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Brain Injury Questions and Answers



What are "acquired brain injury" and "traumatic brain injury" and how do they differ?

Traumatic brain injury (TBI) includes any injury to the structure of the brain caused by an external force or insult.

Acquired brain injury (ABI) is defined as damage to the brain that occurs after birth and is not the result of a congenital defect or a progressive degenerative disease. ABI may be the result of physical trauma or various medical conditions.

ABI is a broader category that includes TBI's (such as those caused by accidents) as well as injuries caused by certain medical conditions (such as strokes).

How are brain injuries classified?

There are mild, moderate and severe head injuries.  A person sustaining a mild head injury may or may not lose consciousness, but may experience some symptoms, even days after the injury which often go untreated. Moderate head injury may be characterized by being unconscious less than 24 hours and may require rehabilitation. Severe head injury survivors usually experience a coma, require rehabilitation, and often need outpatient care and/or long term care.

What are the main causes of traumatic brain injury?

The most frequent causes of brain injury are motor vehicle accidents, pedestrian accidents, gunshot injuries, stabbing injuries, and falls.

How frequently do traumatic brain injuries occur?

Every fifteen seconds someone in the US sustains a traumatic brain injury. Head injuries account for 500,000 hospitalizations per year, and of those, 90,000 are severe brain injury incidents with lasting impairments. In Delaware, every day about 8 people are treated in emergency rooms for traumatic brain injury, and of those, 3 are hospitalized.

When does rehabilitation begin after a traumatic brain injury?

Rehabilitation is the process of helping a person achieve his/her maximum functional potential. This process begins immediately, even when the injured person is in a coma. There may be problems related to movement, memory, attention, slowness of thinking, difficulties with speech and language, behavior problems, and personality changes. These problems, which may persist for a long time, are dealt with during rehabilitation.

What is the Rancho Los Amigos Scale?

This scale was developed by the professional staff of the Rancho Los Amigos Hospital in Downey, California to describe the stages of recovery after brain injury. Originally an eight-point scale, it has been revised to include ten stages. Many hospitals and rehabilitation centers use this scale. At level 1, for example, the patient shows no response, and at Level 10, responses are purposeful and appropriate. (See the Centre for Neuro Skill's TBI Resource Guide for details.)

What happens after a traumatic brain injury patient is released from the hospital?

Nearly 23% of traumatic brain injury patients require additional treatment following discharge from the hospital. For a list of the rehabilitation facilities in Delaware and surrounding areas, please visit the brain injury rehabilitation page of this site.

What are the long-term effects of brain injury?

Long-term effects of brain injury can include:

  • Headache
  • Fatigue and sleep disturbance
  • Nausea
  • Difficulty speaking and listening
  • Decreased speed of thinking
  • Decreased concentration or attention span
  • Memory problems
  • Balance problems
  • Irritability
  • Depression
  • Anxiety
  • Emotional mood swings

What assistance is available for persons in Delaware with brain injury?

Brain injury can be a major challenge for both survivors and caregivers.

The Brain Injury Association of Delaware (BIAD), is a valuable resource for professionals, agencies, brain injury survivors and family members. For more information, call BIAD at 1-800-411-0505 or visit the BIAD website.

The Division of Medicaid and Medical Assistance (DMMA) provides a variety of home and community-based long term care services. Please visit the DMMA website for further information.

Also, you can visit the Resources for Persons with Brain Injury in Delaware page of this site for a list for helpful contacts and phone numbers, as well as the Financial Assistance for Persons with Brain Injury page for information on financial support.

For further information or assistance for brain injury survivors or caregivers, please contact the Delaware Aging and Disability Resource Center (ADRC).

Online Sources



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