110 HEALTH MATTERS brain injury


THE SILENT EPIDEMIC OF ACQUIRED BRAIN INJURY


While Acquired Brain Injury (ABI) poses a major and increasing public health challenge, as a phenomenon, it defies easy categorisation, writes Richard Stables, Information and Support Manager, Headway.


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cquired Brain Injury (ABI) has a wide range of causes, results in a huge number of potential consequences for the individual and family and many of its effects may be totally invisible to the outside observer. No wonder then that it has been dubbed the ‘silent epidemic’. Headway (www.headway.ie), is one of several organisations in the community and voluntary sector who work together and in partnership with the HSE on behalf of people who have been affected by Acquired Brain Injury. We help to rebuild lives following injury by providing rehabilitation services and support to injured people and their families once they return to their own community following treatment or inpatient rehabilitation. The World Health Organisation (WHO)


defines Acquired Brain Injury as ‘an injury to the brain which is not hereditary, congenital or degenerative’. So, rather than a single clinical condition, Acquired Brain Injury is more a collection of conditions with a common presentation resulting from a number of different causes. These are typically: Trauma, of which road accidents and falls would be the largest source; Vascular Disorders including Stroke or Haemorrhage; Anoxic and Hypoxic Injury and Infection. Worldwide, the statistics about brain injury


are bald. According to the WHO, traumatic brain injury is the leading cause of death and disability in children and young adults around the world and is involved in nearly half of all trauma deaths. In Europe, brain injuries from trauma are responsible for more years of disability than any other cause. If we are to assume that the average European incidence of head injuries applies to the Irish population, we expect to see 10,000 new head injuries each year, a figure which is consistent with data produced by the Hospital Inpatient Enquiry system (HIPE).


Stroke is the third most common cause of death and the most common cause of acquired physical disability in Ireland. The www.stroke.ie website, created by the Irish Heart Foundation, tells us that 10,000 people in Ireland are admitted to hospital with Stroke each year and that Stroke kills more than 2,000 people a year in Ireland – a higher death toll than from breast cancer, lung cancer and bowel cancer combined. So, when we combine the statistics for traumatic injuries and vascular disorders, we can see that in Ireland, Acquired Brain Injury represents a major health burden, with an annual incidence of over 20,000 injuries and an estimated prevalence of disability in the region of 30,000 adults, or 0.7 per cent of the population. So what are the consequences for a person who acquires a brain injury through any of the various causes? Our service users seek assistance with a range of activities from aspects of daily living through social participation to reintegration into the job market via training and vocational support. Inevitably, when an organ as complex as the brain becomes injured the potential range of consequence is huge and can vary enormously from individual to individual depending on the type and severity of injury, the location of any damage and the course of recovery following treatment and rehabilitation. For many people following injury there


are obvious physical consequences, such as paralysis, weakness, fatigue, headache or problems with coordination. Many may have difficulty communicating, whether expressively or receptively, or both. For many more, it is the less outwardly visible consequences which nevertheless produce the more severe restrictions to participating in everyday life. Brain injury can affect your ability to maintain attention, to remember, to think, plan and problem-


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