Severe Traumatic Brain Injury

Occurs when the injury results in loss of consciousness of greater than 24 hours, an initial Glasgow Coma Scale of 3-8, and post-traumatic amnesia period of greater than seven days. The impact of a severe brain injury can include cognitive, language, sensory, perceptual, physical and social–emotional deficits, such as:

  • Cognitive: Attention, concentration, distractibility, memory, speed of processing, confusion, impulsiveness, language processing, and executive functions, among others.
  • Speech and Language: Difficulty understanding spoken words; difficulty speaking and being understood; slurred speech; speaking very fast or very slow; problems reading and writing.
  • Sensory: Difficulties with interpretation of touch, temperature, movement, limb position, etc.
  • Perceptual: Difficulty integrating or patterning sensory impressions into psychological meaningful data.
  • Vision: Partial or total loss of vison, weakness of eye muscles, double vision, blurred vision, problems judging distance, involuntary eye movements, intolerance to light, etc.
  • Hearing: Decrease or loss of hearing, ringing in the ears, increased sensitivity to sounds, etc.
  • Smell: Loss or diminished sense of smell.
  • Taste: Loss or diminished sense of taste.
  • Seizures: Convulsions associated with epilepsy, which can involve disruption in consciousness, sensory perception or motor movements.
  • Physical Changes: Physical paralysis/spasticity, chronic pain, control of bowel and bladder, sleep disorders, loss of stamina, appetite changes, regulation of body temperature, menstrual difficulties.
  • Social–Emotional: Dependent behaviors, emotional ability, lack of motivation, irritability, aggression, depression, disinhibition, denial/lack of awareness.
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