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Spinal Cord Injury Paralysis Resource Center

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Brain Injury

The brain serves as the control center for all of the body's functions including conscious activities (walking and talking) and unconscious ones (breathing, heart rate, etc.). The brain also controls thought, comprehension, speech and emotion. Injury to the brain, whether the result of severe head trauma or a closed head injury in which there is no fracture or penetration of the skull, can disrupt some or all of these functions.

Brain injury can have serious and lifelong effects on physical and mental functioning, including loss of consciousness, altered memory and/or personality, and partial or complete paralysis.

Traumatic brain injury (TBI) results mainly from motor vehicle incidents, falls, acts of violence, and sports injuries. It is more than twice as likely in males than in females. The estimated incidence rate is 100 per 100,000 persons with 52,000 annual deaths. The highest incidence is among persons 15 to 24 years of age and 75 years and older.

Enclosed within the bony framework of the skull, the brain is a gelatinous material that floats within a sea of cerebrospinal fluid. This fluid supports the brain and acts as a shock absorber in rapid head movements. The outer surface of the skull is smooth, but the inner surface is jagged – this can cause significant damage in closed head injuries as the brain rebounds within the skull over rough bony structures.

Injury to the brain can be caused by fracture or penetration of the skull (such as in the case of a vehicle accident, fall or gunshot wound), a disease process (neurotoxins, infections, tumors, metabolic abnormalities, etc.) or a closed head injury such as in the case of Shaken Baby Syndrome or rapid acceleration or deceleration of the head.

When the injury results from trauma, damage to the brain may occur at the time of impact or may develop later due to swelling (cerebral edema) and bleeding into the brain (intracerebral hemorrhage) or bleeding around the brain (epidural or subdural hemorrhage).

When the head is hit with sufficient force, the brain turns and twists on its axis (the brain stem), interrupting normal nerve pathways and causing a loss of consciousness. If this unconsciousness persists over a long period of time, the injured person is considered to be in a coma, a condition caused by the disruption of the nerve fibers going from the brain stem to the cortex.

A closed head injury often occurs without leaving obvious external signs but the difference between closed and penetrating injuries can be profound. In a bullet wound to the head, for example, a large area of the brain may be destroyed but the result may be minor if that area was not a critical one.

In contrast, closed head injuries often result in more widespread damage and extensive neurologic deficits, including partial to complete paralysis, cognitive, behavioral, and memory dysfunction, persistent vegetative state, and death.

Injured brain tissue can recover over a short period of time. However, once brain tissue is dead or destroyed, there is no evidence that new brain cells can regrow. The process of recovery usually continues even though new cells do not grow, perhaps as other parts of the brain take over the function of the destroyed tissue.

The rehabilitation process begins immediately. Once memory begins to be restored, the rate of recovery often increases. However, many problems may persist, including those related to movement, memory, attention, complex thinking, speech and language, and behavioral changes.

Beyond the obvious physical effects of brain injury, survivors frequently cope with depression, anxiety, loss of self-esteem, altered personality, and in some cases, a lack of self-awareness by the injury survivor of any existing deficits.



Brain Injury Resource Center, National Institute on Deafness and Other Communication Disorders, National Institute of Neurological Disorders and Stroke.

A Reeve Foundation Fact Sheet on Aphasia (PDF)

A Reeve Foundation Fact Sheet on Brain Injury (PDF)

A Reeve Foundation Fact Sheet on Brain and Spinal Cord Tumors (PDF)

Bob Woodruff FoundationHelping to heal the physical and psychological wounds of war.

Brain Injury Resource CenterBrain Injury Resource Center/Head Injury Hotline (BIRC) operates “to empower you to have your needs met and avoid exploitation.”

Brain Injury Association of America (BIAA)The Brain Injury Association of America (BIAA) is the leading national organization serving and representing individuals, families and professionals who are touched by a life-altering, often devastating, traumatic brain injury (TBI). Together with its network of more than 40 chartered state affiliates, as well as hundreds of local chapters and support groups across the country, the BIAA provides information, education and support to assist the 3.17 million Americans currently living with traumatic brain injury and their families.

Defense and Veterans Brain Injury Center (DVBIC)The mission of the Defense and Veterans Brain Injury Center (DVBIC) is to serve active duty military, their dependents and veterans with traumatic brain injury (TBI) through state-of-the-art medical care, innovative clinical research initiatives and educational programs.

North American Brain Injury Society NABIS is a society comprised of professional members involved in the care or issues surrounding brain injury. The principal mission of the organization is moving brain injury science into practice. Whether it is in the area of clinical care, research, policy or litigation, the organization stands behind the premise that advances in science and practices based on application of the scientific evidence will ultimately provide the best outcomes for those with brain injuries and the community as a whole.

Traumatic Brain Injury Model Systems National Data and Statistical Center (TBINDSC)Located at Craig Hospital in Englewood, Colorado, is a central resource for researchers and data collectors within the Traumatic Brain Injury Model Systems (TBIMS) program. The primary purpose of the TBINDSC is to advance medical rehabilitation by increasing the rigor and efficiency of scientific efforts to longitudinally assess the experience of individuals with traumatic brain injury (TBI). The TBINDSC provides technical assistance, training, and methodological consultation to 16 TBIMS centers as they collect and analyze longitudinal data from people with TBI in their communities, and as they conduct research toward evidence-based TBI rehabilitation interventions.

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship areencouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.