- 1,000,000 hospital admissions
- the majority of the 50,000 deaths from road traffic accidents
- more than 10,000 severely handicapped
- three quarters of the victims are children and young adults.
This is a silent epidemic in which the primary focus is on early medical/surgical matters, and early physical rehabilitation. There is little attention devoted to the long-term emotional, behavioural, social and cognitive problems.
Acute brain injury is caused mainly by trauma (mostly young victims). Other causes include stroke, anoxia, infection, etc.
An “invisible” and poorly known handicap
A person with a brain injury often regains independent mobility, despite problems of hearing or vision, having a clumsy hand, a weak leg, a slurred voice, or epilepsy (the most frequent physical sequelae).
Many people who have had brain injury look well but have “invisible” deficits: intellectual, affective and behavioural sequelae affect the autonomy of the person in the everyday life.
This handicap is “invisible” because it is not palpable as could be a physical handicap; this is why brain injured persons and their families have difficulties to become aware of the handicap.
The disabilities linked to the invisible handicap are:
• Cognitive sequelae : in memory and learning, attention and concentration, information processing speed, communication (expression and understanding), orientation in time and space, visual agnosia, reasoning, decision making, organisation, planning, flexibility, initiative, motivation.
• Behavioural or psycho-affective sequelae: desinhibition, lack of self-control, inhibition or apathy, and lack of initiative, mood changes, indifference, anxiety, discouragement, depression.
• Anosognosia: the person is not aware of her difficulties or underestimates them.
• Important tiredness.
Head injury causes multi-disabilities which do not fit readily into bet ter known categories of disability...
High quality care is usually available in the domains of acute medicine and surgery, but in the later stages difficulties arise as, all too often, little is done for the social reintegration of the victim. The family is often alone to support the burden of the "stranger in the house".