Brain Injury (also known as Head Injury) is damage caused to living brain tissue. Medically it is referred to as Acquired Brain Injury (ABI), indicating that it is an injury that occurred after birth and is not related to a congenital disorder. An Acquired Brain Injury can be the result of trauma (or referred to as a Traumatic Brain Injury or TBI) or of medical problems (include aneurysm, brain tumors, subarachnoid hemorrhages and stroke. It also includes brain injury that may be sustained by alcohol and drug abuse).

Whatever the cause, the resulting damage can impair the individual's abilities both physically and cognitively. 

Traumatic Brain Injury (TBI) can occur when damage is caused to the brain by an external mechanical force. TBIs can range from mild to severe - concussion is the most common form of mild TBI.

In New Zealand, the most common causes of TBI are:

• Falls (38%). Find out more about Fall prevention.

• Mechanical forces (21%)

• Motor vehicle accidents (20%)

• Assault (17%)

Brain injury is a condition that occurs when there is a forceful impact or sudden jolt to your head, which might harm your brain. This injury can take place at the moment of impact or could develop later on. The impact might affect only a specific part of your brain or might involve several different areas. There are primarily three ways through which a brain injury can manifest:

• Bruising and bleeding: This occurs when your brain is forced against the interior of your skull, either at the front or the back, causing bruising or internal bleeding.

• Swelling: Following an injury, if your brain begins to swell, it can lead to an increase in pressure within your skull, potentially damaging other areas of your brain.

• Tearing, shearing, and twisting:  This type involves the tearing apart of the connections between various parts of your brain, disrupting its normal functioning. In terms of what might lead to a brain injury, the most frequent causes are: Vehicular accidents, including cars and bikes- injuries sustained during sports activities, falls from a height or even slipping and  assaults.

It's important to recognise that brain injuries, especially those that are mild, may not be immediately obvious. Nonetheless, even a mild brain injury can significantly alter your life.

• Closed Head Injuries: these happen when there's a strong hit to your head but your skull remains intact. Often referred to as a minor head injury, it can result from your head being shaken vigorously or receiving a forceful blow. Hospitalisation might not always be necessary and losing consciousness is not a given. However, it can lead to issues with behaviour and thinking, which might heavily impact day-to-day life. A typical example of a closed head injury is a concussion.Following a concussion or similar closed head injury, individuals might experience a variety of symptoms such as headache, feeling sick, dizziness, a ringing in the ears, difficulties with memory, or a reduced attention span. These symptoms can differ from one person to the next but are collectively known as 'Post Concussion Syndrome.' Consulting a doctor, who may then refer you to a neurologist for comprehensive advice, is advisable.

• Open Head Injuries categorise those injuries where the skull is fractured, and the brain becomes exposed. This can lead to direct damage to the brain tissue beneath the fracture site, often resulting into loss of consciousness and harming a more extensive area of the brain compared to closed head injuries.

Understanding brain injuries and how they can affect your life is important because it helps you to make informed decisions about your rehabilitation, recovery and your journey forward. Whether it's recognising the symptoms or knowing when to seek professional help, knowledge is power.

Brain Injury Waikato is dedicated to providing support and information to help those affected by brain injuries navigate their recovery pathways effectively.

 Concussion, also referred to as a mild traumatic brain injury (mTBI) is a very common injury in New Zealand, with approximately 24,000 cases every year.

A concussion is when your brain gets injured, and you don't even have to lose consciousness for it to happen. It's caused by a sudden hit to your head or body, making your brain move quickly inside your skull. This can result in the brain being shaken, leading to chemical changes or even injury to the brain cells. Though concussions are often called "mild" because they are not usually deadly, the impacts can still be severe. At Brain Injury Waikato, we're committed to helping our community understand and navigate the challenges of brain injuries.

Some immediate signs that a person has sustained a concussion include:

• Appears dazed

• Confused

• Poor balance and lack of coordination

• Answers questions slowly

• Runs in the wrong direction

• Forgets events that occurred before and after impact

• Loses consciousness – but it is important to remember that a person can sustain a concussion without losing consciousness

A person may complain of:

• Headache

• Nausea and vomiting

• Double or blurred vision

• Confusion

• Fatigue

• Poor concentration

• Memory problems

• Sleep difficulties

• Irritability

• Sensitivity to noise and light

• Ringing in ears

Concussion Advice

If you've had a concussion, or think you have a concussion, take it seriously and see your doctor.

Signs to watch for:

Problems could arise over the first 24 hours. You must go to the hospital if you:

• Have a headache that gets worse

• Are very drowsy or can’t be woken up

• Can’t recognise people or places

• Pass out or have a blackout

• Vomit more than 3 times

• Behave unusually or seem confused

• Have seizures

• Have weak arms or legs, or are unsteady on your feet

• Slur your speech

The person looking after you needs to get you straight to the hospital or call 111 if they notice any of the above symptoms. Don’t hesitate – remember, it is better to be safe.

Some important things to know if you have a concussion or you care caring some someone with a concussion: 

• It is important not to go to sleep in the first 4 hours. After that, a normal night’s sleep is needed, at the normal time. If sleep seems strange in any way, the person looking after you needs to know to rouse you until you can say a word or two, then let you go back to sleep.

• If there is any worry about the severity of the blow, it is safest on the first night to gently rouse the sleeper every 2 hours during the night, and ask them to answer to simple questions. If a person cannot be woken normally, then medical help must be sought.

• Do not drink alcohol or take sleeping pills for at least 48 hours.

• Do not drive for at least 24 hours. You can drive again when you stop feeling giddy and you feel well enough; if you have any concerns, talk to your doctor.

• It's safe to take paracetamol for the headache. Don’t take medication containing aspirin or disprin for the next 4 days. This type of of medicine can make you bleed more from cuts and bruises.

Returning back to sport:

You must stand down from sport for at least 3 weeks AND you should not return to sport or training until you are symptom free AND have medical clearance. That way you’ll return 100% ready for play.

Why?

• Repeated concussions have a cumulative effect, so if you keep having concussions you may end up with a more serious injury and a permanent disability.

Second Impact Syndrome – acute brain swelling and bleeding that occurs when a second concussion is sustained before the first one has healed properly. This can be difficult to treat, and can be fatal.

You must stand down from sport for at least 3 weeks AND you should not return to sport or training until you are symptom free AND have medical clearance. That way you’ll return 100% ready for play.

Why?

• Repeated concussions have a cumulative effect, so if you keep having concussions you may end up with a more serious injury and a permanent disability.

Second Impact Syndrome – acute brain swelling and bleeding that occurs when a second concussion is sustained before the first one has healed properly. This can be difficult to treat, and can be fatal.

The experience of a Traumatic Brain Injury (TBI) or any brain injury varies from person to person, yet there are several symptoms commonly associated with most types of brain injuries.

Ongoing symptoms may include:

• Cognitive problems e.g. difficulties with thinking clearly, maintaining concentration, problem solving and completing projects.

• Memory problems particularly with learning and remembering new information.

• Physical problems e.g. with sense of balance, fatigue causing reduced mental and physical stamina, slower reflexes and headaches.

• Sensory problems e.g. lower tolerance to light and noise, or problems with taste, smell and touch.

• Communication difficulties making it difficult to express yourself and understand others.

• Personality changes e.g. irritability, intolerance, depression, anxiety, socially inappropriate behavior and mood swings.

• Loss of contact with friends and associates

• Fatigue: you may feel intense tiredness and fatigue. Fatigue is a personal experience that is different for everyone. For some it may feel like overwhelming tiredness, which makes them unable to complete normal activities of daily living. People may say they feel exhausted, lacking in energy, weak, unable to motivate themselves, or sleepy. For others it may worsen difficulties associated with their injury, for example, forgetfulness, irritability, slurred speech, distractibility or dizziness. Fatigue often makes resuming previous roles and daily activities more difficult and can contribute to people becoming socially isolated.

  Fatigue may affect:

  • what we think (for example, “I shouldn’t feel like this, I’m useless”)

  • how we feel (for example, frustrated, unable to cope, irritable)

  • what we do (for example, avoiding activities, or increasing effort)

Understanding that these symptoms are common can help in recognizing and addressing the effects of brain injuries.

For some great advice about understanding and working with fatigue you can read what the Brain Injury Association of America has collated which is really helpful Click to view resource

Understanding that these symptoms are common can help in recognizing and addressing the effects of brain injuries. For a helpful self-management after brain injury resource provided by the Middle people project click here 

Many people assume that people who experience a seizure have epilepsy. However, there are many other types of seizures and brain injury can sometimes cause Seizure disorders. 

Seizure disorders can come with the following signs and symptoms:

• Convulsions or shaking

• Involuntary movements of the limbs

• Loss of consciousness

• Confusion or drowsiness

• Staring spells

• Altered behavior

• Sensations in the body

• Auditory or visual hallucinations

• Incontinence (urinary or fecal)

Seizures may cause a loss of consciousness in some individuals. Individuals who lose consciousness may experience incontinence (urine or feces), prolonged confusion, or tongue biting.

There is a great recourse that explains seizure disorders which you can access by clicking this link 

Caring for a loved one who has experienced a TBI or brain injury can impact you emotionally. Your loved one has been through a trauma and may not be exactly who you knew before their injury. It is important to make sure your emotional and physical needs are also prioritised. Keep yourself well, talk to friends, your family, your GP or a support group. It can feel isolating, but you are not alone. Should you feel that your emotions are going to put you at risk of suicide or harm, please reach out to a trained medical professional or reach out to the help lines below:

• 0800 LIFELINE (0800 54 33 54)or free text HELP (4357)

• 0508 TAUTOKO (0508 82 88 65) Suicide Crisis Helpline

If this is an emergency, please phone 111

Caring for a loved one who has experienced a TBI or brain injury can impact you emotionally. Your perfect little child may be different, need more help that they once may have needed and you may not be sure what to do. Keep yourself well, talk to friends, your family, your GP or a support group. It can feel isolating, but you are not alone. Should you feel that your emotions are going to put you at risk of suicide or harm, please reach out to a trained medical professional or reach out to the help lines below:

• 0800 LIFELINE (0800 54 33 54)or free text HELP (4357)

• 0508 TAUTOKO (0508 82 88 65) Suicide Crisis Helpline

If this is an emergency, please phone 111

Children Video on head injury " A bump on the Head and where it lead" 

Everyone using a health or disability service has the protection of a Code of Rights. | Kei ngā tāngata katoa te haumarutanga o te Tikanga Mōtika me ka mahi te ratonga hauora, hauātanga rānei.

Right 1 : The right to be treated with respect | Mana

Right 2: The right to fair treatment | Manaakitanga

Right 3: The right to dignity and independence | Tū rangatira Motuhake

Right 4: The right to appropriate standards | Tautikanga

Right 5: The right to effective communication | Whakawhitiwhitinga whakairo

Right 6: The right to be informed | Whakamōhio

Right 7: The right to choice and consent | Whakaritenga mōu ake

Right 8: The right to support | Tautoko

Right 9: Rights during teaching and research | Ako me te rangahau

Right 10: The right for your complaint to be taken seriously | Amuamu

Click to view a video for an explanation of the Health and Disability rights in New Zealand 

To learn more about your rights, the Nationwide Health and Disability Advocacy Service is a free service that operates independently from all health and disability service providers, government agencies and HDC (Excluding ACC). If you want to know more about your rights when using health or disability services, get questions answered, or make a complaint, they can help. Freephone: 0800 555 050 or visit their website

Each brain injury is different, but we have created a pathway that might help shed some light on some of the services that you may expect to be involved in your recovery. Click to open the pathway. 

If you would like more advice on how to navigate your recovery, please contact our navigator on 07 839 1191