their actions.

The effects of a brain injury can be varied and are unique to the injured person. Many of the effects are ‘hidden’ which can make understanding and coping with them difficult. With good rehabilitation and appropriate support, some symptoms can improve over time, but for many, the effects of a brain injury will be lifelong.

Understanding how a brain injury affects you or someone you know can be an important step in learning how to live well following an injury.