the.brain
Our brain is a beautiful thing. So clever! So complex! Juggling a million things at a mile a minute, its little neurons flashing away. But we can hurt it so easily : Sometimes by accident, and sometimes through our own stupidity.

Just like the flashing 'brain-o-rama', our own brains are a mushy mass, but floating in fluid, protected by the sturdy num-skull that surrounds it. It's easy to imagine what might happen if we were to slop it around a bit!

Perhaps the numskull would smash. Perhaps it would only fracture. Whichever were to happen, imagine what affect all that bouncing around would have on the brain cells themselves - bruised and damaged, the brain itself most likely would have turned and twisted on its axis (the brain stem), and may have rebounded off the sides of the skull!

Seeing stars? no wonder!

Hit your thumb with a hammer and it will swell like a balloon - Wallop the brain and the same thing will happen! However, locked in its bony prison it soon runs out of room to expand, causing more trauma. In general, damaged tissue requires extra oxygen to heal : the more traumatised the brain becomes, the more it swells, the more oxygen it needs. Because it is encased, this swelling causes parts of the brain to compress (squeeze together). This compression restricts the blood flow - and oxygen - which, in turn, causes more swelling. A Catch 22, if you will.

Any internal bleeding within the skull itself can only increase the danger and swelling - Advances in Technology (Cat Scans, MRI - magnetic resonance imaging, ICP - intracranial pressure - monitors, and surgical techniques) mean that prompt medical attention can and does offer a miraculous intervention.

Neurosurgeons are brain-buddies. They are surgeons specializing in the treatment of the nervous system and its surrounding structures - the skull, scalp, spinal column and our friend, the brain. They can give the brain more room, and increased blood flow to stem the cycle of swelling and compression through surgery - removing blood clots, repairing damaged blood vessels. Other professionals become involved as the patient progresses - Orthopaedics, Neuropsychologists, Physiotherapists, Speech Therapists, Social Workers, Rehabilitation experts. The list may be even longer depending on any other injuries sustained.

reality.check

These are U.S. statistics (Source: Interagency Head Injury Task Force Reports, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD)

• Every 15 seconds someone receives a head injury in the US alone
• Every 5 minutes, one of these people will die and one will become permanently disabled
• Equates to 2 million ABI's per year, with 500,000 requiring hospitalisation
• Half of the 2 million are children - 2/3 are under 30, with young men more than twice as likely as women to suffer head injuries
• Vehicle crashes cause 51%, falls 21%, violence 12%, sports and recreation 10% (Child abuse accounts for 64% of infant head injuries)
• Typically, a survivor of severe ABI faces 5-10 years of intensive services at an estimated cost of $4 million US dollars

Only 25 years ago, most of these people would have died. It is only due to medical advances and better standards of care that they survive today.

sick.bay

All better now? Well, not quite. An injury to the brain can turn everyday living into a struggle between Dr Jekyll and Mr Hyde! The physical scars may be on the mend but the families of ABI 'victims' can be in for a rude shock when their dearly beloved comes home from the hospital. Oh yes - all sorts of brochures will be tossed into your lap, however it is unlikely that anyone will sit down with you and actually tell you what might be in store. We will! (Remember though, that each injury is unique and some people may not have a problem with all of these symptoms)

Let's divide them up into 4 categories to make it easy to explain :

Thought-related (Cognitive)

Memory loss (particularly short term) Difficulty processing information (decreased speed, accuracy) Shortened attention span (lack of concentration) Easily distracted Impaired decision-making, judgement and reasoning Difficulty adjusting to change Harder to express thoughts, understand others, finding the right word Difficulties following instructions, multitasking

Headaches Extreme mental and/or physical fatigue Seizures Coordination, movement limitations, weight gain Sensitivity to light, vision loss Speech and/or hearing difficulties Sleep disturbances Loss of strength

Body-related (Physical)

Feeling-related (Emotional)

Irritability and impatience Less tolerance of stress, noise Denial of disability Lack of inhibition (inappropriate behaviour) Aggresiveness Lack of self-esteem, apathy Exaggerated reactions

Altered sense of noise, temperature Altered sense of pain Disorders of smell/taste Altered sense of balance Loss of sense of time Spacial disorientation misunderstanding by others

Environment-related (Perceptual)

(Our personal favorite is 'Irritability' - hmmm!)

contacts Not surprisingly, the majority of ABI references listed on the web are U.S. based. We will endeavour to come up with a decent list of Australian sites in the near future, meanwhile ...

• HEADWAY VICTORIA : Provides free services to Victorian Australians living with ABI, 'works with people with ABI, their carers, families, service providers, governments and the media in ensuring their needs are heard and acted upon'
  http://home.vicnet.net.au/~headway/
  Email : hwvceo@vicnet.net.au
  
  HEADEAST NSW: Aims to help people between 14 and 60 years of age who are motivated to change an aspect of their lives. Priority is given to those who have been injured in a motor vehicle accident. People who have acquired brain injury though trauma, stroke, tumour, infection, hypoxia or drug abuse are also eligible.
  http://www.bensoc.asn.au/centage/coabrain.htm
  Email : mailben@bensoc.asn.au
  
  HEADWAY QLD: The Brain Injury Association's Resource Centre coordinates a range of services to people with brain injury, family members and professionals throughout Queensland.
  http://www2.eis.net.au/~biaq/index.html
  Email : iaq@eis.net.au
  
  EPILEPSY FOUNDATION VIC: Provides vigorous public education, advocacy, employment programs, recreational support, individual and group counselling, support for medical and psycho-social research, and accessible provision of comprehensive epilepsy information, in an organisation which values and respects the diverse skills and life experiences of its members and those who turn to it for support.
  http://www.epinet.org.au/
  Email : epinet@epinet.org.au
  
  COMMONWEALTH OFFICE OF DISABILITY: Provides a link for the disability community to express their views and ideas to Government and vice-versa. The Office also has an important role in the co-ordination of disability policy across the Commonwealth and is committed to encouraging equal access to services, facilities and programs for all.
  http://www.health.gov.au/ood/
  Email : office-disability@health.gov.au
  
  
• WWW.WAITING.COM : The process of recovery from ABI is indeed a waiting game - One of the best U.S. sites packed with loads of really useful information, prepared by families who have been affected by ABI in some way. Nicely presented, in a plain language style that anyone can follow.
  http://www.waiting.com
  Email : becca@beccaltd.com
  
  
• THE PERSPECTIVES NETWORK : Prepared by a 'survivor', this site offers much for many. U.S.
  http://www.tbi.org
  Email : dktaylor@tbi.org
  
  
• MEDICAL INFORMATION :
  http://www.med.harvard.edu/AANLIB/home.html
  http://www.healthgate.com
  
  
• Try a search engine for more information -we have selected a few of the more comprehensive, easily understood sites.