Brain Damage: An Overview

Brain damage, also called brain injury, refers to any injury to the brain. It can come from trauma, such as a car accident, or from a medical problem. Medical conditions that lead to brain damage include infections, certain diseases, or a lack of oxygen.

The severity and prognosis of brain injuries vary significantly. They can be mild and have no lasting impact, cause temporary disability, cause lifelong impairment, or even be fatal. Falls are one of the most common causes of brain injury.

This article reviews the types of brain damage, their symptoms, and their causes. It will also review how to treat and prevent brain injuries. 

Types of Brain Damage

Brain damage is classified as one of two types, depending on what caused it: traumatic brain injury (TBI) and nontraumatic brain injury (NTBI).

Traumatic Brain Injury

TBI is caused by an external force such as an accidental injury or assault.

A concussion is a common TBI. It occurs when your brain bounces inside your skull as a result of being hit. While it’s considered a “mild” brain injury, that’s only because it’s not usually life-threatening. Some concussions are quite medically serious.

Most of the time, a TBI affects a small area of the brain, which means that it affects a narrow range of functions. However, some closed head injuries may cause more diffuse damage that affects several areas and disrupts more of your abilities.

Nontraumatic Brain Injury

An NTBI is caused internally (from inside your body). Some causes are gradual while others are sudden. NTBIs are less common than TBIs.

NTBIs are sometimes called acquired brain injuries. However, that label can be confusing because it’s also used as an umbrella term for any brain damage acquired after you’re born, which includes both TBIs and NTBIs.

Symptoms

Symptoms of brain injuries vary greatly depending on the nature, severity, and location of brain damage.

Because the brain controls the rest of your body, symptoms can affect any system. They may change how you function physically, as well as the way you think, learn, feel, behave, and perceive the world around you.

Cognitive

Brain injuries can have a big impact on your cognitive abilities. This refers to the way you think and remember information. You may have problems such as:

• Confusion
• Short attention span
• Memory problems, including amnesia
• Problem-solving difficulties
• Poor judgment
• Inability to organize
• Inability to understand abstract concepts
• Impaired sense of time and space
• Lack of awareness of yourself and others
• Inability to remember more than one or two instructions at a time
• Forgetting how to perform simple tasks, like brushing your teeth or getting dressed

Communication impairments are common, as well. You may have difficulties with:

• Forming sentences 
• Understanding speech 
• Finding the right words
• Reading, writing, and/or working with numbers
• Slow, hesitant speech
• Forgetting the names of common objects

Perceptual

Sensory deficits are common after a TBI or NTBI. They can include:

• Changes to any of your senses (hearing, vision, taste, smell, touch)
• Double vision, limited range of vision, impaired distance vision 
• Being unaware of objects on one side of your body
• Loss of feeling or increased feeling in some body parts
• Difficulty knowing where your limbs are in relation to your body (poor proprioception)

Physical

Common physical symptoms of brain damage include:

• Headache
• Dizziness
• Fatigue
• Decreased stamina
• Weakness
• Muscle spasms
• Poor balance
• Tremors
• Poor coordination
  
• Loss of bowel and/or bladder control
  
• Changes in sleep and eating habits
• Paralysis

Depending on the location and extent of the damage, you may struggle with some physical skills, such as:

• Walking 
• Eating
• Grooming
• Driving a car

Perhaps the most extreme physical symptoms of a brain injury are a coma (extreme loss of consciousness) or a long-lasting vegetative state (being awake but showing no signs of awareness).

Behavioral or Emotional

You may notice changes in your behavior, emotional regulation, or personality following a brain injury. Common issues include:

• Irritability
• Anxiety
• Depression
• Rapid, extreme changes in mood
• Apathy (lack of caring)
• Low motivation
• Lack of inhibition, including inappropriate emotional outbursts, temper flares, aggression, and inappropriate sexual behavior

Your injury may cause changes that make social interaction difficult. For example, you may have trouble with:

• Understanding and responding properly to social cues
• Forming or maintaining relationships
• Grasping the nuances of social interaction

Causes

There are several possible causes of brain damage.

The most common causes of traumatic brain injury include:

• Falls: Falling down the stairs, from a ladder, in the bathtub, or even out of bed can lead to a TBI. Falls cause nearly half of hospitalizations for TBIs.
• Firearms: In the United States, firearm injury is the most common cause of TBI-related deaths.
• Sports, assaults, or motor vehicle accidents: Being hit in the head, falling, or experiencing a sudden impact can lead to a TBI.

Common causes of NTBIs include:

• Stroke
• Oxygen deprivation (due to heart attack, choking, or drowning)
• Exposure to toxic substances
• Infections, especially brain infections such as encephalitis and meningitis
• Neurological illnesses including multiple sclerosis, Alzheimer’s disease, and Parkinson’s disease
• Aneurysm
• Drug use or misuse
• Hydrocephalus (abnormal buildup of fluid in the brain)
  

Treatment

The treatment for a brain injury depends on several factors, including the type, severity, and location. You should always get immediate medical attention for a head injury.

Mild injuries are often treated at home. Moderate or severe brain damage often requires ongoing care to help you recover.

The first step in treating a TBI or sudden NTBI (like a stroke) is stabilizing the person and treating any life-threatening symptoms. For NTBIs, the underlying cause must be treated. This may include infection, tumor, or disease.

From there, the healthcare team will assess the extent of the damage and the symptoms it’s causing. Clinical tests may include:

• Neurological and/or psychological exams
• Neuroimaging tests, such as X-rays, CT (computed tomography) scans, MRI (magnetic resonance imaging)
• Glasgow Coma Scale (GCS)

Once the urgent treatment needs are met and the damage is fully assessed, the focus shifts to rehabilitation. This may include:

• Physical therapy
• Occupational therapy
• Speech and language therapy
• Mental health support
• Medications for ongoing problems

Prevention

Not all causes of brain injury can be prevented, especially in the case of accidental injury or disease. You can take some steps to protect your brain, though, especially during high-risk activities, including:

• Always wear a seat belt in the car.
• Never drive while drunk or impaired.
• Wear a helmet during contact sports; when skiing, snowboarding, and skating/skateboarding; when riding a bicycle, motorcycle, snowmobile, scooter, or any other motorized vehicle; and when riding a horse.

If you’re an older or medically at risk for falling, consider the following: 

• Make your home safer by removing obstacles and installing railings and hand-holds where appropriate.
• Ask your healthcare provider if you could improve your balance with physical therapy or exercise.
• Have your eyes checked every year and keep your vision correction up to date.
• Use a cane or other assistive device to help you balance.

If you work in a high-risk environment, be sure to observe safety regulations, such as wearing a hard hat or protecting yourself from toxic materials.

Summary 

Brain damage can come from traumatic and nontraumatic brain injuries. Traumatic injuries come from outside of your body (falls, car accidents, assaults) while nontraumatic ones come from inside your body (infection, disease, stroke, lack of oxygen).

Symptoms and treatments vary depending on the location and severity of your injury. Some people recover fully in a matter of days; others need extensive rehabilitation and may always have some impairment. Some brain injuries may be fatal. 

A Word From Verywell 

Whether it’s a TBI or NTBI, brain injuries are scary. Remember that many can be treated, and rehabilitation may help you regain lost abilities. Working closely with your care team is important for your continued progress.

Be sure you and your healthcare providers are addressing all of your symptoms, including your mental health. You may also benefit from attending a support group, either online or in your community. In such a setting, other people can offer you understanding, help, and knowledge based on their own experiences.