Symptoms of head injuries: physical, emotional and cognitive

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Physical problems are less common but more obvious manifestations of damage to the brain. They include difficulties with balance and co-ordination, voluntary movement (dyspraxia), loss of senses (hearing, taste and smell and touch), language problems, headache and dizziness, and epilepsy.

Therapies often produce great improvements in terms of coping with these problems. A Neurophysiotherapist will help with regaining coordination and ‘relearning’ movement; a Speech and Language therapist can remedy speech and language deficits and a Vestibular Physiotherapist will treat a patient with impaired balance and vertigo.

Emotional and behavioural problems are very common after brain injury and their effects can be more serious even than physical or cognitive problems. The mechanisms are not well understood, but the initial injury can cause direct damage to those part of the brain that deal with emotions and mood. Anger, selfishness and lack of empathy, impulsive behaviour and lack of inhibition are all recognised symptoms resulting from brain damage.

In addition, the effects of the brain injury, and any other injuries, can influence behaviour and personality, so even if the accident caused no direct damage to ’emotional’ part of the brain there may still be depression, anxiety and post-traumatic stress attributable to pain, disability loss of employment etc.

Cognitive problems mean difficulties with mental functioning, and in many brain injury cases there will be problems with memory, concentration, attention, speed of thought processing and understanding; motivation and planning.

Brain injury sufferers with cognitive problems often have good insight into their cognitive problems and so it can be extremely frustrating having to cope with what many perceive as a general slowness of thought and blunting of their intellectual powers.

In a brain injury case we will always try to get support to help with cognitive problems because although those problems might not be cured, they can be managed much more effectively with expert assistance. Case Managers, Occupational Therapists and support workers will teach methods and strategies to cope with mental function problems. For instance a support worker will manage a diary and prompt activities (e.g. taking medication, initiating tasks) and ‘smart’ technology will help the patient take on more tasks themselves.

Statistically we all carry a small risk of epilepsy. Following a head injury that risk is increased, certainly over the short term. The more serious the injury the greater the risk, so a bleed within the brain and a fractured skull will produce a higher risk, and a seizure will elevate the risk further. According to the studies, the risk starts to reduce if the epilepsy does not manifest in the first few years, so in many cases it can eventually reduce to the background level.

Because the effect of epilepsy can be profound, this is one of the few exceptions to the legal principle that any settlement or judgment is once and for all, so in a case where there is a significant risk of epilepsy the lawyers may advise you to seek an order from the court that allows you to reopen the case in the future if the risk materialises at some point in the future.