Non-Traumatic Brain Injury/Non-Traumatic Brain Damage

By: Donna Flores & Erlynn Sakisat

RH 430- Medical & Psychosocial Aspects of Disability

Instructor: Roland Merar

Bell work What do you think is the difference between traumatic

brain injury and non-traumatic brain injury?

Be prepared to share…

Student Learning Outcomes

• Students will be able to define non-traumatic brain injury/damage;

• Students will be able to identify the types of non-traumatic brain injury/damage;

• Students will be able to relate to the psychosocial aspects of non-traumatic brain injury/damage.

Non-Traumatic Brain Injury/ Non-Traumatic Brain Damage

-Conditions in which the brain has sustained damage due to conditions unrelated to traumatic brain injury.

- Occurs at the cellular level in the brain, affecting its physical structure, metabolic activity, or the ability of brain cells to function.

Non-Traumatic Brain Injury/Non-Traumatic Brain Damage

The brain has been damaged by an illness. There are no cuts or broken bones.

Common types are infection and brain tumor.

Causes

• Interference with Oxygen reaching the brain (choking, carbon monoxide poisoning, infection).

• Problems within the brain itself (stroke, structural problems within the brain or blood vessels in the brain).

• Specifically, non-traumatic brain damage is caused by conditions that cause restriction or interference with blood

and oxygen reaching parts of the brain.

Types & Classifications

• Meningitis- an inflammation of the meninges (membrane surrounding the brain & spinal cord). Types of Meningitis are bacterial, viral, and fungal.

• Encephalitis- an inflammation of the brain due to direct invasion of an organism.

• Stroke/Cerebral Vascular Accident (CVA)- an acquired brain injury in which there is a sudden alteration in brain functioning, resulting in weakness or paralysis in a body part as well as other neurological deficits due to decreased blood flow to a part of the brain.

Conditions & Complications of Meningitis

• Caused by bacterial viruses, or other organisms. Hallmark of this disease is its rapid onset;

• Many types exist- specific name given to meningitis infection is frequently related to its cause or location:

Cerebral Meningitis refers to meningitis of the brain;

Cerebrospinal Meningitis refers to meningitis of both the brain and the spinal cord;

Meningococcal Meningitis/Spinal Meningitis refers to meningitis of the throat.

Meningitis (cont.)

• Diagnosis: A lumbar puncture, in which a needle is inserted between the vertebrae and into the subarachnoid space. (Spinal tap)

• Cerebral fluid is aspirated and examined microscopically for organisms.

• Symptoms include fever, flu-like symptoms that progress into severe headaches, irritability, lethargy, nausea and vomiting, neck rigidity, slurred speech, seizures, not hearing properly and visual discomfort when exposed to bright lights. Also, a dark purple rash that will not go away even when you press on it.

Non-Traumatic Brain Injury due to Meningitis

Treatment

• Antibiotics reduce the chance of progression, if the cause is bacterial in origin.

• Immunization or vaccines against the meningococcal disease (Haemophilus influenza group B, Hib).

• Prompt treatment and medication has been known to greatly reduce the chances of fatalities from Meningitis; however if it is delayed it can still be fatal.

• Although most individuals with meningitis recover completely, some may have residual neurological deficits such as deafness, paralysis, or cognitive difficulties.

Conditions & Complications of Encephalitis

• Caused by an endemic virus, such as the West Nile Virus, a mosquito borne virus, or it may occur secondary to another infection, such as measles or chicken pox.

• Symptoms are similar to Meningitis and may include: severe headache, stiff neck, and some individuals may go into a coma, if it is not caught early.

• Symptoms can subside in a few weeks, however, the condition can be life-threatening .

• If not treated early, irreversible neurological changes can occur.

Non-Traumatic Brain Injury due to Encephalitis

Treatment

• There is no adequate treatment for encephalitis, except for maintaining comfort and preventing complications.

• It can occur in any age group, although children and adults are more susceptible.

• Individuals with compromised immune systems (HIV,AIDS, Cancer, those who have received organ transplants) are also at greater risk.

Management

• Common tests performed after a brain injury include:

Magnetic Resonance Imaging (MRI); Computerized Axial Tomography (CT Scan); Electroencephalogram (EEG); Arteriogram and Angiogram; Intracranial Pressure Monitor.

Rancho Los Amigo Scale

Types of Rehabilitation Services

• Neuropsychological Services, Nursing Services, Occupational Therapy, Physiotherapy, Social Work, Speech Language Pathology Services, Modified School Programs, Child Life Services.

• These services may be provided in the hospital, at a rehabilitation facility, at home or in the community.

Activity

What Brain Injury Do I Have?

Traumatic or Non-Traumatic

1. I am HIV positive.

2. My boyfriend stabbed me in the head with an ice pick.

3. I contracted the West-Nile Virus from a mosquito bite.

4. My girlfriend gave me Herpes.

5. I am suffering from an allergic reaction.

6. I am an infant with an upper-respiratory infection.

7. I am an athlete suffering from a concussion.

8. I am a soldier who was hit in the head by a shrapnel from a

blast.

9. I fell off my skateboard and cracked my head on the pavement.

10. I have Alzheimer’s.

11. I have a benign brain tumor.

Conditions & Complications of Stroke

• Stroke or CVA is usually the culmination of progressive disease that has occurred over a period of many years (heart disease, hypertension, and diabetes, obesity, high cholesterol levels, physical inactivity, alcohol7 drug abuse-especially cocaine and amphetamine abuse, smoking).

• Caused by one of two events:

-rupture of a blood vessel (hemorrhagic stroke)

-occlusion of a blood vessel (ischemic stroke)

Hemorrhagic Stroke

• Caused by a rupture of a blood vessel, causing hemorrhage.

• In this instance, brain tissues die not only because a certain area of the brain is deprived of oxygen, but because the escaped blood compresses brain tissue against the skull causing further damage.

Ischemic Stroke • Caused by diminished blood flow to the brain.

• Common cause is blocking of a cerebral artery by a clot (thrombus) that has formed inside the artery (Cerebral Thrombosis).

• Brain tissue dies because of the lack of oxygen (anoxia-no oxygen) or (hypoxia-too little oxygen) saturation going to the brain.

• Embolism- occurs when a clot or other substance from another part of the body forms and breaks off while traveling to the brain and lodges in one of the cerebral arteries.

• These are called “ministrokes” or Transient Ischemic Attacks (TIAs).

Functional Consequences of Stroke

• The amount and degree of function lost as a result of the stroke depend on the following factors:

• The side of the brain affected

• The specific area of the brain that has been damaged

• The amount of damage that has occurred.

Non-Traumatic Brain Injury due to Stroke

Functional Consequences (cont.) • Cognitive, language, and motor skills are also affected by stroke. • Weakness or paralysis in an extremity or one side of the body

(hemiplegia) • Loss of coordination (ataxia) • Loss of sensation in half of the body (hemiparesis) • Visual defects • Loss of perception of visual depth and distance • Auditory or other sensations • Inability to organize and sequence specific muscle movements • Difficulty with speech • Bowel or bladder dysfunction

Left-Sided vs. Right-Sided Brain Damage

• The most visible sign of left-sided brain damage, regardless of the underlying cause is the right-sided motor and sensory paralysis.

• Language center, which processes verbal symbols is located in the left side of the brain.

• This means, individuals with left-sided damage will most likely have problems with verbal and/or written communication (aphasia).

• Individuals affected may be slow, hesitant, anxious and disorganized when presented with new or unfamiliar situations.

• The most visible sign of right-sided brain damage is left-sided motor and sensory paralysis.

• Individuals may experience loss of depth perception, some degree of loss in visual perception, lack of awareness of stimuli on the left side of the body, difficulty with navigation in the environment, problems with memory, disorientation, inability to recognize familiar people or places.

Management

• Major focus after stabilization of stroke is the restoration of function and reduction of limitations.

This means… physical therapy and occupational therapy.

So that these individuals can attain, re-establish, as much as possible, his or her independence, and return to pre-existing roles and relationships.

Psychosocial Issues • Alters the individual’s capacity for social role functioning.

• Depression due to a loss of competency, perception of identity, self-concept, and self-esteem.

• Stroke can create a psychosocial crisis for the family not only because of the functional consequences experienced by the individual, but also because of the resulting increased care giving responsibilities that family members must assume, often with little training or support.

Activity

• Presentation by Ms. Amber Lynn Mendiola on

Prevention/Intervention- Healthy Lifestyles

Re-cap Did We: 1. Define non-traumatic brain injury/damage?

2. Identify the major types of non-traumatic brain injury/damage?

3. Relate to the psychosocial aspects of non-traumatic brain

injury/damage?

Thank you!