Use these links to jump ahead to a relevant section:

• What Will Life After Brain Injury Look Like?
• How to Recover Function After Brain Injury
• How to Improve Your Quality of Life After Brain Injury

What Will Life After Brain Injury Look Like?

Traumatic brain injury can cause severe physical and cognitive limitations. While it is possible to recover from many of these, they can still present significant challenges in your daily life.

The following are a few examples of some of the most common secondary effects you might experience after brain injury:

Physical Symptoms

Severe TBIs can cause various physical symptoms, including:

• Dizziness and balance issues
• Severe headaches
• Spasticity
• Muscle weakness and atrophy

In addition to these symptoms, patients can also experience seizures. These mostly only occur after certain types of traumatic brain injuries, however.

Sensory Problems

A traumatic brain injury can also disrupt the brain’s ability to process the senses. For example, TBI can lead to many visual problems, including:

• Double vision
• Hemi neglect or inattention to one side of the environment
• Light sensitivity
• Loss of depth perception

Besides problems with vision, a severe brain injury can also cause the person to have tactile sensory changes, or even lose their sense of taste and smell, a condition known as anosmia.

Cognitive Impairments

Perhaps the most common difficulties that patients experience after brain injury revolve around cognitive impairments. These include issues such as:

• Attention problems
• Difficulties with decision making and other executive skills
• Memory issues
• Lack of insight

Fortunately, you can treat these and other cognitive issues with cognitive exercises for TBI patients.

Emotional Problems

Finally, patients can develop several emotional problems after brain injury. These are primarily caused by frontal lobe injuries.

Some emotional changes that occur after brain injury include:

• Anxiety
• Low motivation
• Depression
• Severe mood swings (emotional lability)
• Lack of emotional expressiveness (flat affect)

Besides all these symptoms, people with a brain injury can sometimes also develop PTSD from the traumatic event. However, not everyone who sustains a TBI develops PTSD. PTSD tends to go more hand-in-hand with mild TBI, because with more severe injuries, the individual typically does not remember the incident that caused it and may not even be aware that they are injured.

PTSD causes many of the same symptoms as brain injury, but they are accompanied by heightened sensitivity to danger and involuntary memories of the traumatic event.

How to Recover Function After Brain Injury

The above list of symptoms above can seem overwhelming at first, but it is important to realize that not every person will experience every secondary effect.

Still, it can be helpful to know what symptoms you may experience after brain injury. That way you can take the correct actions to minimize their severity.

In fact, many of these symptoms can be treated by activating a process called neuroplasticity. This term refers to the brain’s ability to repair neural connections. It allows people to regain functions even after a devastating injury.

Engaging Neuroplasticity After TBI

The key to activating neuroplasticity lies in therapeutic exercise. That’s why doctors encourage so much therapy in the early stages of recovery.

Even after you return home, it is critical to continue with regular therapy. If you struggle to remember your exercises, have your therapist write you a home exercise sheet to help you know exactly how to do them.

There are also home therapy devices, such as FitMi, which walk you through common exercises. Many patients find that these devices help them stay motivated in a way that hand-out sheets do not.

Beyond exercise however, there are other activities you can practice to improve your life after brain injury. We will discuss those in the sections below.

How to Improve Your Quality of Life After Brain Injury

While life after brain injury will not be easy, it is still possible to achieve happiness. Your life may look a lot different now, but it can still be worthwhile.

The following are a few ways to accomplish this:

1. Follow a Brain Injury Diet Plan

A proper diet plan can boost brain injury recovery. Therefore it’s important to consume foods that promote healthy brain function, such as foods rich in flavonoids and omega-3.

The following are a few examples of the best foods for brain injury:

• Fatty fish, such as salmon and mackerel
• Dark chocolate
• Dark, leafy greens such as kale and spinach
• Eggs
• Berries
• Walnuts
• Turmeric root

In addition, it is crucial to avoid fried and processed foods as much as possible after brain injury, as these foods increase inflammation and hamper neuroplasticity.

2. Create a structured routine

In the early stages of your brain injury recovery, your days were most likely fully planned out by others and filled with appointments. If you are like most brain injury patients, however, this schedule didn’t last forever.

Unfortunately, many TBI survivors fall into an unhealthy routine when their schedule opens up. For example, they might sleep in late, spend the afternoon surfing the internet or watching TV, take a nap, and start the routine all over again the next day.

This isn’t meant as a negative judgment. Brain injury makes it much more difficult to make decisions and initiate activities. Therefore, you are not lazy. You might just need help changing your habits.

That’s where a structured routine comes in. It helps you know “what’s next” without having to come up with something on your own every time. That way, you can stay active and prevent decline. Simply engaging in your everyday activities regularly (brushing teeth, getting dressed, bathing, etc.) is a form of “exercise” after TBI, and will boost your recovery if you try to consistently participate.

3. Focus on small victories

It’s important to keep your focus on small victories in the early days of your recovery. This can help you stay motivated to continue your recovery.

For example, instead of focusing on what you have lost, focus on what you have gained during your recovery. Maybe you couldn’t even stand up at all when you first started therapy, and now you can stand for ten seconds unsupported. That’s a big deal, and you should be proud of yourself.

This fact is true for everyone, with or without a brain injury. If you only consider how far you still need to go to get where you want, you’ll soon get discouraged.

But if you break it down into smaller pieces, you’ll find it much easier to stay positive.

4. Stay Physically and Socially Active

As you gain more abilities back, it’s important to stay both physically and socially active.

The more active you are, the more your brain gets stimulated, which helps create new neural pathways and promotes better brain function. Similarly, interacting with peers improves your cognitive function and helps fight off feelings of depression.

If possible, try taking part in some recreational therapy activities for traumatic brain injury patients. These activities are fun ways to stay active and find a social group that understands and supports you.

You can also try volunteering at your local church or charity. Many people find that helping others makes their life after brain injury meaningful again. The key is to have something that keeps you engaged and outside the house at least once a week. This helps improve both your TBI symptoms and your quality of life.

Living Your Life After Brain Injury

As you can see, brain injury doesn’t have to be the end of your story. There are many ways to make your life after brain injury a rewarding experience.

It all depends on how you choose to see your new life. As cliche as it may sound, your attitude really does make all the difference.

If you choose to stay positive and keep yourself active, you’ll have an easier, more fulfilling life than if you focus on the negative.

Yes, life may never look like it did before your injury. Some activities will always be more difficult than they are for others. But this doesn’t mean your life will be empty. You can still find joy and happiness in life after your brain injury. You just have to know where to look.

The post Life After Traumatic Brain Injury: Learn What to Expect and 4 Simple Tips on How to Improve Your Quality of Life appeared first on Flint Rehab.

This scale is helpful because it gives everyone a clear, shared way to talk about a patient’s condition, track changes over time, and make treatment decisions. In this article, we’ll break down what the GCS is, how it works, how scores are calculated, and what the numbers mean.

What is the Glasgow Coma Scale?

The Glasgow Coma Scale (GCS) was created in 1974 by two doctors from the University of Glasgow in Scotland. It gives a simple and objective way to check how alert someone is, especially if they may be in a coma or have trouble staying conscious. Instead of guessing, the GCS helps medical staff measure how someone responds in three main areas:

• Eye opening
• Verbal response (speaking)
• Motor response (moving their body)
  

Each area is scored, and the total score helps show how conscious or responsive the person is. In order to be rated at the top of the scale (fully conscious), an individual must be awake, alert, oriented, and able to respond to simple commands. This standardized approach helps provide a consistent assessment and clear communication for healthcare providers.

Glasgow Coma Scale Meaning: Breaking It Down

The power of the Glasgow Coma Scale lies in its structured approach and straight-forward evaluation of different neurological functions. Specifically, the GCS looks at three specific types of responses. Each one gives different clues about how the brain is working.

Let’s take a look.

Eye Opening Response (E)

This component assesses the patient’s ability to open their eyes in response to specific stimuli. It reflects the function of the ascending reticular activating system (ARAS) in the brainstem, which plays a crucial role in arousal and wakefulness. The scoring for eye opening is as follows:

• 4 – Spontaneous: Opens eyes on their own.
• 3 – To Speech: Opens eyes when someone speaks or shouts
• 2 – To Pain: Opens eyes only when feeling physical pressure or in pain
• 1 – No Response: Does not open eyes at all

Verbal Response (V)

This component evaluates the patient’s ability to communicate verbally and the coherence of their speech. It reflects the function of the cerebral cortex, responsible for higher-level cognitive functions, including language. 

The scoring for verbal response is:

• 5 – Oriented: Answers questions correctly and knows their name, where they are, and the day/year.
• 4 – Confused: Talks but seems confused.
• 3 – Inappropriate Words: Says words, but they don’t make sense.
• 2 – Incomprehensible Sounds: Makes sounds such as groaning, but no real words.
• 1 – No Response: No sound or speech at all

Motor Response (M)

This component assesses the patient’s motor response to verbal commands or painful stimuli. It reflects the integration of cortical and spinal cord function. 

The scoring for motor response is:

• 6 – Obeys Commands: Can follows simple commands (like “raise your arm”)
• 5 – Localizes to Pain: Tries to push away pain. In other words, they purposefully move toward the source of a painful stimulus to try and stop or remove it.
• 4 – Withdraws from Pain: Tries to pull away from pain. In other words they purposefully move away from a painful stimulus indicating some level of motor response, which may be reflexive.
• 3 – Abnormal Flexion (Decorticate Posturing): Makes abnormal bending movements (decorticate posture) in response to pain.
• 2 – Abnormal Extension (Decerebrate Posturing): Makes abnormal straightening movements (decerebrate posture) in response to pain.
• 1 – No Response: No motor movement occurs in response to pain.

Of note, some individuals may have interfering factors that result in them being unable to accurately respond when being assessed with the GCS. For example, those who have severe eye trauma or swelling may be unable to open their eyes. Those with pre-existing communication or cognitive disorders or who are intubated may not be able to produce an appropriate verbal response. Motor response scores may be influenced by paralysis or other physical impairments. In these cases, the corresponding section is considered not testable.

Glasgow Coma Scale Score and Calculator: Putting it Together

The total GCS score is calculated by taking the sum of each individual score from the three components: Eye Opening (E), Verbal Response (V), and Motor Response (M).

Total GCS Score=E+V+M

The total score ranges from a minimum of 3 (deep coma or no response in any category) to a maximum of 15 (fully alert and oriented).

While the GCS assessment itself is relatively quick and can be performed at the bedside, various online and mobile calculators are available to assist healthcare professionals in quickly summing the scores and ensuring accuracy, especially in fast-paced clinical environments.

These calculators typically require the user to input the observed response level for each of the three components, and they automatically generate the total GCS score.

Glasgow Coma Scale Normal Range: Understanding the Spectrum

It’s important to understand that the GCS is a spectrum, and different score ranges correlate with varying levels of consciousness and potential severity of neurological injury. There isn’t a single “normal” GCS score in the context of neurological assessment, as the scale is primarily used for patients with altered consciousness. 

However, a score of 15 is generally considered to represent a fully conscious individual with normal cognitive and motor function.

Here’s a general breakdown of GCS score ranges and their typical interpretations:

• 13-15 (Mild Brain Injury): Patients in this range are typically considered to have a mild brain injury. They may be confused or disoriented but are generally able to follow commands and have some verbal response.
• 9-12 (Moderate Brain Injury): Patients with a GCS score in this range usually have a moderate brain injury. The individual may be sleepy or confused, and responses may not always make sense.
• 3-8 (Severe Brain Injury): A GCS score of 8 or less generally indicates a severe brain injury or coma. Patients in this range have significantly impaired consciousness and are often unable to follow commands or have meaningful verbal responses. The individual may be unconscious and need help breathing or protecting their airway.

It’s crucial to remember that the GCS score is just one component of a comprehensive neurological assessment. Doctors also check other signs like pupil response, reflexes, and CT scans. Furthermore, the GCS score can and often does change over time, reflecting the evolving neurological status of the patient.

Glasgow Coma Scale Interpretation: Beyond the Numbers

While the GCS score provides a valuable summary of a patient’s level of consciousness, it’s actually important in many ways.

The GCS helps to:

• Establish a Baseline: The initial GCS score provides a crucial baseline against which subsequent assessments can be compared to identify trends of improvement or deterioration.
• Communicate Patient Status: The standardized nature of the GCS allows healthcare professionals across different disciplines and locations to have a clear and concise understanding of the patient’s neurological status.
• Guide Initial Management: The GCS score can influence immediate management decisions, such as the need for airway protection (intubation) or further diagnostic imaging (e.g., CT scan of the head).
• Predict Prognosis: While the GCS alone cannot definitively predict long-term outcomes, lower scores can point to more serious outcomes. Lower initial GCS scores are generally associated with a higher risk of mortality and poorer functional outcomes.

Limitations of the GCS

However, it’s important to acknowledge the limitations of the GCS. It can be less reliable and harder to use in certain cases such as:

• If the patient is on a ventilator and can’t speak
  
• If the patient is very sleepy from medicine
  
• If they have conditions that affect communication or movement
  

In these situations, doctors rely more on the individual parts of the score and other tests to provide a more comprehensive assessment. While the GCS can be an excellent tool, some researchers believe that relying too heavily on it in the initial stages of brain injury can delay necessary care and/or provide a false sense of security, as acute brain injuries are often rapidly evolving.

Final Thoughts

The Glasgow Coma Scale remains an indispensable tool in the initial and ongoing assessment of patients with altered consciousness. Its simplicity, objectivity, and widespread use facilitate effective communication, guide clinical decision-making, and contribute to a better understanding of the patient’s neurological trajectory.

By understanding the meaning behind each component and the significance of the total score, healthcare professionals can leverage the GCS to provide better care for individuals with brain injury and other neurological conditions.

The post Glasgow Coma Scale: A Practical Guide to Understanding the Glasgow Coma Scale and What It Is Used For appeared first on Flint Rehab.

The fact is, choosing between home health vs outpatient therapy requires a number of considerations. But don’t worry! We’re here to be your friendly guide, helping you understand the nuances of each option so you can make the best choice for your rehab journey.

Understanding Neurological Rehabilitation: A Personalized Approach

Neurological rehabilitation or neurorehab is a specialized field focused on helping individuals improve and/or recover lost functions and improve their quality of life after a neurological event.  This can include events such as a TBI, stroke, spinal cord injury, and more.

Therapy will often address specific challenges like:

• Motor Skill Impairments: Weakness, paralysis, difficulty with coordination and balance.
• Cognitive Deficits: Problems with memory, attention, problem-solving, and executive functions.
• Communication Difficulties: Aphasia (difficulty with speaking and understanding language), dysarthria (speech articulation problems).
• Swallowing Issues (Dysphagia): Difficulty eating and drinking safely.
• Sensory Changes: Numbness, tingling, or altered sensation.
• Vision Issues: Visual neglect, visual field deficits, and eye movement disorders
• Emotional and Behavioral Changes: Depression, anxiety, impulsivity, and personality changes.

Both home health and outpatient therapy can play vital roles in addressing these challenges. However deciding between home health vs outpatient therapy will differ from person to person as each offers distinct advantages and disadvantages depending on your individual circumstances.

Let’s take a look at each and then we will dive into some of the key differences between home health vs outpatient therapy.

Home Health: Therapy in the Comfort of Home

Imagine receiving specialized neurological rehabilitation therapies without the stress and fatigue of traveling to appointments. Home health brings skilled professionals – physical therapists, occupational therapists, speech therapists, and sometimes nurses and social workers – directly to your home. 

This can be particularly beneficial in the early stages of recovery or for individuals with significant mobility limitations.

Benefits of Home Health

• Convenience and Reduced Travel Burden: Eliminates the physical and logistical challenges of getting to appointments, which can be significant for survivors and their family members/caregivers after a neurological event.
• Familiar and Comfortable Environment: Therapy takes place in your own living space, allowing therapists to tailor interventions to your specific home environment and challenges. You don’t need to translate skills learned in therapy to your home environment because you originally learned those skills in your own home.
• Early Intervention: Therapists can often initiate treatment sooner after hospital discharge, facilitating a smoother transition and quicker start to recovery.
• Personalized and Functional Therapy: Therapists can directly address challenges you face in your daily routines within your home, such as navigating stairs, using kitchen utensils, or communicating with family.
• Caregiver Involvement and Education: Therapists can easily involve family members and caregivers in sessions, teaching them strategies to support your ongoing recovery.
• Assessment of Home Safety and Accessibility: Therapists can identify potential hazards and recommend modifications to prevent falls, improve safety and promote independence at home.
• Reduced Exposure to Illness: Minimizes the risk of exposure to infections, which can be a concern for individuals with weakened immune systems.
• May Provide Increased Support: Many survivors receiving home health therapy also have home nurses and aides who can further support recovery and assist with self-care tasks.

Potential Considerations for Home Health

• Limited Access to Specialized Equipment: While therapists bring necessary equipment, the range may be less extensive than in a dedicated outpatient clinic.
• Potential for Distractions: The home environment can sometimes present distractions that might not be present in a clinical setting.
• Less Opportunity for Social Interaction with Peers: You have fewer opportunities to interact with others undergoing similar recovery journeys compared to outpatient settings.
• Intensity and Duration May Vary: The frequency and duration of home health visits might be more limited by insurance and staffing constraints.
• Insurance May Limit Access: Many insurance companies, including Medicare, require you to be “homebound” in order to receive home health services. Therefore, if you do not have a significant mobility impairment or other condition which limits your ability to leave your home, your insurance may not cover home health therapy sessions. 

Outpatient Therapy: Focused Rehabilitation in a Clinical Setting

Outpatient therapy involves you traveling to a specialized clinic, rehabilitation center, or hospital outpatient department for scheduled therapy sessions. Generally, these facilities have a wider array of specialized equipment and a team of therapists with focused expertise in neurological rehabilitation.

Benefits of Outpatient Therapy:

• Access to Specialized Equipment and Technology: Clinics often have advanced equipment for gait training, balance exercises, cognitive retraining, and communication therapy.
• Dedicated and Stimulating Environment: Clinics specifically design the setting for rehabilitation to minimize distractions and promote focus.
• Opportunity for Social Interaction and Peer Support: Interacting with other individuals undergoing neurological rehabilitation can provide motivation, encouragement, and a sense of community.
• Interdisciplinary Team Approach: Outpatient centers often have a team of therapists (PT, OT, ST) working collaboratively under one roof, facilitating seamless communication and coordinated care.
• Intensive Therapy Programs: Outpatient settings may offer more intensive therapy schedules, which can be beneficial for accelerating recovery.
• Focus on Specific Rehabilitation Goals: Therapists can tailor therapy to focus on specific functional goals, such as returning to driving, work, or hobbies.
• Transition to Long-Term Wellness: Outpatient centers often provide resources and programs for ongoing fitness and wellness after the initial rehabilitation phase.

Potential Considerations for Outpatient Therapy:

• Travel Burden and Fatigue: Getting to and from appointments can be physically and logistically challenging, especially in the early stages of recovery.
• Less Individualized Home-Based Strategies: The direct application to your specific home environment might be less emphasized.
• Potential for Higher Costs: Depending on insurance and the frequency of visits, outpatient therapy might have higher out-of-pocket costs.
• Exposure to Illness: Traveling to and being in a healthcare setting can increase the risk of exposure to infections.

Home Health vs Outpatient Therapy: Key Factors to Consider When Choosing What’s Right for You?

The best choice between home health and outpatient therapy for your neurological rehabilitation depends on a multitude of individual factors. Here are some crucial questions to consider:

1. Your Current Functional Abilities and Mobility

This is often the most immediate and critical factor influencing the initial choice.

Are you able to leave your home safely and comfortably? 

For individuals with significant motor impairments, such as hemiparesis (weakness on one side of the body), severe balance issues, or the need for assistive devices like wheelchairs or walkers, leaving the home for appointments can be a major undertaking. 

Home health eliminates the logistical hurdles and physical strain of travel, allowing you to focus your energy on therapy itself. It also allows therapists to directly observe and address mobility challenges within your actual living environment.

Do you require assistance with transportation? 

Even if you have the physical capability to leave your home, do you rely on family members, friends, or specialized transportation services? Outside of motor impairments, it is vital to consider cognitive challenges and visual deficits when determining whether you can safely and independently drive or navigate to a therapy clinic. If you need assistance getting to therapy, the frequency and feasibility of outpatient appointments can be significantly impacted. 

Coordinating schedules and managing transportation logistics can add significant stress to both you and your caregivers. Consider the potential for fatigue associated with travel, which can detract from your energy levels for therapy sessions. 

Remember, home health will generally be covered by insurance companies if you are normally unable to leave your home due to significant challenges. However, if you are able to navigate the community easily and do not have a medical condition requiring limited exposure, your insurance will likely only cover outpatient therapy services.

2. The Severity and Specificity of Your Neurological Deficits

The nature and extent of your neurological impairments will significantly influence the type and intensity of therapy needed. Some questions to consider include:

Do you primarily need help with basic daily living skills and navigating your home environment?

If your primary challenges involve activities like dressing, bathing, eating, and moving safely within your home, home health occupational therapy can be particularly beneficial. Therapists can assess your home environment, identify barriers, and teach you adaptive strategies and techniques using your own belongings. This direct application to your daily life can lead to more immediate and functional improvements.

Do you require access to specialized equipment for gait training, balance, or cognitive retraining?

Outpatient clinics often have a wider array of advanced equipment that may not be feasible to bring into a home setting. This could include body-weight supported treadmills for gait retraining, sophisticated balance platforms, virtual reality systems for cognitive exercises, and specialized communication devices. If your recovery requires this type of technology, outpatient therapy may be necessary. 

Of note, if you have self-care concerns and significant mobility challenges, it may be beneficial to begin with home health therapy, then transition to outpatient therapy as your mobility improves. This can allow you to access both the benefits of home health, and the specialized equipment and interactions that outpatient therapy provides. However, unless another significant medical change occurs, individuals usually are not qualified to transition from outpatient therapy back to home health.

What are your primary rehabilitation goals?

Are your primary goals focused on regaining independence in your home, or are you aiming to return to specific activities outside the home, such as driving, work, or hobbies? While home health can address foundational skills, outpatient therapy might be better suited for more advanced, goal-oriented rehabilitation that requires specialized equipment or simulated environments (e.g., a mock kitchen or driving simulator).

3. Your Support System and Home Environment

The level of support you have at home and the characteristics of your living space play a crucial role in the success of both home health and your overall recovery. Some questions to ask when when it comes to home health vs outpatient therapy in this context include:

Do you have family or caregivers who can actively participate in your home-based therapy?

In home health, family members or caregivers can be directly involved in therapy sessions, learning techniques to assist with exercises, implement safety strategies, and reinforce learned skills between visits. This active participation can significantly enhance the effectiveness of therapy and promote carryover into daily routines.

While this type of caregiver training and involvement is possible in outpatient therapy sessions, it may not be as intensive. 

If you lack a strong support system at home, the benefits of direct caregiver involvement during home health therapy sessions may be limited.

Is your home environment conducive to therapy exercises and safety modifications?

A cluttered or inaccessible home environment can hinder therapy progress and increase the risk of falls. Home health therapists can assess your home for safety hazards and recommend modifications, but the feasibility and extent of these modifications will depend on your living situation.

Outpatient clinics provide a controlled and safe environment specifically designed for rehabilitation.

4. Your Insurance Coverage and Financial Resources

As always, the financial financial aspect of healthcare is always a consideration. Here are a few things to consider when comparing home health vs outpatient therapy.

What are your insurance benefits for home health and outpatient therapy?

Coverage for both types of services can vary widely depending on your insurance plan (Medicare, Medicaid, private insurance). Some plans may have limitations on the number of visits, require prior authorization, or have different copays or deductibles for home health versus outpatient services. Many insurance companies require you to be homebound in order to cover home health therapy services. It’s crucial to contact your insurance provider to understand your specific coverage details for both options.

Consider the potential costs associated with transportation to outpatient appointments.

Even if the therapy itself is covered, the cost of gas, parking, public transportation, or specialized transport services can add up, especially with frequent appointments. Home health eliminates these transportation costs.

5. Your Personal Preferences and Motivation

Your own feelings and attitudes towards your recovery environment can significantly impact your engagement and progress in therapy. Consider the following tradeoffs between home health and outpatient rehab.

Do you prefer the comfort and privacy of your own home, or do you find a dedicated clinical setting more motivating?

Some individuals feel more relaxed and receptive to therapy in the familiar surroundings of their home. Others find the dedicated and structured environment of a clinic to be more conducive to focus and motivation. Consider where you feel you would be most comfortable and likely to actively participate in your rehabilitation.

Do you value the social interaction and peer support offered in an outpatient setting?

For some, interacting with other individuals who are also on their recovery journey can provide a sense of community, encouragement, and shared experience. This peer support can be a powerful motivator. Home health, while providing interaction with therapists, lacks this peer-to-peer connection.

6. The Stage of Your Recovery

Over time, your needs and abilities will change as you progress throughout the recovery process. As a result, the most appropriate therapy setting may change accordingly. Consider the following differences between home health and outpatient therapy based on your stage of recovery.

Early Stages: Immediately following a stroke or brain injury, individuals often experience significant physical and cognitive limitations. 

Home health can provide essential early intervention, focusing on basic functional skills, safety in the home, and adapting to new challenges in a familiar environment. The reduced travel burden is also a significant advantage during this phase.

Later Stages: As you regain strength, mobility, and cognitive function, you may benefit from the more intensive and specialized therapies offered in an outpatient setting. 

Outpatient clinics can provide access to advanced equipment and a wider range of therapeutic approaches to address more complex rehabilitation goals, such as returning to work, driving, or participating in leisure activities.

7. Recommendations from Your Healthcare Team:

​​Your doctors, neurologists, rehabilitation specialists, and therapists are the experts in your specific situation. Therefore, their recommendations should be a major factor in any decision you make.

They will assess your neurological deficits, functional abilities, and overall medical condition to determine which setting they believe will be most effective and safe for your rehabilitation. They can also explain the rationale behind their recommendations and address any concerns you may have. 

Of course don’t hesitate to ask questions and actively participate in the discussion about your care plan.

Remember, by carefully considering all of these key factors and having open communication with your healthcare team, you can make a well-informed decision!

Home Health AND Outpatient Therapy: It’s Not Necessarily an Either/Or

It’s important to remember that the choice between home health and outpatient therapy isn’t always an either/or situation. Many individuals benefit from a continuum of care that involves both settings at different stages of their recovery.

As an example, this might look something like:

• Initial Phase (Home Health): Focus on establishing basic functional skills, ensuring safety at home, and providing early intervention when mobility is limited.
• Transition Phase (Combination): Although uncommon, you may be able to utilize both home and clinic-based services simultaneously. As you become more mobile, you might transition to a combination of outpatient clinic-based therapy for accessing specialized equipment and more intensive interventions and outpatient therapy in your home for addressing specific home-based challenges. In this case, since both are technically considered outpatient services, insurance likely would not require you to be homebound to receive these home-based services..
• Later Phase (Outpatient Therapy): As you progress, outpatient therapy can become the primary focus for achieving higher-level functional goals and transitioning back to community activities.

The goal is to figure out what best fits your situation and recovery plan!

Home Health vs Outpatient Therapy: Informed Decisions Lead to Progress

Choosing between home health and outpatient therapy is a personal decision—one that depends on your unique situation, preferences, and goals. By understanding the strengths of each option and actively engaging with your healthcare team, you’re taking a powerful step toward reclaiming your independence and quality of life. 

Don’t hesitate to ask questions, voice your needs, and advocate for the path that feels right for you. When you’re informed and involved, you’re not just choosing a therapy—you’re choosing progress.

The post Home Health vs. Outpatient Therapy After Stroke or Brain Injury: What Is The Better Option? appeared first on Flint Rehab.

These two terms are often used in discussions about attention and perception, particularly after neurological events like a stroke or brain injury. However, while they can sometimes overlap, they represent distinct challenges in how the brain processes visual information.

In this article, we’ll explore visual neglect and inattention—what they are, how they differ, and practical steps individuals can take to manage these conditions.

What is Visual Inattention? The Scattered Spotlight

Imagine your attention as a spotlight. Normally, you can direct this spotlight wherever you need it – focusing on a specific object, a conversation, or a task at hand. Visual inattention, also sometimes referred to as visual attentional deficits, is like having a scattered or unstable spotlight.

With visual inattention, the individual has difficulty focusing and sustaining their attention on visual stimuli. They might:

• Miss details: They might scan a scene but fail to notice important elements, like a word in a sentence or a face in a crowd.
• Be easily distracted: External stimuli, like a noise or movement in their peripheral vision, can easily pull their attention away from what they were initially focused on.
• Have trouble filtering information: They might struggle to ignore irrelevant visual information and focus on what’s important.
• Show inconsistent performance: Their ability to notice things might fluctuate depending on their level of alertness, motivation, or the complexity of the visual environment.

Think of it like trying to read a book in a busy coffee shop. The surrounding conversations, the clinking of cups, and the movement of people can all pull your attention away from the text, making it harder to concentrate and understand. For someone with visual inattention, this struggle can be amplified and more persistent, even in less distracting environments.

What is Visual Neglect? The Ignored Half of the World

Visual neglect, on the other hand, is a more profound and often more debilitating condition. Unlike inattention, which is a problem with focusing, neglect involves a lack of awareness of stimuli on one side of the visual field – even though the eyes themselves are perfectly capable of seeing.

Imagine your visual world divided into two halves – left and right. For someone with visual neglect, it’s as if one of these halves simply doesn’t exist.

For example, they might:

• Fail to notice objects on the affected side: This can range from not seeing food on one side of their plate to bumping into doorways or people on their neglected side.
• Not respond to stimuli on the affected side: If someone speaks to them from their neglected side, they might not turn their head or acknowledge them.
• Only draw or copy one side of an image: When asked to draw a clock, for example, they might only draw the numbers on the right side.
• Read only one side of a page: They might start reading in the middle of a sentence or only read the words on the non-neglected side.
• Neglect one side of their own body: In severe cases, they might even forget to groom or dress the neglected side of their body.

The key difference here is that with visual neglect, the information from the affected visual field isn’t even being processed by the brain in a way that leads to awareness. There is evidence that many cases of visual neglect also involve multisensory aspects, particularly auditory deficits. It’s not just a matter of difficulty focusing. It’s as if that part of the visual world has been erased from their conscious experience.

Visual Neglect vs Inattention Key Differences

To make the distinction clearer, let’s use a simple analogy:

Visual Inattention: Imagine a spotlight that keeps flickering and jumping around, making it hard to keep it focused on one thing. The information is there, but the spotlight isn’t steady enough to illuminate it consistently.

Visual Neglect: Imagine a blind spot in your vision. No matter how hard you try to focus, you simply cannot see what’s in that area. The information isn’t even reaching your conscious awareness.

Here’s a table summarizing the key differences:

What Causes Visual Neglect vs Inattention?

Both visual inattention and neglect are often the result of a neurological injury, most commonly stroke. Other injuries such as TBI, tumors, and other neurological conditions can also cause visual neglect and inattention. 

Generally, the specific areas of the brain affected for visual neglect vs inattention tend to differ. This leads to the different symptoms and presentation for each.

Visual inattention is often associated with damage to the frontal and parietal lobes, which play crucial roles in attention control, executive functions, and the filtering of information. Damage to these areas can disrupt the brain’s ability to direct and maintain focus on visual stimuli.

Conversely, visual neglect is most commonly linked to damage in the posterior parietal lobe, particularly in the right hemisphere. This area is critical for spatial awareness and the representation of space. Damage here can disrupt the brain’s ability to process information from the contralateral (opposite) side of the body and visual field. Right hemisphere damage often leads to left-sided neglect, which is more common and often more severe than right-sided neglect.

It’s important to note that there can be overlap, and an individual might experience both inattentive tendencies and some degree of neglect, especially in the acute stages after a brain injury.

Living with Visual Inattention and Neglect: Challenges and Adaptations

Living with visual inattention or neglect can significantly impact daily life. For example, imagine trying to navigate a crowded street when you constantly miss people walking on one side or trying to read an email when your attention keeps drifting away.

Here is an overview of some challenges individuals with visual inattention or neglect may face.

Visual Inattention Challenges May Include:

• Difficulty with tasks requiring sustained visual focus, such as reading, writing, or computer work.
• Increased risk of errors and accidents due to missed details.
• Challenges in social situations due to difficulty following conversations and noticing non-verbal cues.
• Frustration and fatigue due to the constant effort required to maintain focus.

Visual Neglect Challenges May Include:

• Difficulties with basic self-care activities like eating, dressing, and grooming the neglected side of the body.
• Increased risk of falls and collisions due to a lack of awareness of obstacles on the neglected side.
• Challenges with navigation and mobility in both familiar and unfamiliar environments.
• Difficulties with reading and writing, often leading to significant communication challenges.
• Social isolation due to difficulties interacting with others and navigating social situations.

Despite these challenges, individuals with visual inattention and neglect can learn to adapt and improve through various rehabilitation strategies.

Visual Neglect vs Visual Inattention Rehabilitation and Management: Retraining the Brain 

The good news is that the brain has a remarkable capacity for recovery and adaptation, a concept known as neuroplasticity. While complete recovery may not always be possible, various therapeutic interventions can help individuals with visual inattention and neglect improve their awareness and function.

Let’s take a look at some strategies you can use to manage or improve both visual inattention and neglect.

Rehab and Management Strategies for Visual Inattention

Attention Training Exercises: These exercises aim to improve sustained, selective, and divided attention through tasks that gradually increase in complexity.

Environmental Modifications: Reducing distractions and organizing the environment can help minimize attentional demands.

Compensatory Strategies: Using techniques like verbal self-instruction, scanning strategies, or visual cues to help maintain focus.

Medication: In some cases, medication may be used to address underlying attentional deficits.

Rehab and Management Strategies for Visual Neglect

Visual Scanning Training: Encouraging systematic scanning of the neglected side by providing visual cues and feedback.

Prism Adaptation: Using prism glasses that shift the visual field to the non-neglected side, which can temporarily improve awareness of the neglected side and have lasting effects.

Limb Activation Therapy: Encouraging movement of the limb on the neglected side to increase awareness of that side of the body and space.

Environmental Adjustments: Placing important items on the non-neglected side initially and gradually encouraging scanning to the neglected side.

Virtual Reality Therapy: Offering immersive and engaging environments to practice scanning and navigation skills.

Researchers are continuing to examine which methods are most effective for treating visual inattention and neglect. For anyone experiencing visual inattention or neglect, it’s helpful to work with your care team of specialists. These professionals can help create a personalized rehab plan just for you!

Living With Visual Neglect and Inattention: Final Thoughts

Visual inattention and visual neglect are distinct but related conditions that can significantly impact an individual’s ability to perceive and interact with the world around them. While both involve challenges with visual processing, inattention is primarily a difficulty with focusing attention, while neglect involves a lack of awareness of one side of the visual field.

Understanding these differences is critical to effective rehabilitation and providing appropriate support to individuals living with these conditions. If you or someone you know is experiencing difficulties with attention or seems unaware of one side of their environment, it’s essential to seek professional medical advice. Early diagnosis and intervention can make a significant difference in improving quality of life and fostering greater independence. 

The brain is amazing and can bounce back in incredible ways. With the right support and strategies, individuals with neglect or inattention can find new ways to navigate the world and keep moving forward.

The post Seeing What’s Not There (or Missing What Is): Understanding Visual Neglect vs. Inattention appeared first on Flint Rehab.

If you or someone you know is navigating the complexities of homonymous hemianopsia, you’re not alone. In this comprehensive guide, we will take a look at what homonymous hemianopsia is and why it happens. We will also explore the different features of left and right homonymous hemianopsia as well as incomplete hemianopsia. 

Our goal is to help you better understand the condition and break down intricacies in a friendly and easy to understand manner – let’s jump in!

What Exactly is Homonymous Hemianopsia?

Let’s break down the term itself. “Homonymous” means “on the same side,” and “hemianopsia” refers to a loss of vision in half of the visual field. So, homonymous hemianopsia is the loss of vision in the same half of the visual field in both eyes. This is in contrast to bitemporal hemianopsia (also called heteronymous hemianopia), where vision loss occurs on the temporal (outer) side of both eyes.

Think of your visual field as a complete circle surrounding you. Normally, both your eyes work together to capture this entire circle. In order for the brain to integrate information from both eyes and both sides of the visual field, approximately half of the nerve fibers from each eye (the middle portions) cross to the opposite side of the brain, while the other half continue toward the same side of the brain. This crossover occurs at the optic chiasm. 

Therefore, information from the right side of what you see goes to the left side of your brain, and information from the left side goes to the right side of your brain. This intricate cross-wiring is what allows us to have a full and integrated visual experience.

However, in individuals with homonymous hemianopsia, this pathway is disrupted, typically due to damage in the brain after the optic chiasm. This means that all of the information from one side of the visual field from both eyes has been lost.

If the visual pathway is disrupted before the optic chiasm, vision loss occurs only in the eye on the side of the damaged nerve, referred to as monocular vision loss. However, damage occurring at the optic chiasm can result in bitemporal hemianopsia, in which the outer portion of the visual field from both eyes is lost.

What Causes Homonymous Hemianopsia? The Common Culprits

Homonymous hemianopsia isn’t a condition that develops on its own. It’s usually a consequence of another neurological event that affects the visual pathways in the brain. 

HH frequently arises from vascular injury. In adults, cerebral infarcts (strokes) and intracranial hemorrhages are the most common culprits, accounting for a significant majority of cases. In fact, it is estimated that 52-70% of cases of hemianopsia result from stroke, with 8-10% of all stroke survivors experiencing homonymous hemianopsia permanently.

Other contributing factors include:

• Traumatic Brain Injury (TBI): accounts for 14% of homonymous hemianopsia cases
• Tumors: Particularly prevalent in pediatric cases, responsible for 11% of HH cases
• Iatrogenic Events: Injury resulting from medical treatment, such as neurosurgical procedures or radiation necrosis.
• Demyelinating Disorders: Such as multiple sclerosis (MS).
• Neurologic Diseases: Including Alzheimer’s disease and Creutzfeldt-Jakob disease.
• Vascular Malformations: Like arteriovenous malformations.
• Infections: Such as brain abscesses or toxoplasmosis.
• Inflammatory Diseases: Beyond MS, like neuromyelitis optica.
• Metabolic Diseases: Such as MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes).
• Seizures or Epilepsy: occipital, temporal or parietal lobe seizures may result in temporary homonymous hemianopsia
• Migraines: can cause temporary homonymous hemianopsia
• Transient Ischemic Attacks (TIAs): may also cause temporary HH with spontaneous recovery
• Nonketotic Hyperglycemia: can resolve with proper blood sugar management

The specific location of the brain lesion dictates the type and extent of the HH. Studies have shown that the most common lesion locations are the occipital lobe, followed by the optic radiation, optic tract, and less frequently, the lateral geniculate nucleus (LGN).

The location and extent of the brain injury will determine which side of the visual field is affected and the severity of the vision loss.

Understanding the Impact: Common Symptoms and Features of Homonymous Hemianopsia

Individuals with homonymous hemianopsia experience a loss of vision in either the right or left  half of their visual field in both eyes. This can manifest in various ways:

• Complete Hemianopsia: Loss of the entire half of the visual field on the affected side, including the central macular vision.
• Partial or Incomplete Hemianopsia: Vision loss that doesn’t encompass the entire half of the visual field. This includes:
  • Homonymous Quadrantanopia: Loss of one-quarter of the visual field (either upper or lower, on the same side in both eyes). Damage to the upper or lower banks of the visual cortex or specific parts of the optic radiation can cause this.
  • HH with Macular Sparing: Retention of central vision despite the hemianopic defect. This is often seen in occipital lobe strokes due to the dual blood supply to the macular region.
  • Homonymous Scotomatous Defects: Rare, localized blind spots within the central 30 degrees of vision, respecting the vertical midline; this is somewhat of a reversal of HH with macular sparing.
  • Homonymous Sectoranopia: A rare, wedge-shaped loss of vision, often linked to LGN involvement.
  • Temporal Crescent Sparing: Loss of the outermost peripheral vision on one side only, resulting from anterior occipital lobe damage on the side of the brain opposite from the eye with vision loss.

Patients with HH may initially report difficulties such as bumping into objects on their blind side, struggling with reading (especially tracking lines of text), and challenges with navigation and driving.

Understanding Left, Right Homonymous Hemianopsia and the Concept of Contralateral 

Now, let’s take a look at some of the specifics in how homonymous hemianopsia can manifest. Specifically, we will look at left and right homonymous hemianopsia and the concept of contralateral hemianopsia.

1. Right Homonymous Hemianopsia

Imagine looking straight ahead. If you have right homonymous hemianopsia, you will have lost vision in the right half of your visual field in both eyes. This means you can see things to your left, but everything on your right side will be out of view.

Think about everyday scenarios:

• Walking
• Reading
• Driving
• Eating

With right homonymous hemianopsia, each of these everyday scenarios become significantly more difficult.  Reading can be particularly challenging with right HH when trying to read from the left to the right, as it is continually challenging to see the next word.

Right homonymous hemianopsia is typically caused by damage to the left side of the brain, specifically the occipital lobe or the visual pathways leading to it. Remember the cross-wiring described above – the left side of the brain processes information from the right visual field.

2. Left Homonymous Hemianopsia

Conversely, left homonymous hemianopsia involves the loss of vision in the left half of the visual field in both eyes. In other words, you’ll be able to see things on your right, but everything to your left will be invisible.

Left homonymous hemianopsia is usually caused by damage to the right side of the brain, affecting the occipital lobe or the visual pathways leading there. The right side of the brain processes information from the left visual field.

3. Contralateral: The Key Concept

The terms “left” and “right” homonymous hemianopsia inherently involve the concept of contralateral. “Contra” means “opposite,” and “lateral” refers to “side.” In the context of the visual pathways, the brain processes visual information from the opposite side of the visual field.

Therefore:

• Damage to the left side of the brain results in a visual field defect on the right side (right homonymous hemianopsia).
• Damage to the right side of the brain results in a visual field defect on the left side (left homonymous hemianopsia).

Understanding this contralateral relationship is crucial for patients and healthcare professionals to understand the location of the brain injury that caused the vision loss.

Living with Homonymous Hemianopsia: How To Adapt to Challenges in Daily Life

Living with homonymous hemianopsia presents a unique set of challenges that can significantly impact daily life. The loss of half of the visual field can affect:

• Mobility and Navigation
• Reading and Writing
• Grooming and Self Care
• Driving
• Social Interactions
• Work and Hobbies

However, it’s important to emphasize that individuals with homonymous hemianopsia can learn to adapt and lead fulfilling lives. Let’s take a look at several rehabilitation strategies and assistive devices that play a crucial role in this process.

Navigating the Challenges: Rehabilitation and Compensation Strategies for Homonymous Hemianopsia

While lost vision in HH often cannot be restored, various strategies can help individuals adapt and improve their daily functioning.

These include:

• Prisms: Special lenses that can shift the visual field towards the blind side, increasing awareness of objects in that area. Peli prisms, placed in the upper and lower parts of the spectacle lens on the side of the HH, are a common type.
• Visual Scanning Training: Therapy focused on teaching conscious and systematic eye and head movements to compensate for the lost visual field, improving detection of objects on the affected side.
• Exploration Therapies: Techniques aimed at enhancing awareness of the visual field loss and improving visual search strategies.
• Occupational Therapy: Helps individuals adapt to daily activities such as dressing, eating, and navigating their environment.
• Orientation and Mobility Training: Specialists teach safe and effective techniques for moving around indoors and outdoors.
• Assistive Technology: Computer software, screen readers, and navigation apps can aid with reading, writing, and mobility.
• Psychological Support: Addressing the emotional impact of vision loss and providing coping strategies is crucial.

Can You Improve Homonymous Hemianopsia?

Spontaneous improvement of HH can occur, particularly in the initial months after the injury, especially following a stroke. Studies suggest that 50-60% of individuals may experience some visual field recovery within the first month, with most improvement occurring within three to six months. Complete spontaneous recovery is less common, but may occur in 8-12% of those with homonymous hemianopsia.

Spontaneous recovery after six months is less common. At that point, improvements may also be linked to the resolution of underlying medical conditions.

Potential Complications of Homonymous Hemianopsia

Beyond the visual field deficit itself, individuals with HH may experience:

• Increased Risk of Falls and Injuries: Due to reduced awareness of their surroundings.
• Difficulties with Mobility and Navigation: Making everyday tasks like walking and crossing the street challenging.
• Reading and Writing Difficulties: Affecting communication and daily tasks.
• Driving Limitations: Often making driving unsafe and legally restricted in many areas.
• Psychological Impact: Including feelings of disorientation, anxiety, and depression.

Living Fully with Half the World

While the diagnosis of homonymous hemianopsia can be life-altering, it doesn’t define a person’s potential. With dedicated rehabilitation, adaptive strategies, and a strong support system, individuals can learn to navigate their world effectively and participate fully in life. By understanding the nuances of left and right homonymous hemianopsia, as well as incomplete hemianopsia, we can better support those living with this condition and empower them to see their world in new and meaningful ways.

If you or someone you know is experiencing vision loss, it’s crucial to seek professional medical advice promptly. Early diagnosis and intervention are key to maximizing adaptation and improving quality of life. Remember, even with half the visual field, a whole and fulfilling life is still within reach.

The post Seeing Half the World: Understanding Left and Right Homonymous Hemianopsia Plus Strategies Adapt and Improve appeared first on Flint Rehab.

This article will discuss the causes of TBI involuntary movements, the different types, and how to find the best treatment.

Use the links below to jump straight to any section:

• How a TBI Causes Involuntary Movements
• Types of Involuntary Movement Disorders
• Delayed Onset of TBI Symptoms
• Restoring Movement with Neuroplasticity
• Treatment for Involuntary Movement Disorders

Causes of Traumatic Brain Injury Involuntary Movements

A traumatic brain injury can disrupt communication between the brain and the body. Without proper communication, the muscles are unable to receive signals from the brain, and the brain may not receive feedback from the muscles. This can result in impaired motor control. Studies have shown that involuntary movement disorders have been reported in about 22.6% of survivors with a severe head injury, with 12.2% of individuals reporting persistent symptoms.

Of note, persistent post traumatic movement disorders are rarely experienced by survivors with a mild or moderate traumatic brain injury, and only 5.4% of severe brain injury survivors report significant disability due to involuntary movement disorders.

The type of involuntary movement disorder that develops depends on which area of the brain is injured. For example, common causes of post traumatic movement disorders include:

• Primary motor cortex damage: can cause muscle weakness or paralysis
• Cerebellum damage: can cause tremors and/or loss of balance and coordination
• Basal ganglia damage: can cause uncontrollable twitching, spasms, or dystonia
• Thalamus damage: can cause apraxia (difficulties with motor planning) or other motor impairments

Since post traumatic movement disorders may have an immediate or delayed onset, studies report a wide range of prevalence, with anywhere between 13-66% of TBI survivors experiencing movement disorders.

Fortunately, many involuntary movements caused by TBI damage can be managed through rehabilitative techniques.

Types of Involuntary Movement Disorders After TBI

Understanding the various types of traumatic brain injury involuntary movements that can occur is important in order to receive the appropriate treatment and promote recovery.

Some of the most common types of movement disorders after TBI include:

1. Tremors

What it looks like: unprovoked, uncontrollable, rhythmic shaking

Tremors are one the most common types of involuntary movements that occur after a brain injury. Studies show that about 9% of severe TBI survivors experience persistent tremors, while nearly half of all children with traumatic brain injuries experience tremors, lasting up to 18 months. These tremors are characterized by an uncontrollable, rhythmic shaking of different parts of the body, typically the hands.

Tremors are further classified into different categories, including:

• Resting tremors: occur when the muscles are relaxed, such as when the hands are resting in an individual’s lap.
• Action tremors: occur when the muscles are in use. There are many types of action tremors, including postural tremors (occur when an individual holds a position against gravity) and intention tremors (occur when completing a purposeful movement).

The most frequent types of tremors that develop after a head injury are cerebellar tremors, which as the name implies, are caused by damage to the cerebellum. They are a type of action tremor that only occurs at the end of a movement.

2. Dystonia

What it looks like: slow, repetitive twisting movements

Dystonia is another common involuntary movement disorder that occurs from damage to the basal ganglia. Dystonia refers to slow, repetitive twisting movements. These involuntary muscle contractions often force people into abnormal positions. About 4% of severe TBI survivors experience dystonia after brain injury.

This can include different types of dystonia such as:

• Focal dystonia: affects only part of the body such as the eyes, jaw, mouth, neck, arms, or legs. A more specific type of focal dystonia is known as cervical dystonia, which causes spasms in the neck.
• Segmental dystonia: affects two or more adjacent muscle groups simultaneously. For example, survivors may experience spasms in the jaw and neck at the same time.
• General dystonia: affects the whole body.

Generally speaking, movements resulting from dystonia occur on the opposite side of your body from where the injury occurred. For instance, if you experience a left-hemisphere brain injury, it is likely you will experience dystonia on the right side of the body. Though less common, dystonia may also cause the torso to bend or writhe.

3. Chorea

What it looks like: provoked, uncontrollable, rhythmic, dance-like movements

The word chorea comes from a Greek term meaning “to dance”. This is due to characteristic brief, repetitive movements of chorea, which tend to start in one body part and move abruptly to another part. Chorea is caused by damage to the basal ganglia.

Hemiballismus is a severe secondary type of chorea, which involves an aggressive, involuntary flinging of the arm and/or leg on one side of the body.  Those with hemiballismus usually exhibit wider and more vigorous movements than those with primary chorea due to extended damage in the thalamus. Chorea can often occur simultaneously with another movement disorder known as athetosis.

4. Athetosis

What it looks like: slow, flowing, writhing movements

Athetosis refers to a stream of slow, flowing, writhing movements. This involuntary movement disorder primarily occurs in the hands, feet, and torso. Both chorea and athetosis are caused by overactivity in the basal ganglia, usually due to excess dopamine in the brain.

5. Clonus

What it looks like: rhythmic shaking after a muscle is stretched

Clonus refers to a hyperactive stretch reflex that is often mistaken for a tremor because the symptoms are similar. Both conditions can cause rhythmic shaking that is painless, and mainly occur in the arms or legs. However, a distinct feature of clonus is that it is triggered and/or exacerbated by stretching the affected limb.

Similar to other movement disorders however, clonus often occurs when the electrical signals sent by the brain to the muscles are disrupted. Without proper stimulation from the brain, the muscles do not know whether to contract or relax. This uncertainty causes the muscles to do both.

6. Myoclonus

What it looks like: unprovoked, unrhythmic muscle spasms 

Though myoclonus sounds similar to clonus, it is a distinct disorder that does not cause rhythmic shaking nor does it change in response to stretching. Myoclonus refers to sudden muscle spasms that can happen at rest or during active movement. 

Many individuals experience myoclonus throughout their life such as when they hiccup or jerk awake just before falling asleep. However, myoclonus after a head injury tends to be more severe and frequent. While it may affect the limbs, it may also affect the palate or the oculomotor (eye movement) muscles.

7. Parkinsonism

What it looks like: a combination of involuntary movement disorders

Parkinsonism is an umbrella term that refers to a group of movement disorders that share similar symptoms. It typically occurs after repeated head trauma. 

Symptoms of Parkinsonism can include: 

• Resting tremor
• Stiff muscles
• Slow movements
• Shuffling gait
• Difficulty with balance and/or walking

Parkinson’s Disease is the most common type of parkinsonism that occurs. However, there are several other types including drug-induced parkinsonism, vascular parkinsonism, and post-traumatic parkinsonism (caused by damage to the cerebellum or basal ganglia). Approximately 3.1% of individuals with TBI experience post-traumatic parkinsonism, and that percentage increases to 11.6% in those with TBI after age 65. Post-traumatic parkinsonism often has a delayed onset, with an average estimated onset of 3.3 years after TBI.

 Parkinsonism can also cause uncontrolled, repetitive movements known as tics (see below).

8. Tics

What it looks like: sudden, repetitive movements or vocalizations

Tics are primarily involuntary movements that occur from damage to the basal ganglia, poor communication between different brain structures, or excess dopamine in the brain. Tics can cause individuals to make sudden, repetitive movements. Though most tics develop within the first few weeks after a brain injury, some may appear up to one year post-injury.

9. Gait Apraxia

What it looks like: uncoordinated movements while walking

Apraxia is a condition that causes difficulty with planning, coordinating and executing voluntary movements. There are different types of apraxia that can manifest, depending on the areas of the brain affected. For instance, damage to the cerebellum or frontal lobe can result in gait apraxia, which refers to the loss of ability to properly use the lower limbs. This can cause difficulty walking and/or maintaining balance.

10. Other Movement-Related Disorders

In addition to causing involuntary movements, a brain injury can also cause a variety of coordination disorders. These are typically caused by damage to the cerebellum, and can affect the ability to precisely perform voluntary movements. Many of these disorders can make it difficult to control the arms, legs, or trunk.

Movement-related disorders that may occur after a brain injury can include:

• Ataxia: is a coordination disorder that can make it difficult to perform everyday movements such as reaching for an object or walking. It often involves damage to the cerebellum, and may occur even following mild TBI. Individuals with ataxia of the legs are more prone to falls and may take wide, staggering steps when walking.
• Dysmetria: is when an individual cannot judge how far and how quickly their arms need to move to carry out a smooth purposeful movement. For instance, when reaching for an object, they will usually miss the mark.
• Apraxia of Speech: is a condition in which individuals cannot coordinate the muscles used for speech. As a result, they may make irregular mouth movements and have trouble speaking.
• Nystagmus: is a condition that makes it difficult to coordinate eye movements. This can cause the eyes to seem like they are bouncing around.

These types of movement and coordination disorders can often prevent individuals from controlling their arms, legs, or trunk. They may even inhibit them from using the muscles of their mouth or eyes accurately. Therefore, obtaining proper treatment is essential in order to improve muscle coordination after head injury.

Consult with your doctor or therapist if you notice any new or recurrent symptoms from any of the involuntary movement disorders listed above. With a proper diagnosis, treatment can be administered and rehabilitation started.

Delayed Onset of Involuntary Movements After TBI

Many involuntary movement disorders are not apparent right after the injury. Some individuals may experience a delayed onset of TBI symptoms or secondary effects. One study roughly estimated 57% of individuals reported new symptoms within one year of initial injury. This included a combination of different symptoms including physical, emotional, and cognitive effects.

Therefore, it’s important to keep track of any new recurrent symptoms and seek proper medical care. This can help lower the chances of TBI symptoms worsening over time or experiencing a decline during your recovery.

Speak to your doctor if you have any questions or concerns about your symptoms.

How Neuroplasticity Can Help Improve Traumatic Brain Injury Involuntary Movements

To treat TBI involuntary movements, the communication between the brain and the rest of the body must be restored. This can be accomplished with the help of neuroplasticity, the brain’s ability to heal and rewire itself. 

After a brain injury, many of the neural pathways used for communication between the brain and body may become damaged or destroyed. However, neuroplasticity can help strengthen existing neural pathways and create new ones, allowing the brain to adapt and recover from injury.

The best way to stimulate the brain and activate neuroplasticity is through repetitive exercise, also known as massed practice. Stimulating the brain after a head injury can help reduce the symptoms of post-traumatic involuntary movement disorders.

Practicing a movement consistently will help the brain create new neural pathways for those specific movements. With time, pathways associated with targeted movements may be rewired and reinforced in healthy, undamaged regions of the brain.

The stronger neural pathways, the better communication between the brain and body. And with better communication, the higher the chances of restoring motor control.

Treatment for Traumatic Brain Injury Involuntary Movements

Every brain injury is different, and treatment for involuntary movements may vary depending on the type and severity of the disorder. If your post-traumatic movement disorder is severe or causing you pain, doctors may prescribe medication such as baclofen. This helps relax the muscles and prevent spasms. 

However, medication is often only a temporary solution because it does not address the root cause of a post-traumatic movement disorder, which is the lack of communication between the brain and muscles. 

As previously mentioned, to improve the neural connections needed to regain functions, neuroplasticity must be activated through massed practice. Therefore, it is crucial to attend physical, speech, and/or occupational therapy sessions and practice rehabilitation exercises to promote recovery.

Each of these therapies utilize unique techniques and yield unique benefits for improving motor control, including:

• Physical Therapy: focuses on improving mobility, coordination, and strength. Physical therapists may use personalized stretches, hands-on techniques, repetitive exercises, and modalities to improve affected movements.
• Speech Therapy: assesses and treats oral motor concerns including dysphagia (difficulty swallowing) and speech difficulties through practicing specialized exercises.
• Occupational Therapy: addresses difficulty participating in daily tasks due to involuntary movements. To improve independence, occupational therapists may use activity-based exercises and/or introduce compensatory techniques and adaptive equipment.
• Home Exercise Programs: rehabilitative therapists usually recommend participating in a home exercise program to maximize the chances of recovery. They may provide a written exercise program or suggest usinghome therapy devices such as FitMi, aninteractive therapy device  designed to improve full-body mobility.

Depending on what types of involuntary movements you are experiencing, you may participate in more than one type of rehabilitative therapy. Starting therapy promptly can improve recovery, so be sure to start as soon as possible after symptoms appear.

Understanding Involuntary Movements Post-TBI

Traumatic brain injury involuntary movements can make it difficult to perform daily activities and continue with everyday life. Fortunately, the brain is capable of utilizing neuroplasticity to improve motor control. The most effective way to promote neuroplasticity is through high repetition of exercises.

We hope this article helped you understand the most common types of TBI involuntary movements, and the best ways to promote recovery.

The post Traumatic Brain Injury Involuntary Movements: Causes, Types, and Treatment appeared first on Flint Rehab.

This article will discuss the causes and symptoms of hypothalamus damage and some of the most effective management techniques. Use the links below to jump straight to any section.

• Hypothalamus function
• Causes of hypothalamus damage
• Symptoms of hypothalamus injury
• Health conditions affected by hypothalamus damage
• Diagnosis
• Treatment

What Is the Function of the Hypothalamus?

The hypothalamus is a structure located in the center of the brain that serves as  the primary link between the central nervous system and the endocrine system.  It has a few main functions including:

• Making hormones, including vasopressin and oxytocin
• Releasing hormones that communicate with the pituitary gland
• Regulating basic functions (body temperature, hunger/thirst, sleep/wake cycles, other autonomic life-sustaining functions)

These functions are vital to maintaining homeostasis, or the body’s internal state of balance. By sending messages to the pituitary gland, the hypothalamus is able to increase or decrease the release of certain hormones (chemical messengers) into the bloodstream to help the body function properly.

The specific functions controlled and regulated by the hypothalamus include: 

• Body temperature
• Blood pressure
• Respiration
• Digestive secretions
• Appetite
• Hydration
• Weight
• Breast milk production
• Salt and water balance
• Circadian rhythm (sleep-wake cycle)
• Growth
• Childbirth
• Sex drive
• Emotions and behavior
• Memory

The body sends signals to the hypothalamus alerting it when there is an imbalance in any one of these functions. In response, the hypothalamus  releases hormones to balance the body.

What Hormones Does the Hypothalamus Produce?

While the hypothalamus drives the production and release of hormones, it most often  secretes releasing or inhibitory hormones. These travel directly below the hypothalamus to the pituitary gland to increase or decrease related hormone secretions.

While there are many important hormones released by the hypothalamus, three examples include:

• Corticotropin-releasing hormone: stimulates the production of cortisol, a critical stress hormone
• Thyrotropin-releasing hormone: responsible for stimulating the thyroid gland, an essential part of metabolism, growth, and development of the body
• Vasopressin (antidiuretic hormone): helps the kidneys absorb water and regulate water levels throughout the body to help with blood pressure regulation

Damage to the hypothalamus can interfere with many biological processes, including homeostasis. Without the proper exchange of hormones, many organs cannot function properly. Therefore, it’s important to identify the cause of hypothalamus damage to receive the appropriate treatment.

Causes of Hypothalamus Damage

The hypothalamus—especially its anterior (front) region—is particularly vulnerable to injury during traumatic events. Research shows that approximately 27–32% of traumatic brain injuries lead to pituitary gland dysfunction, and about 49% of individuals who experience an aneurysmal subarachnoid hemorrhage also face pituitary disruptions. Given the close connection between the hypothalamus and pituitary gland, it’s likely that hypothalamic damage occurs in many of these cases as well.

Other medical conditions that may also cause hypothalamus damage, include:

• Traumatic brain injury
• Surgery
• Tumor
• Brain swelling 
• Radiation treatment or chemotherapy
• Eating disorders like anorexia or bulimia
• Tuberculosis
• Aneurysm
• Pituitary apoplexy
• Inflammatory diseases like multiple sclerosis and neurosarcoidosis
• Infection due to immune system disorders

Hypothalamus damage may also occur due to genetic disorders such as the Prader-Willi syndrome, the Kallmann syndrome, or birth defects. Although the causes of hypothalamus damage may vary, the symptoms are usually the same.

Symptoms of Hypothalamus Injury

When hypothalamus damage is caused by a traumatic event, it can often be overlooked during brain injury treatment because the symptoms are similar to other types of brain injuries or medical conditions. However, many individuals experience neuroendocrine disruptions after brain injury. Therefore, it’s important to understand the signs of a hypothalamus injury to help you differentiate between the symptoms and seek the proper medical care.

Common symptoms of hypothalamus damage include:

• Fatigue and/or insomnia
• Muscle weakness
• Headache
• Frequent thirst and/or dehydration
• Unexplained weight loss or gain
• Changes in appetite or poor appetite
• High or low blood pressure
• Frequent urination
• Loss of vision
• Infertility

Symptoms of hypothalamus damage may evolve over time. Be sure to follow-up with your doctor if you notice any new or recurring symptoms after a brain injury to obtain a proper diagnosis and treatment plan.

Health Conditions Affected by Hypothalamus Damage

The hypothalamus is versatile meaning it plays a role in many different functions of the body. For this reason, when the hypothalamus sustains damage, it can result in various health conditions or complications.

Some of the most common health conditions caused by hypothalamus damage include:

• Adrenal Insufficiency: occurs when the hypothalamus cannot instruct the adrenal glands (located above the kidneys) to release cortisol into the bloodstream. This can cause weight loss, fatigue, muscle weakness, low blood pressure, vomiting, and dehydration.
• Hypothyroidism: occurs when the hypothalamus is unable to produce thyroid releasing hormone, resulting in an underactive thyroid. This can cause concentration and memory problems, unexplained weight gain, cold sensitivity, extreme fatigue, depression, constipation, infertility and/or irregular periods.
• Diabetes Insipidus: occurs when the hypothalamus does not produce enough antidiuretic hormone and the body is unable to retain enough water. Unlike other forms of diabetes after brain injury, diabetes insipidus does not affect the body’s ability to use glucose. Rather it causes symptoms such as extreme thirst, dehydration, excessive urination, dry skin, and muscle weakness.
• Growth Hormone Deficiency: occurs when the hypothalamus is unable to stimulate the production and release of sufficient amounts of growth hormone necessary for development. This can result in slow growth, osteoporosis, muscle weakness, and high cholesterol levels.
• Hypothalamic Obesity: occurs when the balance between energy intake and expenditure is disrupted by hypothalamus damage. This can lead to fast weight gain, uncontrollable appetite, low metabolism, sleep apnea, and mood disorders.

Hypothalamus damage can also lead to extreme fluctuations in body temperature. The hypothalamus plays a critical role in stabilizing the body’s core temperature. For example, when the body’s temperature is above 98.6° F, the hypothalamus signals the sweat glands to help the body cool down. Other cooling responses by the hypothalamus include increasing water retention and dilating blood vessels. 

However, when the hypothalamus becomes injured, it can no longer accurately control your temperature. Therefore, you may experience frequent hot or cold flashes. A prolonged increase in core body temperature can lead to further brain damage. That’s why it is important to seek treatment as soon as possible.

How Is a Hypothalamus Injury Diagnosed?

Treatment for hypothalamus damage may vary depending on the diagnosis. To obtain a proper diagnosis and treatment plan, your medical team will perform a combination of different lab tests.

Hypothalamic dysfunction after brain injury may be measured by heart rate variability (HRV). To perform this exam, your doctor will give you a Holter monitor that records heart function over the course of 24 hours. Electrodes are placed on your chest to allow you to continue with your daily activities during this period.

The HRV measures how much your heart rate fluctuates. Changes indicate that the endocrine system is functioning well and keeping the body regulated. If there are very few or no changes it can indicate hypothalamus dysfunction. When the heart rate is either consistently high or low, it’s because there is limited communication between the body’s sympathetic and parasympathetic responses, which are autonomic functions controlled by the hypothalamus.

Other exams used to diagnose hypothalamus damage may include:

• MRI or CT scans
• Eyeball pressure tests (particularly if there is a tumor)
• Blood or saliva tests used to assess cortisol, estrogen, thyroid, and other hormone levels

With a proper diagnosis of hypothalamus damage your doctor can start you on hormone therapy to replace any deficiencies, or provide different forms of treatment.

Treatments for Hypothalamus Damage

Treatment for hypothalamus damage involves replacing lost hormones. Therefore, it’s important for all individuals to check their hormonal levels with their doctor as soon as possible after sustaining hypothalamus damage. 

Some of the most common hormones your doctor may suggest to increase include:

• Antidiuretic hormone (vasopressin): which helps the body absorb more water
• Growth hormone: helps keep the bones and muscles healthy
• Hydrocortisone: is used to replace cortisol
• Progesterone: is needed for the menstrual cycle

Many of these hormones may need to be taken daily to help regulate the body and compensate for hypothalamus damage. Along with hormonal therapy, there are other management techniques that can help with a hypothalamus brain injury. 

Management for hypothalamus damage may also include:

• Medication (to replace deficient hormones or to regulate affected functions)
• Surgery or radiation (to remove tumors)
• Maintaining a well-balanced diet after brain injury
• Proper sleep (about 8 hours daily)
• Exercising regularly (to boost overall health)

Every brain injury is different, and while many survivors may experience similar symptoms, treatment will vary for everyone. Speak with your doctor to ensure which course of treatment is safe and suitable for your condition.

Understanding Hypothalamus Brain Injury Recovery

Hypothalamus damage can occur due to various conditions such as a head injury, tumor, and immune diseases. The hypothalamus plays a crucial role in many of our bodily functions which can be lost after a traumatic event such as a head injury or tumor. 

Fortunately, many of these functions can be improved and restored with hormonal therapy. The sooner you seek treatment, the higher the chances of improving hypothalamus damage.

We hope this article helped you understand how hypothalamus damage can occur, and encouraged you to seek the proper medical care. seek the proper medical care.

Recovery from a traumatic brain injury (TBI) is a challenging journey, but the right guidance can make all the difference. Our free eBook, “15 Recovery Tips Every TBI Survivor Should Know,” offers practical strategies and expert insights to help you or your loved one navigate the challenges of recovery – Download our FREE eBook “15 Recovery Tips Every TBI Survivor Should Know”!

The post Hypothalamus Damage and Brain Injury: Understanding the Causes, Symptoms, and Treatment appeared first on Flint Rehab.

In this article we will break down each type of injury by looking at their causes and symptoms. Additionally we will outline the best treatment options for each to promote recover and neuroplasticity.

Let’s dive in!

What Is a Focal Brain Injury?

A focal brain injury occurs when damage is localized to a specific area of the brain. This type of injury is typically caused by a direct impact – for example a blow to the head or penetrating injury. Since the damage is concentrated in one area, symptoms depend on the affected brain region.

Causes of Focal Brain Injury

Focal brain injuries often result from incidents that involve direct trauma. This may include:

• Blunt force trauma, such as falls, sports injuries, or vehicle accidents that exert significant force on a particular part of the brain leading to localized damage.
• Penetrating injuries, where objects like bullets, shrapnel, or skull fragments pierce the brain tissue and cause specific damage.
• Hematomas and contusions, resulting from bleeding or bruising within the brain that creates pressure within a specific region, further contributing to localized injury.

These mechanisms of injury highlight the importance of using protective measures such as a helmet when engaging in high-risk activities, as direct impacts to the head are a leading cause of focal brain injuries.

Symptoms of Focal Brain Injury

The symptoms of a focal brain injury depend on the specific area of the brain that is damaged. Individuals may experience:

• Frontal lobe injuries, which can result in personality changes, difficulty with problem-solving, and impaired judgment.
• Temporal lobe injuries, leading to memory loss, difficulty understanding speech, and emotional instability.
• Parietal lobe injuries, which often cause trouble with spatial awareness and coordination.
• Occipital lobe injuries, where visual disturbances and difficulty recognizing objects may occur.

Because focal injuries affect a defined area, symptoms can often be linked to specific functional impairments, making diagnosis and treatment more targeted.

What Is a Diffuse Brain Injury?

A diffuse brain injury involves widespread damage across multiple areas of the brain. Unlike focal injuries, which are confined to a specific location, diffuse brain injuries affect the brain more generally, often leading to significant cognitive and functional impairments.

Causes of Diffuse Brain Injury

Diffuse brain injuries often result from events that cause rapid movement of the brain within the skull. Common causes include:

• Diffuse axonal injury (DAI), which occurs when rapid acceleration or deceleration—such as in a car crash or shaken baby syndrome—causes nerve fibers to stretch or tear.
• Hypoxic-ischemic injuries, which result from a lack of oxygen to the brain due to incidents like cardiac arrest, drowning, or suffocation, leading to widespread brain damage.
• Repeated head trauma, such as severe concussions from contact sports, which may contribute to diffuse brain injuries over time.

These injuries typically result in more widespread damage, affecting multiple areas of brain function.

Symptoms of Diffuse Brain Injury

Because diffuse injuries impact multiple brain regions, symptoms are often complex and widespread. Some of the most common symptoms include:

• Loss of consciousness, which can range from brief blackouts to prolonged comas.
• Cognitive impairments, including memory loss, difficulty concentrating, and slower processing speed.
• Motor function issues, such as muscle weakness, tremors, or difficulty with balance and coordination.
• Emotional and behavioral changes, including mood swings, depression, and anxiety.

Since diffuse injuries affect broader areas of the brain, recovery can be more unpredictable. This can require comprehensive treatment strategies to address the multiple deficits.

Diagnosis and Assessment of Focal and Diffuse Brain Injuries

Accurately diagnosing a brain injury is critical for effective treatment. Medical professionals use a combination of clinical evaluations and imaging techniques to assess the severity and location of the injury.

Medical Imaging

Doctors rely on various imaging techniques to diagnose brain injuries:

• CT scans are commonly used in emergency settings to detect bleeding, fractures, and swelling.
• MRI scans provide detailed images of soft tissues and help identify more subtle brain injuries, such as diffuse axonal injury.
• Functional MRI (fMRI) evaluates brain activity by measuring blood flow in different areas. This can be useful in assessing cognitive function following an injury.

Neurological and Cognitive Assessments

In addition to imaging, doctors and therapists conduct cognitive tests to evaluate memory, attention, and problem-solving skills. Standardized tools, such as the Glasgow Coma Scale (GCS), help assess the severity of TBIs based on responsiveness and consciousness. Neurological exams evaluate motor function, reflexes, and coordination, providing further insight into the extent of the injury.

13 Treatment and Recovery Strategies for Diffuse and Focal Brain Injury

Recovery from brain injury is highly individualized, and rehabilitation strategies must be tailored to address the specific patient needs. The approach for focal brain injuries differs vs diffuse brain injuries due to the nature and extent of damage.

Focal Brain Injury Recovery Strategies

For focal injuries, progress may be more predictable since the damage is isolated. Recovery is often dependent on neuroplasticity—the brain’s ability to reorganize itself by forming new neural connections. Since neuroplasticity is activated by repetitive experiences, most rehabilitative strategies focus on consistently practicing specific skills.

Here are several tried and true therapies for focal brain injury recovery.

• Targeted rehabilitation is often more effective since the damage is localized. Therapy is designed to address specific deficits related to the injured brain region.
• Physical therapy is used for motor function recovery if movement is affected, with exercises tailored to the impacted side or limb.
• Occupational therapy is recommended for those who have trouble performing daily activities to improve independence and learn compensation strategies as needed.
• Speech therapy may be required if speech and language centers are affected, particularly for temporal or frontal lobe injuries.
• Cognitive therapy focuses on problem-solving and memory enhancement when these functions are impaired by a focal injury.
• Behavioral therapy can assist in managing emotional regulation, especially for those with frontal lobe injuries that impact impulse control.

Diffuse Brain Injury Recovery Strategies

Because diffuse brain injuries affect multiple regions, recovery is often less predictable, requiring a multidisciplinary approach and longer rehabilitation periods.

• Comprehensive and integrative rehabilitation is required, as damage affects multiple brain areas.
• Physical therapy may need to address widespread motor impairments, including muscle tone regulation and coordination.
• Occupational therapy can focus on improving independence with daily self-care tasks. This may include introducing compensatory strategies and caregiver training in more severe cases.
• Cognitive therapy is often extensive, targeting widespread cognitive impairments such as slowed processing speed, attention deficits, and memory problems.
• Speech and language therapy may be needed for communication difficulties, especially in cases where processing speed and word retrieval are impacted.
• Psychological support is crucial for both survivors and their loved ones, as individuals with diffuse injuries often experience mood swings, depression, and behavioral challenges due to the widespread nature of brain damage.
• Neuroplasticity-based interventions such as brain stimulation techniques, repetitive cognitive exercises, and mindfulness training may help rewire the brain (neuroplasticity) and improve function.

7 New and Emerging Treatment Options for Focal and Diffuse Brain Injuries

While the above approaches are tried and true, recent advancements in medical science have introduced new strategies for treatment of both focal and diffuse brain injury.

Let’s take a look at which ones are gaining the most traction.

New Treatments for Focal Brain Injuries

The following 3 strategies for recovery have gained some popularity for focal brain injuries to enhance rehabilitation and improve outcomes. They include:

• Stem cell therapy is being explored as a potential breakthrough, using regenerative cells to repair damaged brain tissue.
• Targeted brain stimulation, such as transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS), is also showing promise in aiding neural recovery in individuals with focal injuries affecting motor function or cognition.
• Robot-assisted therapy has become increasingly common in rehabilitation settings. This technology, which may be used in combination with virtual reality, helps individuals regain motor skills through precise, repetitive movements that stimulate neuroplasticity.

New Treatments for Diffuse Brain Injuries

Because diffuse brain injuries impact multiple regions of the brain, treatment approaches must address widespread damage instead of focusing on a narrow area. Here are some of the most popular new options over the last 10 years.

• Neuroplasticity-based therapies, which focus on reprogramming the brain through intensive cognitive training, virtual reality rehabilitation, and brain-computer interface (BCI) technology.
• Hyperbaric oxygen therapy (HBOT) has also gained attention, as increased oxygen levels may help repair brain tissue and improve cognitive function in individuals with diffuse injuries.
• Intranasal drug delivery is another innovative approach which bypasses the blood-brain barrier to deliver neuroprotective compounds directly to injured brain tissue.
• Wearable neurotechnology, such as robotic exoskeletons and EEG-based biofeedback devices, allows patients to monitor and enhance brain function through real-time feedback and guided cognitive exercises.

The Future of Diffuse and Focal Brain Injury Treatment

While traditional rehabilitation strategies remain essential, these emerging treatments offer new hope for individuals recovering from focal and diffuse brain injuries. Research in personalized medicine, where treatment plans are tailored to an individual’s unique injury and genetic profile, is expected to further improve recovery outcomes.

As technology and medical science advance, the future holds great promise for more effective, targeted therapies that help individuals regain function and quality of life after brain injury. We hope this article provided you and your loved one with a better roadmap to recovery moving forward!

The post Focal vs. Diffuse Brain Injuries: Causes, Symptoms, and the Path to Recovery appeared first on Flint Rehab.

According to the American Art Therapy Association, art therapy includes using “active art-making, the creative process, and applied psychological theory…to enrich the lives of individuals, families, and communities.” Art therapy for brain injury patients is a great way to enhance cognitive and emotional skills and improve overall wellbeing.

If you want to learn more about this awesome therapy for TBI patients, keep reading!

Art Therapy for TBI Recovery

Art therapy for brain injury patients is a personalized therapy approach that can help strengthen cognitive function and emotional resilience. 

While art has helped people find peace and inner healing for millennia, it was only in the mid-twentieth century that art was accepted as a valid therapeutic approach to treating brain injury.

The great thing about art therapy is that it engages both the right and left hemispheres of the brain. In fact, in a recent study, researchers found that art, specifically drawing, activates multiple areas in each hemisphere.

This has huge implications for brain injury patients, since one of the main goals in TBI recovery is to stimulate the brain and activate neuroplasticity, the brain’s natural mechanism for healing itself.

The more you stimulate the brain, the more the brain can form and strengthen neural pathways that repair the damage done to it. This means creating art can literally help heal your brain.

Besides the fact that art therapy activates neuroplasticity, there are many other benefits that it offers for brain injury patients. We’ll look at those in the section below.

Benefits of Art Therapy for Brain Injury Patients

The following are some of the best reasons to try art therapy for brain injury.

1. Sharpen fine motor skills and visual perception

Handling paint on a paintbrush can help improve fine motor coordination and precision. These skills can transfer to other areas of your life, such as eating and other activities involving using utensils in a coordinated manner.

Working on fine details while painting also improves your hand-eye coordination. Plus, painting helps you develop stronger perception skills, since you’ll need to learn how to make 2-D objects look three-dimensional.

2. Improve concentration and attention

Art therapy, whether it involves painting, drawing, or taking a pottery class, requires heavy concentration.

You not only need to concentrate on making a flower the right shape, but you also have to keep in mind where it belongs in relation to the rest of the painting.

This will help you improve your ability to focus for longer periods of time and teach you to keep more than one thing in your mind at once.

You might find this hard at first, but the more you practice, the easier it will become.

3. Boost problem-solving skills

Art might look easy, but it actually takes a lot of hard thinking.

Unless you’re a natural artist, your painting is not going to come out perfectly on the first try. This means you must know how to identify problems in your painting or drawing and find creative solutions.

Again, this won’t happen right away. You probably will get frustrated a lot in the beginning. But art therapy gives you a safe place to develop your problem-solving skills and learn how to work through disappointment.

4. Relieve symptoms of depression and build social skills

Art therapy has been shown to help combat the chemical imbalances that cause depression.

According to one study, brain injury survivors are nearly 11 times more likely to experience depression in the first year  after brain injury than the general population. Therefore, it is critical to find effective methods to combat and/or prevent depression among brain injury survivors. Art therapy can be a great way to do so!

Because it often takes place in groups, art therapy also gives brain injury survivors a chance to rebuild their social skills and form friendships, which is key to making a good recovery.

5. Improve self-management and self-esteem

One of the best reasons to try art therapy after brain injury is it gives you a space where for once, you are in control.

You get to decide what to create, and how to create it. This helps you practice decision making and gives you back some autonomy, which will also boost your self-esteem.

Do you want to paint a landscape with grass and trees and mountains? Go ahead! Do you want to just have fun and mix a bunch of colors together? You can do that too!

There are no wrong answers here; that’s the beauty of art.

6. Increase mental flexibility and perseverance

Painting almost never goes the way you planned. You might run out of the right color, you might have used the wrong brush, or drawn things too big. But mistakes can provide an excellent opportunity to improve mental flexibility.  If something doesn’t look right, you can figure out how to fix it through problem-solving skills, mental flexibility and perseverance.

Doing this often enough will help you develop more flexibility and creativity in the rest of your life as well. You’ll learn not to get too attached to things, since when you’re painting you always have to be prepared to wipe it out and start over.

In short, art therapy teaches you how to deal with unexpected problems in a healthy way. All of that makes it a worthwhile activity for patients after brain injury.

7. Overcome emotional barriers

Sometimes it’s hard to talk openly about your feelings, especially after a brain injury. That’s where art comes in.

Art therapy is a cathartic experience that lets you access feelings deep within your subconscious. It can help you work through any emotional problems you might have in a constructive, non-threatening way.

That’s why so many psychologists prescribe art therapy to their patients suffering PTSD.

In fact, many patients find it helpful to express themselves through painting. They might use colors to represent their feelings, or draw an image that means a lot to them.

Sometimes just the act of immersing yourself in something else for a while, without having to worry about what others think, is enough to relieve feelings of anxiety and anger.

Effects of Art Therapy for Brain Injury Survivors

Over the years, researchers have been examining the use of art therapy to treat a number of conditions. Here are some of the helpful effects of art therapy for brain injury that have been uncovered:

• A 2019 study looking at art therapy in a group setting found that it increased socialization and improved the participants’ emotional states.
• This 2020 study determined that group art therapy in conjunction with psychotherapy could help survivors learn to adapt to challenging life experiences, improve social function, reduce depression symptoms, and learn to better regulate their emotions.
• Another 2020 study found that long-term art therapy, administered over approximately 2 years, could address frustration tolerance, grief and loss, emotion regulation, personal insight, resiliency, and trauma processing among military service members with both TBI and PTSD.

With its many benefits, it is easy to see how art therapy could benefit TBI survivors. If you are interested in art therapy, consider using this locator to find an art therapist near you!

Finding Hope through Art Therapy for Brain Injury Patients

As you can see, art therapy offers many psychological and cognitive benefits for patients after a traumatic brain injury.

Not only does art activate neuroplasticity, it can help improve your mood, problem-solving skills, attention, and coordination.

Most importantly, art helps patients find a healthy outlet for their emotions, and rebuild their sense of self, something few other therapies can offer after a traumatic brain injury.

We hope this article inspires you to add art therapy to your life and find hope after your injury.

The post 7 Benefits of Art Therapy for Brain Injury Patients Plus the Effects and Impact on the Brain appeared first on Flint Rehab.

To help you understand what recovery from a coup-contrecoup brain injury entails, this article will discuss:

• What Causes a Coup-Contrecoup Brain Injury?
• Diagnosing a Coup-Contrecoup Injury
• Coup-Contrecoup Injury Symptoms and Signs
• Coup-Contrecoup Brain Injury Treatment

What Causes a Coup-Contrecoup Brain Injury?

The terms coup and contrecoup are French for “blow” and “counterblow.” Therefore, a coup-contrecoup injury actually refers to two separate brain injuries sustained during the same incident.

A coup injury refers to the brain damage that occurs directly under the point of impact. In contrast, a contrecoup injury occurs on the opposite side of the brain from where the head is struck. These injuries can occur separately (as only a coup injury or only a contrecoup injury), but if the blow is strong enough, they often appear together (as a coup-contrecoup injury).

The brain is encased within the skull and is surrounded by cerebrospinal fluid. Generally, this provides enough protection from the bumps and jolts we experience throughout the day. However, when the force of a blow to the head is severe enough, the brain can slam against the skull, causing serious damage.

Most coup-contrecoup injuries occur when the person’s head slams against a stationary object. For example, if a car hits you from behind, you may experience whiplash and hit your head against the steering wheel.

When the skull hits the object, the brain moves toward the object until it collides with the skull. Then, due to the impact of the initial trauma, it rebounds, causing the second impact to the brain due to hitting the opposite side of the skull. This is demonstrated in the video below.

Coup-contrecoup injuries are considered focal brain injuries, meaning that they are confined to specific areas of the brain. While individuals may demonstrate symptoms associated with both areas of brain damage, the contrecoup injury is often more severe than the coup injury. In the following section, we’ll discuss the various signs and symptoms an individual may experience after this type of head and brain injury.

Diagnosing a Coup-Contrecoup Injury

Diagnosis of a coup-contrecoup injury usually involves a physical and neurological examination. Doctors are able to identify whether a coup, contrecoup, or coup-contrecoup injury has occurred through a detailed assessment, along with imaging tests such as an MRI or CT scan. If imaging tests reveal two distinct areas of damage that occur opposite from one another, it is usually considered a coup-contrecoup injury.

Coup-contrecoup injuries often involve brain contusions (bruising) and/or intracerebral hemorrhages (bleeding). Although individuals may display a wide variety of symptoms depending on which areas of the brain sustained damage, imaging tests can often paint a clearer picture in order to obtain an accurate diagnosis.

Coup-Contrecoup Injury Symptoms

Coup-contrecoup brain injuries may affect any 2 regions of the brain, with one injury at the point of impact and the other at the opposite part of the brain. While symptoms may vary depending on which areas of the brain sustain damage, the most common symptoms of coup-contrecoup injuries include confusion and seizures.

Each hemisphere of the brain is divided into 4 lobes: the frontal lobe, parietal lobe, occipital lobe, and temporal lobe. Most brain functions involve the collaboration of various regions of the brain. However, generally there is a specific region that each function can be primarily attributed to (the region that plays the greatest role in regulating that function).

Although coup-contrecoup injuries can affect any 2 areas of the brain, the frontal and temporal lobes are most often affected. Below, we’ll discuss common signs and symptoms of damage to each lobe of the brain.

1. Frontal Lobe Damage

The frontal lobe takes up the largest area of the cerebral cortex. It is primarily responsible for higher cognitive skills, such as attention, planning, memory, and behavior.

A coup-contrecoup injury that damages the frontal lobe may result in the following functional challenges:

• Impulsivity
• Poor judgement
• Memory loss
• Concentration problems
• Aphasia (language difficulties)
• Behavioral and personality changes
• Problem-solving difficulties
• Decision-making problems

Additionally, damage to the frontal lobe may impair motor control. As a result, individuals may experience weakness or paralysis of voluntary muscle movements.

2. Parietal Lobe Damage

The parietal lobe is located behind the frontal lobe. This region of the brain is responsible for processing sensory information such as touch and proprioception (your sense of where your body is in space). If a coup-contrecoup injury affects the parietal lobe, it may cause problems with sensation and perception. As a result, individuals may struggle to interact with their surroundings.

Common symptoms of parietal lobe damage include: 

• Numbness
• Burning
• Poor hand-eye coordination
• Difficulty differentiating right from left
• Loss of direction
• Difficulties distinguishing temperatures
• Abnormal perception of pain
• Difficulties with reading, writing, and mathematics

3. Occipital Lobe Damage

Behind the parietal lobe and towards the back of the brain resides the occipital lobe. This region of the brain is primarily responsible for processing visual stimuli.

A coup-contrecoup injury that affects the occipital lobe may involve different types of blindness and visual distortions, such as:

• Partial blindness (hemianopsia, also known as a visual field cut)
• Decreased peripheral vision
• Visual hallucinations/illusions
• Word blindness (alexia)
• Poor visual recognition and attention

4. Temporal Lobe Damage

The temporal lobe is located in the lower middle part of the brain, next to your temples and above the ears. Its main responsibility is processing auditory information, but it also plays a role in interpreting smell and sight.

A coup-contrecoup injury that affects the temporal lobe may result in:

• Hearing loss
• Trouble recognizing faces and objects
• Memory loss
• Difficulties understanding spoken language
• Difficulties finding the right words to say
• Attention problems
• Changes in emotional behavior

5. Additional Signs and Symptoms

Because coup-contrecoup brain injuries may affect any region of the brain, individuals may also experience other common secondary effects of brain injury, including:

• Severe headache
• Seizures
• Confusion
• Dizziness
• Emotional challenges
• Sensitivity to sound and light
• Amnesia (memory loss)
• Nausea
• Slurred speech

Now that you understand the potential outcomes the following section will discuss how to treat this type of head and brain injury.

Coup-Contrecoup Brain Injury Treatment

Treatment of coup-contrecoup injuries primarily depends on the severity of the injuries and which regions of the brain are affected. Every injury is unique, so a personalized approach to treatment that targets each individual’s specific secondary effects is ideal.

Frequently recommended rehabilitative interventions include:

• Physical therapy. If motor control and/or balance is affected after a injury, physical therapy can help improve these functions through targeted exercises.
• Occupational therapy. Occupational therapy can help individuals become as functional and independent as possible by rehabilitating affected functions and/or teaching survivors new ways to perform everyday activities.
• Speech therapy. If your injury results in aphasia, you may lose your ability to communicate. A speech therapist can help you regain language skills, as well as relearn swallowing skills if needed.
• Cognitive training. Cognitive training may help improve memory, attention, problem-solving, and learning skills after injury.

To improve outcomes after a coup-contrecoup injury, it is essential to practice rehabilitative exercises and activities as much as possible. This will stimulate the brain, reinforce demand for those functions, and promote neuroplasticity (the brain’s ability to rewire itself).

One way to perform as many repetitions as possible is to download a neurorehabilitation app on your phone or tablet, such as the CT Speech & Cognitive Therapy App. It provides access to over 100,000 speech and cognitive therapy exercises designed by speech therapists so you can practice whenever you want.

Additionally, the CT App targets a variety of functions including listening, speaking, attention, memory, and visual processing. This makes it ideal for all coup-contrecoup injury survivors, regardless of which regions of the brain are affected.

Likewise, if a coup-contrecoup injury has affected your mobility, it may be worth investing in home rehab devices like the Award Winning FitMi Home Therapy to retrain the brain to move again. FitMi includes 40 exercises for the leg, core, arm, and hand. They’re all designed by physical and occupational therapists to strengthen and improve motor control over muscles affected by brain injury.

Here’s what a caregiver said about FitMi during her son’s brain injury recovery:

“My son Sam has a TBI as a result of being hit by a car 5 years ago. We were looking for some way to get him to move since he would prefer to sit on the couch all day. He works with the FitMi on his own without anyone telling him to, and that is saying a lot. Any moving he does is good for him, and the FitMi is geared for reps of movements to help him continue to regain mobility. Best investment we have made since he left rehab!” — Ann L.

FitMi works best when used daily at home between outpatient therapy sessions. It helps fill in the gap when you can’t see your therapist daily or when insurance stops covering the sessions you need to continue improving.

Coup-Contrecoup Brain Injuries: Key Points

Coup-contrecoup brain injuries affect both the site of impact and the opposite side of the brain. Because two regions of the brain are affected, individuals with these injuries may experience a wide range of secondary effects. Treatment will vary depending on which regions of the brain are affected and their subsequent effects.

We hope this article helped you understand the implications of a coup-contrecoup brain injury as well as the best practices for recovering from one.

The post Coup-Contrecoup Brain Injury: Looking at Causes, Symptoms, and Treatment for this 2 Sided Head Injury appeared first on Flint Rehab.