A brain injury (sometimes called an acquired brain injury or ABI) is any damage to the brain that happens after birth and is not related to a congenital (existing at/dating from birth) or a degenerative disease. The definition of a brain injury comes from the World Health Organization [1].
Check out this video on brain injury–it’s a great introduction to what it is, how it affects people and what Brain Injury Canada does.
There are two types of brain injury: traumatic and non-traumatic.
Let’s talk about
Traumatic brain injury
Traumatic brain injuries (TBIs) are caused by something that comes from outside the body. This includes blows, bumps, and jolts to the head. Traumatic brain injuries can result in temporary injury or more serious, long-term damage. Causes of traumatic brain injuries can include:
- Assault
- Explosive blasts, combat injuries
- Falls
- Gunshot wounds
- Intimate partner violence (assault, strangulation, suffocation)
- Motor vehicle accidents
- Shaken baby syndrome
- Sports injuries
Is a concussion a brain injury?
A concussion is a type of traumatic brain injury, but it doesn’t show up on imaging tests. This means diagnosis and treatment for concussion is different.
Non-traumatic brain injury
Non-traumatic brain injuries are caused by things happening inside your body or through substances you introduce into your body. There are no external impacts to the head causing the damage.
Just because they’re called non-traumatic doesn’t mean they aren’t serious–it’s simply a term used to describe how the brain injury happened.
There are several different causes of non-traumatic brain injury.
Before you keep reading
Some of these causes of non-traumatic brain injury may not be relevant to you. But that doesn’t mean they never happen to people your age, or that this information won’t be useful.
A brain aneurysm is when there is a bulge in a weak area in a wall of an artery that may leak or rupture. This puts pressure on the brain or nerves depending on where the aneurysm is located. If it bursts – or hemorrhages – blood will spill onto the tissue between the brain and the skull. This can lead to brain damage, a stroke, or in rare cases, death.
Causes and risk factors of a brain aneurysm include:
- Age – older individuals are more likely to develop aneurysms
- Excessive alcohol or drug use
- Family history/genetics
- Gender – specifically, females are more likely to develop aneurysms
- High blood pressure
- Past aneurysms
- Smoking
Aneurysms can develop after head trauma or infection – but these causes aren’t as common.
In many cases, there will be no visible symptoms of an aneurysm. When symptoms do appear, it is because the brain aneurysm has burst. The symptoms will appear suddenly. Emergency services should be called at 9-1-1 immediately. First-responders are necessary because they may have to use life-saving measures quickly. Symptoms of an aneurysm include:
- Sudden, severe headaches
- Blurred vision
- Changes in speech
- Neck pain
- Nausea
- Sensitivity to light
- Fainting
- Seizures
An unruptured brain aneurysm is normally found during unrelated tests/screenings.
[2]
A brain tumour is an abnormal growth of cells within or around the structure of the brain. They can impact all areas of the brain and change how a person thinks, feels, and reacts. There are over 120 types of brain tumours, ranging from non-malignant (non-cancerous) to malignant (harmful or cancerous). In some cases, brain tumours can put pressure on surrounding tissue, leading to long-term effects.
It is unknown what causes brain tumours. Family history, age, and the environment someone lives in consistently may be risk factors.
Brain tumour symptoms vary from person to person and may appear overtime or all at once. Not every type of brain tumour will generate the same symptoms. The symptoms may also occur with other conditions, so may not indicate a brain tumour.
Common symptoms of a brain tumour include:
- Behavioural changes
- Cognitive changes
- Dizziness or unsteadiness
- Double or blurred vision
- Frequent headaches
- Hearing impairment
- Morning nausea and vomiting
- Seizures
- Weakness or paralysis
Symptoms of a brain tumour will depend on the size and location of the tumour, and not everyone will experience all the symptoms listed.
[3]
A cerebral edema (also known as increased intracranial pressure or ICP) is when brain tissue swells. This happens when there’s injury, an infection, after a stroke or because of a lack of oxygen. When the brain swells, water collects in the tissues and pushes against the skull. This happens because the body is trying to get more blood to the injured area. In the case of the brain, this puts pressure on the tissue which leads to damage. Cerebral edema can be life-threatening if the swelling isn’t managed quickly.
[4]
Encephalitis (en-ceph-a-li-tis) is inflammation of the brain. It’s an uncommon non-traumatic brain injury, but can cause severe damage or even death.
Causes of encephalitis include bacteria, parasites (such as ticks), and viral infections. There are several different strains of encephalitis, often coming from the different viruses (for example, the West Nile virus).
Symptoms of encephalitis include:
- Confusion
- Drowsiness
- Fever
- Headaches
- Light sensitivity
- Nausea
- Stiffness in the neck
More serious symptoms include seizures, tremors and hallucinations. Many of the symptoms for encephalitis overlap with more mild conditions, such as flu. But you should seek medical attention if the symptoms – particularly fever and confusion – appear suddenly without no clear cause.
Encephalitis vs. meningitis
The symptoms of encephalitis are similar to those of meningitis. That’s because both are inflammation in the brain. Inflammation of the membranes that surround the brain and spinal cord (called meninges) is meningitis, while encephalitis is inflammation of the brain tissue itself.
[5]
Hydrocephalus occurs when excess cerebrospinal fluid (CSF) builds up in the brain. Too much CSF causes the ventricles of the brain to expand, increasing pressure and causing damage.
Hydrocephalus can be congenital or acquired. Congenital hydrocephalus happens in the womb from conditions such as spina bifida (when the spine doesn’t properly form) or a brain malformation such as Aqueductal Stenosis, Arachnoid cysts, Porencephaly, and Dandy-Walker syndrome. Acquired hydrocephalus can occur at any age. It can be caused by stroke, brain tumour, meningitis, intracranial bleeding, head injury, and other unknown (idiopathic) causes. While there are treatments available to help manage hydrocephalus, there is no permanent cure.
[6]
Hypoxia is when the body or brain is kept from getting the oxygen it needs. This can lead to permanent damage. When the brain and body completely loses its oxygen supply, hypoxia becomes anoxia. And this can lead to severe permanent damage as well.
Causes of hypoxia – which can lead to anoxia – include:
- Breathing problems that affect oxygen supply, like asthma or pneumonia
- Carbon monoxide or other toxins in the body
- Cardiac arrest or stroke
- Events that restrict air, like choking or near-drowning
- High altitudes where oxygen is low
- Significant blood loss
In the situations where oxygen loss is more immediate – like choking or cardiac issues – symptoms will show up quickly. In other cases, like high-altitude climbing or breathing problems, they may appear more gradually.
Mild symptoms of hypoxia and anoxia include:
- Difficulty concentrating
- Difficulty moving your body
- Dizziness
- Memory trouble
- Slurred speech
- Unexpected or strange headaches
More severe symptoms include:
- Hallucinations
- Loss of consciousness
- Seizures
[7]
Meningitis is the inflammation of the membranes around the brain and spinal cord because of an infection. There are two main strains of meningitis – viral and bacterial. Viral meningitis is the most common and is rarely fatal. Bacterial meningitis is extremely serious – if not caught and treated within a few hours it can lead to death.
Meningitis commonly spreads through close contact, including coughing and sneezing. There are some vaccines that help prevent meningitis, but they don’t protect from all possible causes. People with compromised immune systems because of cancer treatment, HIV, infection, or other auto-immune diseases are more at risk of catching meningitis and need to be extra-cautious.
Symptoms of meningitis
Early symptoms (in the first 6 hours) of meningitis include:
- Fever
- Headache
- Irritability
- Nausea/vomiting
Later symptoms of meningitis (6-12 hours) include:
- Drowsiness
- Leg pain
- Muscle aches
- Pale skin
After 12 hours, symptoms could include:
- Cold hands and feet
- Confusion
- A decrease in responsiveness
- Neck pain or a stiff neck
- A rash (common for meningococcal disease)
While these symptoms are common with other conditions, if they appear suddenly, you should get medical attention as soon as possible.
[8]
Opioids are a drug used to manage pain, typically after surgery. They create feelings of euphoria (happiness or ‘feeling high’). When prescribed by a doctor and taken in the recommended dosages, opioids can be safe.
Opioids can also be produced and obtained illegally and in a variety of forms. When obtained on the black market, opioid production is not controlled.
Opioids have their effect by causing the brain to release dopamine in greater amounts. Dopamine is tied to feelings of reward and pleasure. When used over a long period of time, the brain adapts by reducing the number of receptors, a process known as tolerance. Opioids alter the brain and how a person responds to normal rewards in the environment. Things that would normally make someone feel good and happy may no longer do so. That is why some people may use drugs in a dangerous way, even though they know their opioid use is causing problems. This leads to a greater risk of overdose.
Approximately 12 people die from opioid overdoses in Canada every day, having the biggest impact on Canadians aged 15-24 [9].
An opioid overdose can cause damaging effects such as slowing breathing/heart rate and starving the brain of oxygen. Depending on what parts of the brain are damaged and how long the brain was without oxygen, a person may experience [10]:
- Limb weakness
- Balance and coordination issues
- Spasticity or rigidity in muscle tone
- Abnormal, involuntary movements
- Loss of vision
- Memory loss
- Speech and language challenges
- Changes in cognitive abilities related to thinking and decision-making – this can affect future planning, work and social interactions
- Changes in personality – this includes irritability, impulsiveness, and social impairments
More information on opioids and substances
- Opioid overdose–Brain Injury Canada
- Substance use
Strokes are caused when blood flow to the brain is suddenly interrupted due to a clot or a ruptured blood vessel. The interrupted blood flow causes damage to the brain. Stroke can happen at any age and may result in the loss of the ability to move, to communicate, to process information, to swallow, to cope with stress, and more. Its after-effects often include extreme fatigue, depression, anxiety, deficits with memory, attention and vision, and the inability to sense self-movement and body position.
Identifying a stroke using FAST
The key to minimizing the damage a stroke can do to the brain is getting medical attention as quickly as possible. The Heart and Stroke Foundation advocates using the FAST method to identify strokes in others (or in some cases, yourself). FAST stands for Face, Arms, Speech, and Time.
- Face – is it drooping?
- Arms – can both be raised?
- Speech – is it slurred
- Time – call 9-1-1 immediately
These are the main symptoms of stroke. Additional symptoms can include confusion, loss of consciousness, sudden and severe headaches, and nausea/vomiting.
Stroke is normally talked about more in adults–but it can happen in kids and teens as well. If you would like more information about strokes, check out the following links.
[11]
The challenges of prognosis
Prognosis means the likely path a disease or injury will take. For brain injury, prognosis is meant to give a best estimate of effects and recovery. Brain injuries are all different, and there are a lot of factors that will impact a prognosis of recovery.
Factors that affect prognosis include:
- Severity of injury
- Previous injuries and existing conditions
- Access to treatment
- Age
- Location of injury
Research shows that there is no system or set of variables that can accurately predict outcome for a single patient [12]. There is no definite timeline for recovery – it’s different for everyone. Doctors will update their prognosis as recovery progresses and provide next steps at the same time.
Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:
- The product or service promises a quick fix
- Sound too good to be true
- Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
- Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
- The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
- Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based
Always proceed with caution and with the advice of your medical team.
[1] World Health Organization (1996). Brain injury definition. Geneva.
[3] Brain Tumour Foundation of Canada
[5] HealthLink BC
[7] Healthline
[8] Meningitis Foundation of Canada
