Physical Deficits after Brain Injury

Physical Deficits after Brain Injury Forefront in Rehabilitation

By Gordon Johnson

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Physical deficits after brain injury is the part that Hollywood forgets in its coma/amnesia plots.  Those who survive extended coma usually wake up, not only to memory problems, but having to relearn so much about how to use their bodies. Further, severe brain injury not only injures the cognitive parts of our brains, it often injures the motor system.  The motor system is the part of the neurological system that operates the muscles.  Motor system damage can also include not just our extremities like our arms and legs, but also the muscles of the throat, the eyes, the face.  Thus, the physical deficits after brain injury may include difficulties with speech, with vision, with something as important to who we are as a smile.

Physical deficits after brain injury pose a significant challenge in rehabilitation. Here, Mike’s wife demonstrates helping him out of his wheel chair. Note the strap to assist.

Often physical deficits are one sided, called hemiparesis or hemiplegia.  Hemi means one hemisphere or one side of the brain. Hemiparesis is weakness on one side of the body. Hemiplegia means total loss of use of one arm, one leg, one side of the body.   Physical deficits after brain injury such as Hemiparesis or hemiplegia are associated with damage to the opposite side of the brain from where the one sided physical problem manifests itself in the body. For example, a hemiparesis of the left arm, will be caused by right sided brain damage.

Physical deficits after brain injury may also occur not from brain damage, but to localized injury to other parts of the body. The nature of the kind of accidents where brain injury occurs, often involved multiple traumas.  The kind of blow that can cause a severe brain injury, might fracture a bone, damage an organ. Our TBI Voices story about Mike (above) is an example. From his wife describing his physical injuries:

His whole body swelled up.  His chest was totally black and blue.  He fractured the side of his face and his jaw.  His right eye was swelled shut.  It was very, very bad.  They had his head wrapped every day with layers and layers of gauze.

I didn’t know if he was going to  be able to see.  The doctor had said the part of the brain they did surgery on was for the left side.  (They told us) we wouldn’t know if he could see until he could talk and tell us what he could see.  The one side of his face was swelled right shut.  I was worrying that the left side wasn’t going to  function right. To See TBI Physical Limitations click here.

The problem in mild brain injury is that the orthopedic (bone) injury gets all of the attention.  In a severe brain injury involving coma, sometimes those injuries go undiagnosed, because the injured person is not capable of complaining about the injury. Thus, it is important that a thorough physical exam is done on someone in a coma, to make sure that the physical deficits after brain injury get attention, even while the coma persists.  With Mike, there was an undiagnosed broken clavicle.

His wife tells us more about his physical deficits after brain injury:

Mike needs help walking.  He is now right-handed.  He was left-handed for 51 years.  He wears glasses all the time.  He never wore them all the time.  He needs help getting dressed, bathing and putting his shoes on.  He had a bad ankle before but it’s gotten worse because he wasn’t able to use it for the two months.  He’s got to have special shoes for the brace on his left foot. that has to fit inside of his shoe.

Treating physical deficits after brain injury is one of the areas where excellent progress has been made over the years.  Physical therapy is very helpful and the physical therapist is one of the most important members of the severe brain injury medical team. The good news about the physical deficits is that after the person regains awareness, the physical deficits will get plenty of medical attention.

Next – Relearning to Walk After Brain Injury

Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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