The brain sits inside a skull made up of bone. Brain tissue occupies a certain amount of space within that skull. The rest of the space is completely filled up with controlled amounts of two fluids: blood and cerebrospinal fluid (CSF). Since the bone of the skull cannot expand to make more space, an increase in the amount of any of its contents---brain tissue, blood or CSF---means that there must be a decrease in the other two. Bleeding caused by the brain injury, for instance, can add to the normal amount of blood inside the skull. The extra blood causes pressure, which causes damage to delicate brain tissue. The brain controls all the body's functions. This includes thinking, moving, being awake, and eating. Because the brain has been hurt, a brain injury survivor may suddenly lose control of some or many of these functions. Changes in cognitive (thinking), physical, emotional, and behavior functioning can happen following a brain injury. What is a Traumatic Brain Injury? A Traumatic Brain Injury (TBI) is an injury to the brain caused by an external physical force. Common causes are falls, motor vehicle accidents, gun shot wounds, work related injuries, shaken baby syndrome, and domestic violence.

An Acquired Brain Injury (ABI) is the result of changes in the activity of the brain not related to injury or birth processes. Most common causes of acquired brain injury are strokes, blood clots, tumors, infections, and lack of oxygen to the brain.

Approximately 1.5 million people per year will sustain a head injury in the United States. Of those, the majority are males. The two highest age groups at risk are 0 to 4 years of age and 15 to 19 years of age. Leading causes are falls, motor vehicle accidents, gun shot wounds, and assaults.

Mild brain injury presents with no or brief loss of consciousness. Initial testing may appear normal. The individual may appear dazed or mildly confused. Symptoms include headache, irritability, sleep disturbance, fatigue, pain, memory problems, and depression. Symptoms may last days or months.

Moderate head injury refers to situations with a loss of consciousness ranging from a few minutes to a few hours. Confusion may last for days or weeks. Cognitive, physical, and behavioral impairments may last for months or be permanent.

Severe head injury may be characterized by an extended period of unconsciousness (coma), lasting days to months. Individuals with severe head injuries may make progress, however, often sustain significant permanent impairments.

Symptoms and related deficits fall into four major groups:

1. Cognitive
2. Perceptual
3. Physical
4. Behavioral/Emotional

Keep in mind that because of the uniqueness of each injury, some survivors may or may not face or exhibit some or all of the symptoms. The number of symptoms doesn't reflect on the impact that the injury will have on the survivors. Much of that depends on where the injury is located. The following is, by no means, a complete or comprehensive listing.

1.  Cognitive Symptoms:

• Difficulty in processing information (decreased speed, accuracy and consistency)
• Shortened attention span
• Inability to understand abstract concepts
• Impaired decision-making ability
• Inability to shift mental tasks or to follow multi-step directions
• Memory loss or impairment
• Language deficits (difficulty expressing thoughts and understanding others, inappropriate word selection)

2.  Perceptual Symptoms:

• Change in vision, hearing or sense of touch
• Loss of sense of time and space and spatial disorientation
• Disorders of smell and taste
• Altered sense of balance Increased pain sensitivity

3.  Physical Symptoms:

• Persistent headache
• Extreme mental and/or physical fatigue
• Disorders of movement - gaiting, ataxia, spasticity and tremors
• Seizure activity (traumatic epilepsy)Impaired small motor control
• Photosensitivity (sensitivity to light)
• Sleep disorders
• Paralysis
• Speech that is not clear due to poor control of the muscles in the lips, tongue and jaw and/or poor breathing patterns

4.  Behavioral/Emotional Symptoms:

• Irritability and impatience
• Reduced tolerance for stress
• Lack of initiative, apathy
• Dependence (failure to assume responsibility for one's actions)
• Denial of disability
• Lack of inhibition (may result in aggression, cursing and inappropriate sexual behavior)
• Inflexibility
• Flattened or heightened emotional responses/reactions

Each injury is different and unique to the survivor just as all survivors have different capacities for recognizing and compensating for the symptoms they exhibit. Much depends on getting the correct diagnosis and treatment and ensuring that good support systems are in place for the ENTIRE family. Changes and improvement continue although sometimes they are so slight they are hard to notice. It doesn't happen overnight. Some of the deficits may remain for a lifetime while others may improve to the point that they are not a major factor in day-to-day living.

In the most mild of cases, the brain still gets bruised in much the same way your leg might get bruised if you bump into a coffee table. However, the head and the brain is pretty resilient and it can usually handle that injury without much effort. Sometimes people can get a really tremendous blow on the head and it not have any external effect. Again, much depends of the location of the injury and the brain's ability to compensate.

NO! Estimates place the annual occurrence of Acquired Brain Injury at 2 million. Tasks shared are tasks light. PLEASE take advantage of the people and organizations waiting to help you. You will find resource listing in this site.

Brain injury is traumatic...physically, mentally and emotionally. It is hard on the person who has sustained the injury and it is hard on the family and friends of that person. It usually occurs quickly and without warning and finds everyone scared, confused, overwhelmed and in a state of shock.

Just as the definition of ABI varies so does the information that is passed onto the survivor and their family. I can either be too much or too little. It can be only the good or only the bad. There might be times when you're so tired you don't think you can go another step. You'll find yourself caught up in many different emotions. You might feel that all hope is gone...but never give up!

Brain injury requires that someone without prior knowledge quickly become informed and aware of what is happening now and what might happen in the future. It requires that lines of communication be put into place and then used to their maximum, advocating for the survivor until he/she is able to assist with that responsibility or take it over completely.

If you are the survivor, there will be times when you are so frustrated, so angry, so depressed, so confused that you will want to give up...don't! Reach out and find a peer groups of survivors and let them help you. You will find out that you ''are not going crazy' inspite of what it sometimes seems like.

Recovery will vary and changes will occur long after you were told they would stop. A great deal will depend on the desire of the survivor to improve but 'desire' alone won't do it. Never feel that this injury will go away if the survivor really wanted it to. It will take work and lot's of it on everyone's part.

Some interesting facts about Traumatic Brain Injury!