|Physical||Communication||Cognitive||Behavioural / Emotional|
Headache is a common issue following brain injury and can be a long lasting problem. Headache may result from the brain injury, neck and skull injuries that have not yet fully healed, tension and stress, or side effects from medication. The type of headache depends on the source of the issue.
People with milder brain injury have higher rates of complaints of headaches when compared to those with moderate and severe brain injury. The reason for the higher rates
of headaches with milder severity brain injury is not well understood.
Headaches may be treated with over the counter medication, changes in lifestyle, therapeutic massage, heat or cold packs, or relaxation therapy. Frequent headaches may require prescribed medication such as antidepressants, anti-seizure medication, beta blockers or botox injections.
Fatigue is one of the more common effects of brain injury, even after a mild traumatic brain injury. The brain may have to work harder than before due to damage within the brain. Medications to treat spasticity, seizures and mood can cause fatigue. Sleep disorders and changes in hormonal levels post brain injury may also cause fatigue.
Some people may be very fatigued all the time and others may only be fatigued after mental or physical exertion.
Most people who have fatigue resulting from brain injury only experience the problem at certain times and not all the time. They have more energy in the morning and tend to be more tired later in the day. People’s levels of fatigue also depend on how much they are pushing themselves physically or cognitively, and whether they are making time to rest periodically during the day and pace themselves. The following steps may help:
If a cause for the fatigue cannot be found post injury/incident and the fatigue is not improving and is long term, then the use of a stimulant medication can be considered but you would need to speak to a doctor about this.
Studies show that more than 50 percent of people suffer from chronic pain disorders in the years following a brain injury. Headaches and neuropathic (nerve-related) pain is most commonly from injury to the head and neck. The head is the most common location of pain.
Doctors can effectively treat pain by identifying it, quantifying it, reviewing the history of the person’s pain, and understanding how it limits function. Treatment of pain is a balancing act when considering medications since many medications to treat pain can worsen memory and cause sleepiness, especially with opioid and antidepressant drugs.
Patients with TBI may be even more vulnerable than other patients to the cognitive side effects of certain pain medications. Because of this, the use of non-sedating analgesics should be a first line in treating pain in patients with TBI. Mood disturbance can be caused by chronic pain or worsen chronic pain and needs to be addressed as part of treatment.
Cognitive behavioural therapy (or CBT) has been shown to be very effective at helping to relieve problems with chronic pain, it works because pain is a subjective experience, it can be enhanced or reduced by thoughts and feelings. Therefore by changing the way you feel or think about your pain the severity of its sensations can be reduced.
In severe or chronic cases a referral to a pain clinic may be considered.
"NHS clinicians struggle with what intervention to prioritise in paediatric neuro-rehabilitation due to limited clinical time and the complexity of needs. Children, clinicians, parents and schools all have different neuro-rehabilitation priorities"
"When different organisations assess different aspects of a child's neuro-rehabilitation needs, everyone looks at things from a different perspective and highlight needs and conflicting priorities"
"Positive and coordinated neuro-rehab interventions for children and young people is proven to bring health improvements; improve independence; reduces the need for sheltered living; decreases vulnerability; decreases drop-out rates in schools; decreases youth offending"
"We need to harness the power of brain plasticity for treating children and young people with brain injury. Stressful experiences alter brain development of a child, especially at the key ages of 0-3 and at ages 10-16"
"Rehabilitation interventions can lead to positive outcomes for children and their families if delivered in the familiar home environment and applied to everyday situations"
"Thousands of children and young people living in the UK today without the help and support that can make a huge difference to their lives"
"Brain development is complex and prolonged. Brain plasticity is influenced by a range of factors. Plasticity provides a base for neuro-rehab therapies and treatment"
"When someone has a brain injury, early access to local, specialist rehabilitation is crucial to ensure the maximum recovery and make significant savings to the state in health costs"
"There are problems with getting people into neuro-rehab centres. Those most in need are often those most excluded due to a lack of socio-economic resources."
"We are medical practitioners. The real experts are the parents. Over the last 35 years they have taught me everything I know"