IMPACTS OF TBI ON COGNITION
Theprocess of learning is facilitated by the cognitive ability of aperson. Cognition is the process involved information processing inthe brain. The aspects of cognitive functioning include thinking,memory, perception, and attention. The thinking ability of the brainenables an individual to make and implement decisions in variousactivities. Levin, Decker & Butcher (2012) describe memory as thecapacity to remember past events, people, places, ideas, andexperiences. Perception is the process that enables a person to see,hear, or be aware of a stimulus in the environment through thesenses. Attention is the capability of an individual to detect astimulus and focus on it rather than others. It enables a person toperform a task in the presence of distractions and transfer thestimulus to the higher-level processes. When these aspects ofcognition are affected, a person experiences difficulties inprocessing information faster, remembering information, responding tostimulus, thinking, being attentive, and speech. According toPonsford, Sloan & Snow (2012), psychological and traumaticconditions affect the cognitive functioning of a person. This paperdescribes traumatic brain injury and its impact on the cognitivefunctioning of an individual.
DíazL. (2013) describes traumatic brain injury as the injury to the brainresulting from an external energy that may penetrate the skull or hitthe head bluntly. The external forces may be due to crashes, falls,or accidents. Injury can be closed or open. In closed injury, anobject damages the brain but leaves the skull intact. The open injuryinvolves the penetration of the skull into the brain. Afterpenetrating the skull, the external force may damage a specific lobeor the entire brain.
Traumaticbrain injury ranges from mild to severe injury. Concussion, mildtraumatic brain injury, is associated with the loss of consciousnessand does not result in permanent brain damage. Diffuse axonal injuryis the injury to the nerves at the cellular level. It results fromthe back and forth movement of the brain inside the skull leading totearing of nerve axons. When the axonal injury is widespread,cognitive functions of the brain and wakefulness of a personexperience significant changes (Levin, Decker & Butcher, 2012).Cognitive deficits associated with traumatic brain injury (TBI)include attention, memory, the speed of processing information,confusion, impulsiveness, language, and executive functions.
Effects of TBI on Cognitive Functions
TBIhas some effects on the cognitive ability of an individual. Peoplewho suffer from traumatic brain injury are unable to concentrate on aspecific stimulus or attend to one thing at a time. Such peoplecannot work well in an environment with distractions. Therefore, theyhave difficulties in finishing a project. Levin, Shum & Chan(2014) opines that the lack of attentiveness in individuals with TBIlimits their ability to focus on a given stimulus and transfer it thehigh-level information processing. Victims of TBI find it difficultto maintain long conversations. Since attention is one of the pillarsof higher level skills, individuals with attention issues usuallyexperience other cognitive problems as well.
Afterhaving brain injury, an individual develops problems in processingand understanding information. The slowing down of informationprocessing is due to damage to nerve cells and axons (Richmond,Morrison, Chein & Olson, 2011). As a result, victims usually takea relatively longer time to understand what other people are saying.They are usually slow in understanding and following directions.Victims of TBI always have trouble following TV shows, movies andlistening to the radio. People with traumatic brain damage processesinformation about a particular stimulus slowly. Therefore, they takea longer time to respond to changes in the external environment. Dueto the problems with processing and understanding information,individuals with TBI need help when carrying out physical tasks androutine activities such as dressing.
Traumaticbrain injury affects short-term memory more than long-term memory.People with TBI do not forget everything in the past. Additionally,they are more likely to recall events and experiences in the past.This is what is referred to as long-term memory. Jonides et al.(2008) argue that short-term memory involves remembering newinformation, recent experiences, or daily happenings. Becauseindividuals with TBI have short-term memory problems, they usuallyforget important details of a conversation and request others toremind them what they have just discussed. They keep asking the samequestions several times. Difficulties in locating things like keysand mobile phones are common in people suffering from traumatic braininjury. They normally forget to execute plans after developing them.According to Levin, Shum & Chan (2014), TBI may also result inprospective memory problems and post-traumatic amnesia. The latter isthe inability to recall events after the moment of brain injury.Victims usually do not remember the event that led to brain injury.
Thedetection of various stimuli is affected by TBI. Victims experiencedifficulties with seeing, hearing or being aware of certain changesin the environment. This situation results from the damage of nervesby the external force. Nerves cells are involved in the perceptionand transfer of stimuli to the brain. Impairment of the nervoussystem and lose of sensitivity and perception may result after TBI(Levin, Shum & Chan, 2014). People with this traumatic conditionmay lose wakefulness. As a result, they may not perceive changes inthe environment. There are cases where victims are not aware thatsomeone is calling them. The lack of attention affects theperceptions and sensitivity of individuals with TBI.
Function of Different Parts of The Brain
Cognitiondeficits after traumatic brain damage are results of damage to partsof the brain that controls specific cognitive functions. The brainhas the right and left hemispheres. In most individuals, the lefthemisphere regulates language and speech while the right hemisphereis responsible for nonverbal and spatial skills (Levin, Shum &Chan, 2014). Injury to the right side results in problems associatedwith movement of limbs, vision on the left side, or hearing in theleft ear. The frontal lobe is located just under the forehead, and itcontrols executive functions such as thinking, decision-making,planning and problem-solving skills (Rabinowitz & Levin, 2014).It also controls attention, language processing, and comprehension.
Theparietal lobe is located at the top of the head and above the ears.It functions in integrating senses, construction ability, andlanguage. Thompson (2013) argues that when it is injured, anindividual may develop perception problems and lose sensation onparts of the body. The parietal lobe gives a person the ability toread, write and understand. The occipital lobe is found at the backof the head. It controls vision. Injury to this lobe causes problemsin depth perception, color perception, difficulty in tracking objectsin motion, and partial or total blindness. The temporal lobe controlsmemory, verbal perception, face and object recognition, attention,speech, and comprehension. Levin, Shum & Chan, (2014) argues thatwhen this lobe is damaged, an individual finds it difficult to payattention and screen out distractions. Misunderstanding verbalinformation can result if the upper temporal lobe is injured. Damageto this lobe may cause short-term memory loss. Injury to cerebellummay cause difficulties in distance perception and slurred speech.When TBI affects the brain stem, attention, arousal, andconsciousness problems develop.
Treatment of TBI
AccordingLevin, Shum & Chan, (2014), mild traumatic brain injury does notneed hospitalization. However, is necessary to pay close attention tothe progress of the victims’ condition. For concussions, victims ofTBI are given time to rest to regain their consciousness. Moderateand severe traumatic brain injuries need medication. Diuretics maybe given to reduce the capacity of the fluid to lower pressure insidethe brain. People with TBI have a high risk of having seizures due toadditional damage to the brain. Anti-seizure drugs prevent furtherinjury to the brain. Coma-inducing drugs are used to initiatetemporary comas. Auth & Kerstein (2012) argue that a comatosebrain needs a low amount of oxygen to functions and is in a restingstate. The Blood flow to the brain reduces and thus reducing pressurein the brain. The four aspects of cognition improve when the brain isin a coma. Surgical interventions may also be employed to reducepressure, remove clots, and repair fractures on the skull. Theremoval of blood clots helps in avoid further damage to the cognitivefunctioning of the brain.
Cognitive functioning is a product of various parts of the brain. Thebrain is divided into structures known as lobes. Psychological ortraumatic conditions affect cognitive ability of an individualbecause of the damage they cause to one or more lobes. There arefrontal, parietal, occipital, and temporal lobes in each hemisphere.Injury to any lobe, brain stem or cerebellum interferes with thefunctions it controls. The various aspects of cognitions such asperception, attention, thinking and short-term memory areinterdependent. The impairment of perception ability results inproblems associated with attention, speech, processing andunderstanding information, and memory. Medications of TBI enhancecognition functioning by reducing pressure in the brain, repairingfractures, inducing a coma, and preventing addition damage.
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