1.1 Describe acquired brain injury

This guide will help you answer 1.1 Describe acquired brain injury.

Acquired brain injury (ABI) is a medical term used for any brain damage that occurs after birth. This means that the person was not born with the injury, but developed it later in life. ABI affects how the brain works and can change a person’s ability to think, feel emotions, or move their body.

ABI is a broad term. It covers any injury to the brain, no matter the cause, which leads to new challenges for the individual. These challenges can be physical, emotional, behavioural, or cognitive (thinking and understanding).

ABI does not include damage that happens before or during birth, such as congenital (present at birth) brain conditions. It also excludes injuries that are due to progressive diseases like Alzheimer’s disease, which gradually destroy brain cells over time. ABI only refers to brain damage that is sudden or develops from incidents after birth.

Types of Acquired Brain Injury

There are two main types of ABI:

• Traumatic brain injury (TBI)
• Non-traumatic (or ‘atraumatic’) brain injury

Traumatic brain injury happens when an outside force causes the brain to move inside the skull or to be penetrated. Non-traumatic brain injury occurs because of things happening inside the body, such as a lack of oxygen or a bleed.

Traumatic Brain Injury

Traumatic brain injury results from a physical blow or jolt to the head or body. Here are some common causes:

• Falls (down stairs, slips, trips)
• Road accidents (involving cars, bicycles, or being struck as a pedestrian)
• Sports injuries (like being hit by a ball or player)
• Assaults or violent incidents
• Accidents at home, work, or in public

A traumatic injury can lead to bruising, bleeding, movement of the brain, or direct damage to brain tissue. The effects can range from mild (concussion) to severe (long-term disability or coma).

Non-Traumatic Brain Injury

Non-traumatic brain injury does not involve any blow to the head. Instead, it comes from internal events or medical conditions such as:

• Strokes (when blood flow to part of the brain is blocked or a blood vessel bursts)
• Brain infections (like meningitis or encephalitis)
• Lack of oxygen (hypoxia), possibly from choking or drowning
• Brain tumours (growth of abnormal cells inside the brain)
• Exposure to toxic substances (such as carbon monoxide poisoning)
• Alcohol or drug poisoning
• Bleeding in the brain (haemorrhage)

Non-traumatic injuries can have serious and lasting effects, depending on which part of the brain is affected and how quickly the person receives help.

Main Causes of Acquired Brain Injury

Knowing what can cause an ABI helps in spotting risks and supporting people who go through it. Here are some common causes:

Trauma and Accidents

• Road traffic collisions
• Falls (at any age, but especially among older adults)
• Accidents at work (using machines or tools)
• Sporting injuries (head contact in rugby, boxing, football)
• Physical violence (being punched, kicked, or hit with objects)

Medical Conditions

• Stroke (blockage or bleeding in the brain)
• Brain tumours
• Infections like meningitis
• Epileptic seizures (especially prolonged ones)
• Heart attacks (leading to reduced oxygen for the brain)

Substance Misuse or Poisoning

• Alcohol poisoning
• Drug overdose
• Poisonous gases (carbon monoxide, which stops oxygen getting to the brain)
• Illegal drug use (which may restrict blood flow or cause vessel leaks in the brain)

Lack of Oxygen

• Near drowning
• Suffocation, choking
• Heart or breathing stoppage (cardiac arrest, respiratory arrest)
• Severe asthma attacks

Surgery or Medical Treatment

Sometimes, complications during surgery, especially to the heart, lungs, or brain, can lead to ABI if the brain does not receive enough oxygen.

Areas of the Brain and Functions

Understanding the brain’s different areas helps in recognising how an ABI might affect someone. Each area controls different skills or functions:

• Frontal lobe: Thinking, planning, organising, memory, controlling behaviour, emotions, and movement
• Parietal lobe: Sensation, body awareness, and spatial (space) skills
• Temporal lobe: Hearing, understanding speech, memory
• Occipital lobe: Sight and visual understanding
• Cerebellum: Balance and coordination
• Brainstem: Breathing, heart rate, sleeping, and swallowing

When a brain injury occurs, problems depend on which area was affected. These effects might be short or long-term. Some people recover fully, while others have ongoing challenges.

Physical Effects of Acquired Brain Injury

ABI can have many effects on the body. These vary from person to person, depending on the injury’s cause and severity. Some of the most common physical impacts are:

• Weakness or paralysis (not able to move part of the body)
• Loss of balance and coordination
• Fatigue (feeling tired all the time)
• Reduced fine motor skills (like buttoning up a shirt)
• Headaches or dizziness
• Difficulty swallowing (this is called dysphagia)
• Changes to senses (like smell, taste, or touch)

People may face mobility problems. Some need walking aids or wheelchairs after injury. Muscle stiffness or spasms can occur, impacting movement further.

Sometimes physical symptoms appear right after an incident. In other cases, they develop slowly as swelling or bleeding in the brain increases.

If a person has seizures, these need careful management, as they can be life-threatening or lead to new injury.

Cognitive and Behavioural Effects

ABI does not just cause physical problems. Often, changes happen in how a person thinks, remembers, or acts. These are called cognitive and behavioural effects.

Cognitive Changes

• Memory loss (forgetting names, dates, or what was just said)
• Trouble concentrating or paying attention
• Slower thinking, puzzling over simple tasks
• Difficulty finding words or understanding speech
• Struggling to plan, organise, or make decisions
• Challenges with problem-solving

These may affect someone’s confidence, relationships, and ability to work or study.

Behavioural Changes

After ABI, some people’s behaviour may change. These changes can be distressing for both the person and those around them.

Common behavioural effects:

• Sudden anger or mood swings
• Impulsiveness (doing things without thinking)
• Poor control of emotions (crying or laughing at unusual times)
• Anxiety or low mood
• Restlessness or frustration
• Lack of motivation

Sometimes, people may not realise how much they have changed. This is called lack of insight.

Emotional Effects

Emotional health can be affected by ABI in many ways. The brain controls emotions, so injury may disrupt mood regulation. Effects might include:

• Depression
• Anxiety
• Emotional lability (unexpected or extreme emotions)
• Low self-esteem
• Social withdrawal

Grief over lost abilities can be very common. Fear and uncertainty about the future are difficult for most people to cope with after injury.

Impact on Daily Life

ABI can make day-to-day tasks more difficult. This can leave a person feeling like they have lost their independence. Some examples of daily challenges after ABI are:

• Needing help with personal care (washing, dressing, using the toilet)
• Trouble with cooking, shopping, or handling money
• Communication problems (trouble talking, understanding, or writing)
• Trouble returning to work, school, or social activities
• Family roles may change, with relatives needing to become carers

People may need support from occupational therapists, speech and language therapists, or physiotherapists. Social care workers offer help at home or in supported living environments.

Recognising Hidden Disabilities

Some effects of ABI are invisible. People with ABI might look well but still struggle with fatigue, memory, or mood swings. This can cause misunderstandings at home, work, or in the community.

Hidden disabilities can lead to frustration or conflict with others who do not understand why the person’s behaviour has changed. Raising awareness of these hidden effects is important.

Rehabilitation and Support

Once someone survives an ABI, recovery can be slow. Rehabilitation is the process of relearning lost skills and maximising independence. This may include:

• Physiotherapy (to rebuild movement and strength)
• Occupational therapy (to work on daily skills)
• Speech and language therapy (for speech, language, or swallowing problems)
• Cognitive therapy (improving memory, attention, and thinking)

Rehabilitation happens in hospitals, specialist centres, or at home. Support continues for as long as the person needs it.

Support networks make a big difference. Family, friends, social workers, and peer support groups all play a role. Some people need support for the rest of their lives. Others need help only for a short period.

Legal and Safeguarding Aspects

Brain injury can make it hard for someone to make their own decisions or keep safe. This is called lacking mental capacity. Staff should follow the Mental Capacity Act 2005, which protects rights and supports best interests.

People with ABI may become more vulnerable to abuse, neglect, or exploitation. It is important that workers know how to protect and empower those in their care. Safeguarding policies must be followed at all times.

Privacy, dignity, and choice are basic rights for people with ABI.

Final Thoughts

Acquired brain injury can change anyone’s life at any time. The effects are serious and affect far more than just the body; they reach into how a person thinks, feels, and interacts with others. It can happen for many reasons, such as accidents, illnesses, or lack of oxygen, and the impacts can be temporary or long-term.

Support makes a real difference. Health and social care workers, family, and friends all help people rebuild their lives after a brain injury. Some effects are easy to see, like movement problems. Others, such as changes to mood or memory, are hidden but just as important.

Being informed and supportive allows you to play a key role in someone’s recovery. Patience, respect, and clear communication help people with ABI live with dignity and reach their best potential. The journey after brain injury is never easy, but with the right approach, each day can bring progress.