Acquired brain injury is a problem that affects more than 400,000 people in Spain, which makes it the third cause of death in the population of our country, first in women, a group more affected than men by this problem. Dr. María José Fernández Aguirre, specialist in Physical Medicine and Rehabilitation, explains what ACD consists of.
Acquired brain injury (ABI) consists of an injury that occurs suddenly in the brain, and is characterized by a series of sequelae that vary according to the severity of the brain injury and the area injured. Acquired brain damage can appear in two ways, due to a disease or after suffering a blow or trauma. – ACD due to disease: this is a cerebrovascular accident or stroke. In this case, there is an abrupt interruption of blood flow in an area of the brain.
– ACD due to stroke or trauma: this is a traumatic brain injury. The most frequent cause of this trauma is traffic accidents, although there are also cases following accidents at work or assaults.
Common symptoms of acquired brain injury
The symptoms of acquired brain injury vary depending on the area that has been affected, i.e. the area of the brain that has lost blood flow. Thus, the symptoms will vary according to the area where the problem has been located as well as its intensity. Currently, more people survive after suffering a stroke or traumatic brain injury thanks to emergency assistance. Early treatment -especially in certain strokes- makes it possible to minimize later sequelae, although a large number of people will suffer important sequelae, such as severe limitations in both physical and mental function -knowledge and memory-, communication disorders, mood disorders and difficulties in achieving social reintegration.
Rehabilitation after Acquired Brain Injury
Rehabilitation consists of a process whose final objective is to prevent and treat the deficits that occur after suffering brain damage, such as physical and motor problems, mental problems, speech and behavioral problems. Given that the presentation of these symptoms can be very varied and complex, it is essential to have a multidisciplinary team made up of different professionals who, properly organized and coordinated, will strive to recover the maximum capacity of the altered or affected functions. Thus, the objective of rehabilitation is to achieve social reintegration. Although the first and most urgent care is carried out in the Intensive Care Unit or in the Emergency Department, specific comprehensive treatment units are proliferating more and more frequently. Neurology services are integrated in these units, although the rehabilitation process is usually coordinated and directed by a rehabilitation specialist. The healthcare professionals that form part of a rehabilitation unit include physiotherapists, occupational therapists, speech therapists, psychologists, orthopedic technicians and social workers, although occasionally the presence of orthopedic surgeons and psychiatrists may also be required. Depending on the area of rehabilitation being worked on, the sequelae of ACD can be classified into seven major areas: level of alertness, motor control, reception of information, communication, cognition, emotions and activities of daily living. The bases of a good recovery are based on attending a center that has the necessary equipment and professionals, being able to withstand intensive treatment and having a family that supports the patient unconditionally. As for the rehabilitation process, it will be considered stabilized when both the acute and subacute phases have been overcome, i.e., at the moment when improvement seems to be stagnant. However, this concept is under revision since the phenomenon of neuronal plasticity is known, in which improvements have been seen even later than two years, especially in young brains. However, in general cases, rehabilitation is no longer carried out in the way it was done until then. In this stabilization stage, social reintegration and prevention of complications, especially neuroorthopedic ones, are the most important goals.
The role of the family after Acquired Brain Injury
It is essential that the family be informed and receive clear instructions from the very beginning. Thus, it will be easier to assume the shocking reality, and it will be necessary to become aware that during the whole rehabilitation process, the role of the family is basic and fundamental to achieve results. The family is the one who will spend the most time with the patient and who will know him best.
October 26, National Acquired Brain Injury Day
Since 2007, Acquired Brain Injury Day has been commemorated every October 26, with the aim of raising public awareness of sudden brain injuries and the consequences they have on the lives of affected families. Stroke is one of the most frequent causes of morbidity and mortality worldwide, and is nowadays considered a medical emergency. Its early treatment with the implementation of the stroke code has meant a great advance in survival and reduction of sequelae in those patients in whom it has been applied. For those who are left with significant sequelae, intensive and early rehabilitation programs play a fundamental role. Drawing attention to obvious facts, involving professionals, social agents, families, associations of those affected and citizens in general more than justifies the designation of a national day to commemorate Acquired Brain Injury.