2.1 Describe the initial effects of acquired brain injury on the individual

This guide will help you answer 2.1 Describe the initial effects of acquired brain injury on the individual.

Acquired brain injury (ABI) means a brain injury that happens after birth. It is not caused by any congenital (from birth) issue or by anything genetic. ABI can occur suddenly, bringing with it a wide range of physical, mental and emotional effects.

Some common causes include:

• Traumatic injury, such as from a car accident, fall, or blow to the head
• Stroke
• Infections like meningitis or encephalitis
• Alcohol or drug misuse
• Lack of oxygen (hypoxia), for example from near-drowning or heart attack
• Tumours or neurological illnesses

Every person’s brain is unique, so each individual may experience ABI differently. The effects can range from mild concussion to severe disability. Sometimes, even a mild injury can have big effects on a person’s daily life. The early, or “initial”, effects can be wide-ranging and often change over the first hours, days or weeks.

Physical Effects

Physical changes are often the easiest to spot after someone sustains an ABI. These effects may appear immediately or over the next few hours.

Common early physical effects include:

• Headaches or migraines
• Dizziness or loss of balance
• Nausea or vomiting
• Fatigue and sleep disturbances
• Blurred vision or changes to hearing
• Weakness or paralysis of one side of the body (hemiplegia)
• Loss of coordination
• Difficulty swallowing (dysphagia)
• Sensitivity to light or noise

Depending on which part of the brain is injured, a person could have specific movement difficulties. For example, injury to the right side of the brain can affect the left side of the body.

Some individuals go into a coma immediately. Others may look alert at first but become drowsy or confused later. This delayed onset is known as “lucid interval” and can be especially risky. Monitoring a person closely in the first hours after an injury is very important.

Not everyone will show every sign. Some after-effects, like seizures (fits), may develop suddenly later on. Post-traumatic epilepsy is more likely following an injury that damages the cortex or causes bleeding.

Cognitive Effects

Cognitive means anything to do with thinking, understanding and memory. After ABI, people often describe a “mental fog” or trouble focusing.

Key initial effects include:

• Confusion or disorientation
• Difficulty with concentration
• Trouble remembering recent events (“short-term memory loss”)
• Slower thought processes
• Difficulty learning new information
• Poor problem-solving or planning skills
• Losing track of time or surroundings

For example, someone may not know what day it is or why they are in hospital. They might keep asking the same questions or forget names and faces. These changes can be subtle at first and may become clearer once the person tries to return to daily activities.

A person may also struggle to understand or use language. This is called aphasia. It can involve:

• Trouble finding the right words
• Slurred, slow, or muddled speech
• Difficulty reading or writing

The type and severity depends on which areas of the brain are involved.

Emotional and Behavioural Effects

Personality and mood changes can be some of the most upsetting early effects of ABI. Family and staff may notice that “something isn’t right” long before the person realises it themselves.

Common emotional and behavioural signs in the early stages:

• Irritability or agitation
• Mood swings or sudden crying
• Frustration or anger
• Anxiety or fearfulness
• Laughter or crying that seems out of place (“emotional lability”)
• Flatness of mood, showing little emotion
• Lack of interest in surroundings

Impulse control can be reduced, meaning the person might act without thinking. They might be more likely to shout or say inappropriate things.

Some people feel disconnected from what’s happened. They may deny there is a problem, or have poor insight. This can make care more difficult, as the person may refuse help or try to leave the hospital too soon.

Depression can start straight away, or develop over days. Worries about the future, pain, confusion, and loss of independence all add to distress.

Sensory Effects

ABI can affect any of the senses. Early effects may involve:

• Loss of vision or double vision
• Hearing loss, ringing in the ears (tinnitus)
• Loss or abnormal sense of taste or smell
• Numbness, tingling or altered sensation in parts of the body
• Feeling less aware of pain, pressure or temperature

Some people lose “proprioception”, the sense of where their body is in space. This can make it very hard to move or walk safely.

Injury in the parietal lobe can affect touch and spatial awareness. For example, a person may ignore one side of their body—a problem called neglect or inattention.

Communication Difficulties

Communication problems may appear straight away or soon after recovery from unconsciousness. These can include:

• Slurred or hesitant speech
• Problems understanding spoken or written language
• Loss of social skills (interrupting, not taking turns)
• Difficulty paying attention in conversation
• Trouble reading facial expressions or social cues

Some people lose the ability to communicate completely, a condition known as global aphasia.

Fatigue, pain, and confusion make communication harder. Patience and clear, simple communication are important in the first stages.

Loss of Independence

The early effects of ABI often mean a person cannot care for themselves. They may need help with:

• Personal care tasks (washing, dressing, eating)
• Using the toilet
• Moving around safely
• Taking medication
• Managing money or appointments

This loss of independence can happen very suddenly. For someone used to being active and self-sufficient, it can feel frightening and humiliating.

Cognitive Overload

ABI reduces the brain’s capacity to cope with “everyday” demands. Noisy, busy or unfamiliar environments can be overwhelming. Tasks that were once simple may now lead to anxiety or fatigue.

A person may seem easily distracted, forgetful, or need everything repeated several times. They may not finish tasks, or avoid activity altogether.

Minimising noise, reducing the number of instructions and keeping to a routine can help in the early days.

Impact on Relationships

Families and carers often bear the brunt of the initial effects of ABI. Changes in personality, confusion, irritability and tiredness can put pressure on even the closest relationships.

Loved ones might worry that “the person they knew” has changed or disappeared. Disputes and misunderstandings are common. Children may feel scared or act out in response to the changes in their parent.

Medical Complications

In the hours and days after an ABI, the risk of further problems is high. Common complications include:

• Seizures
• Bleeding on the brain (haemorrhage)
• Swelling of the brain (oedema)
• Infection (if there is an open wound)
• Blood clots (due to immobility)
• High or low blood pressure
• Changes to heart rate or breathing

Immediate medical care focuses on preventing or managing these risks. Each complication has its own effects, such as drowsiness, coma, or worsening paralysis.

Unseen Injuries

Some effects of ABI are not visible. People may look well but struggle with:

• Headaches
• Memory problems
• Poor concentration
• Slow thinking

These “hidden” effects can be misunderstood by friends, family, or colleagues. The individual may feel frustrated at not being believed or supported.

Post-traumatic Amnesia

After a brain injury, it is common to see a period called post-traumatic amnesia (PTA). During PTA:

• The person may not recognise people or places
• They might not remember events, even a few minutes later
• They often act confused or restless
• Behaviour can be childlike or unpredictable

PTA can last minutes, hours, days, or even weeks. Recovery from PTA signals the first step towards a more stable phase of rehabilitation.

Fatigue

Extreme tiredness is very common after ABI. Even short activities can lead to exhaustion. This is very different from normal tiredness and does not always improve with sleep.

People often need lots of rest in the days following the injury. Noise, conversation or light can make the fatigue worse.

Pain and Discomfort

Pain comes in many forms after ABI. People may feel:

• Headaches or pressure inside the skull
• Neck pain or muscle stiffness
• Sensitivity to touch
• Neuropathic pain (burning, tingling, numbness)

Managing pain is key to improving comfort and helping recovery begin.

Insight and Awareness

Many people with ABI at first do not understand they have a problem. This lack of insight is part of the injury—brains process information differently after trauma.

A person may:

• Say they feel fine and refuse help
• Insist they can return to work or drive straight away
• Ignore advice from staff or family

This can create risks for safety and slow down recovery.

Individual Differences

Not everyone will have the same initial effects. The pattern depends on:

• The part of the brain injured
• The severity and type of damage
• Age and overall health
• Pre-existing health or mental health issues
• Level of support

Some people recover quickly. Others may face lasting or even permanent issues.

Role of Health and Social Care Workers

As a health and social care worker, you need to:

• Support the individual with patience and respect
• Communicate clearly and calmly
• Observe for worsening symptoms and report promptly
• Provide reassurance to both the individual and their family
• Help maintain safety and dignity
• Give help with daily tasks as needed

Early support can make a big difference to well-being and future recovery prospects.

Final Thoughts

Acquired brain injury changes lives in an instant. The initial effects range from physical problems and confusion to memory loss and changes in behaviour. Every person will react differently. Some effects will fade within hours or days. Others take longer to improve or may last for life.

Being aware of all possible initial effects means you can spot problems quickly and respond in a supportive, caring way. Early intervention helps prevent risks, offers reassurance and begins the slow process of rebuilding independence.

Families, friends, and colleagues play a huge role in supporting someone after ABI. Kindness, patience, and understanding are key. Small actions—like a calm tone, slow instructions, or quiet companionship—can make the early days a little easier. Your role as a care worker is vital in helping the person regain confidence and face the future, step by step.