Acquired Brain Injury

Overview

An acquired brain injury (ABI) is damage to the brain that happens after birth. It is not something you are born with. It can be caused by an accident, an illness, or a lack of oxygen to the brain. ABI can affect how you think, feel, move, and interact with others.

Yes. Acquired brain injuries are a leading cause of disability worldwide. Head injuries alone affect millions of people each year, and stroke is a common cause of ABI.

ABI can affect people of all ages and backgrounds. It is slightly more common in men, especially from head injury. In older adults, stroke is a frequent cause. Certain groups, such as people with epilepsy or those who have had a previous brain injury, may have a higher risk.

Symptoms

Common symptoms

• Headache, dizziness, or nausea
• Confusion or feeling 'foggy'
• Memory problems or trouble concentrating
• Mood changes, irritability, or depression
• Difficulty speaking or understanding words
• Weakness, numbness, or balance problems
• Changes in sleep patterns

Symptoms in children

• Crying that will not stop or is inconsolable
• Not feeding or eating normally
• Repeated vomiting
• Unusual drowsiness or trouble waking up
• Loss of interest in favourite toys or games
• Seizures (fits)

Symptoms in older adults

• Increased confusion that is worse than usual
• Feeling very sleepy or hard to wake up
• Difficulty walking or sudden loss of balance
• Changes in personality – such as being more withdrawn or agitated
• Vision problems or difficulty speaking
• Loss of consciousness for any amount of time

Causes

Main causes

• Traumatic injuries – such as a fall, road traffic accident, or assault
• Stroke – when the blood supply to part of the brain is blocked or bursts
• Brain infection – such as encephalitis or meningitis
• Lack of oxygen to the brain – for example, after a heart attack, near-drowning, or severe asthma attack
• Brain tumour – either benign (non-cancerous) or malignant (cancerous)
• Other conditions – such as multiple sclerosis or Parkinson's disease, which can cause damage over time

Risk factors

• Being male – males have higher rates of traumatic brain injury
• Age – older adults have a higher risk of falls and strokes; children and young adults also have more accidents
• Drinking alcohol or using recreational drugs
• High blood pressure, diabetes, or high cholesterol – these increase stroke risk
• Having a job or hobby that involves heights, vehicles, or heavy equipment
• Previous brain injury – makes another one more likely

When to see a doctor

See a doctor urgently if:

• You have any of the emergency symptoms listed above
• You have had a head injury and are taking medicine to thin your blood
• You have a seizure for the first time
• You have sudden vision changes, weakness on one side, or slurred speech

Book a routine appointment if:

• You or a family member notice memory problems, mood changes, or difficulty concentrating that is getting in the way of daily life
• You have headaches that keep coming back
• You feel anxious, depressed, or cannot sleep after a head injury
• You are worried about a child's behaviour, speech, or balance after a minor head injury

Diagnosis

A doctor will start by asking about your symptoms, your medical history, and how the injury or illness happened. They will do a physical and neurological examination – checking your movement, reflexes, balance, vision, and memory.

Tests that may be done

• Neurological exam – checks nerves, movement, coordination, and mental status
• CT scan – a quick X-ray that creates detailed pictures of the brain to check for bleeding or damage
• MRI scan – uses magnetic fields to create very detailed brain images
• Blood tests – to look for infection, bleeding problems, or other conditions that could affect the brain
• Sometimes a spinal tap (lumbar puncture) – if infection or bleeding is suspected

What to expect at your appointment

The process may happen in stages. In an emergency, you will be seen in a hospital and may have scans within minutes to hours. If your symptoms are not urgent, your doctor may arrange an outpatient scan or referral to a specialist. After a brain injury, you may be cared for by a team that includes doctors, nurses, physiotherapists, occupational therapists, and speech therapists.

Treatment

Treatment for an acquired brain injury depends on the cause and how severe the injury is. The main goals are to protect the brain from further damage, manage symptoms, and help you recover function and independence. Many people receive rehabilitation – a structured programme to relearn skills and adapt to changes.

Self-care at home

• Rest and sleep – your brain needs time to heal
• Avoid alcohol and recreational drugs – they can slow recovery and increase risk
• Take painkillers only as advised by your doctor – do not exceed the recommended dose
• Return to work or school gradually – take regular breaks
• Ask for help – family, friends, and community services can support you

Medical treatments

Medical treatment depends on the underlying cause. For example, after a stroke, medicine may be given to prevent further blood clots. For brain infections, antibiotics or antiviral medicine may be used. If pressure inside the skull rises after an injury, you may be given medicine to reduce it. Surgery is sometimes needed to remove blood clots, repair a tear in a major blood vessel, or remove a tumour. Your healthcare team will explain what your treatment is and why it is recommended.

When is surgery considered?

Surgery may be needed if there is bleeding in the brain that is putting pressure on it, or if a tumour or aneurysm (a bulging blood vessel) is causing problems. Surgery is always discussed with you or your family first, and the decision depends on your specific situation.

Living with this condition

Living with a brain injury can feel overwhelming. It helps to keep a steady routine – eat at regular times, sleep at night, and plan activities when you are most alert. Use lists, reminders, and alarms for tasks and appointments. Break tasks into small steps. Let others know what your limits are, and give yourself permission to rest.

Lifestyle tips

• Keep a notebook or phone app to write down important information
• Set aside time each day for a short rest – even 20 minutes can help
• Stay connected with trusted friends and family
• Avoid driving until a doctor says it is safe – brain injury can affect reaction times
• Return to hobbies gradually – start with low-stress activities

Diet and exercise

A balanced diet helps your brain recover. Include fruits, vegetables, whole grains, and lean protein. Drink enough water. Gentle exercise – with your doctor's permission – can improve mood, sleep, and energy. Start with short walks or light stretching. If you have balance or weakness, physiotherapy can help you exercise safely.

Mental health and emotional wellbeing

A brain injury can affect your emotions and personality. It is common to feel sad, angry, anxious, or confused. These feelings are part of the injury, not a sign of weakness. Talk to your doctor – they can offer treatment, such as counselling, and support.

Prevention

Not all brain injuries can be prevented, but many can. Wearing a helmet when cycling or riding a motorbike, using a seatbelt in the car, and making your home safer for older adults can reduce the risk of head injury. Managing high blood pressure, diabetes, and heart disease lowers the risk of stroke. Avoiding alcohol before activities that need concentration also helps.

Complications

If left untreated

• Worsening brain damage – if bleeding or swelling is not treated, it can cause permanent disability
• Ongoing memory problems or difficulty with planning and decision-making
• Changes in personality or emotions that strain relationships
• Depression or anxiety
• Development of epilepsy (recurrent seizures)
• Increased risk of further injury, especially if balance or judgment are affected

Long-term outlook

Many people with an acquired brain injury improve with time, especially if they get early treatment and rehabilitation. The brain has some ability to heal and rewire itself, especially in younger people. Recovery can take weeks, months, or even years. Even if some effects last a long time, support, therapy, and lifestyle changes can help you live a full and meaningful life.

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