An acquired brain injury (ABI) is defined by the World Health Organization as damage to the brain that occurs after birth, and is not related to a congenital or degeneration disease. This damage may be temporary or permanent and cause partial or functional disability or psychosocial maladjustments. (Geneva '96)

Causes of acquired brain injury include:

• Trauma to the brain (e.g. car crash, assault)
• Cerebral vascular accidents (e.g. strokes, aneurysms)
• Tumors
• Infections (e.g. meningitis)
• Toxic exposure (e.g. exposure to toxic gases, solvents, carbon dioxide)
• Lack of oxygen to the brain due to a variety of causes (e.g. drowning)
• Symptoms of an acquired brain injury may include communication, cognitive, physical and psychosocial deficits.

Communication deficits include:

• Difficulties with speech
• Unable to comprehend/understand directions
• Difficulties with reading and writing

Cognitive deficits may include:

• Difficulty concentrating and focusing
• Problems with planning and organizing
• Memory problems (forgets appointments) –very common
• Difficulty finding the right word
• Environmental overload (e.g. feels overwhelmed in crowds, stores)
• Misunderstands what is said by others
• Difficulty expressing thoughts verbally

Physical deficits may include:

• Headaches
• Nausea
• Balance problems
• Fatigue/sleep disorders
• Poor coordination
• Ringing in the ears/loss of hearing
• Visual problems
• Muscle weakness/paralysis

Initially less obvious but equally severe are the social/behavioral difficulties. These include:

• Changes in emotion (mood swings)
• Impulsivity or inappropriate social behavior
• Anger outbursts
• Depression
• Reduced motivation and isolation
• Reduced judgment
• Decreased insight into self and others
• Denial or lack of awareness of deficits
  

It's important to remember that each acquired brain injury is as unique as a fingerprint. An individual may experience all or only some of the effects described. But for everyone Acquired Brain Injury results in difficulties on the job, at home and at school.

• Without rehabilitation, only 12% of survivors return to work
• 75% of individuals with brain injury are unemployed

The cost to society is immense as Brian Injury alone costs Canadians more than $1 billion per year. Access to cognitive retraining, support groups and counseling are needed among children and adults. Vocational training, case management and occupational therapy have also been reported to be difficult to access and highly needed.

By the most conservative estimates over twelve thousand sustain a brain injury each year in BC car crashes, falls, assaults, other blows from blunt objects, diving accidents, sports-related concussions). At least the same number (6,000) sustain a brain injury from other causes (anoxia, tumor, stroke, aneurysm infections, disease, metabolic causes such as anorexia, surgery, drug overdoses, drug/alcohol interactions, toxins such as lead poisoning). These estimates are very conservative as they are based on hospital admissions procedures, which often fail to record brain injuries, unless they are severe and obvious at admission.

• There is approximately the same number of people in British Columbia with brain injury as those with chronic schizophrenia
• There are more people living with a brain injury in British Columbia than people with a developmental handicap
• The Government provides approximately 10 million dollars in community-based support to people with brain injury
• More than 400 million dollars is available for community support to those with a mental illness and 300 million dollars is available for community support to those with developmental handicaps
• Brain injury is the greatest killer under the age of 35. It kills more people than heart disease, cancer, AIDS or any other malady
• Brain Injury kills more children under the age of 20 than all other causes of death combined
• More than twenty times as many people experience a brain injury as compared to spinal cord injury

Within the previous Provincial Brain Injury Program, there was less than ten staff responsible for development and maintenance of community support for people with brain injuries as compared to the 200 government staff providing support to people with mental illness and approximately 250 staff who provide support to people with developmental handicaps.

British Columbia has a two-tiered health care system for people with brain injury. Extensive professional community-based rehabilitation and support services exist for people who can afford to pay. People who do not have personal resources (i.e. Third party funding) must access severely limited hospital-based services or charitable services, which are virtually non-funded for essential care, needs. Many existing services for British Columbians are unavailable to people with brain injury and one in six acute care, long-term care or extended care beds in British Columbia is occupied by someone with a brain injury. In most cases extended hospital stay, long-term care institutional settings and extended care settings are inappropriate for people with brain injury and institutional care in the majority of cases, provides little or no rehabilitation, and results in a decrease in functional capacities and decreases the likelihood of return to community. Community based care costs no more than institutional based care. Current rehabilitation resources are completely inadequate to provide the service people are entitled to under the Canada Health Act. By the time a small amount of funding is received the critical period to make rehabilitation effective has passed and that is if the person has been diagnosed with a brain injury. Of the 12,000 recognized British Columbians who sustain a brain injury each year. We know that between 10 – 15% of these individuals will need community-based support for the rest of their lives. The majority of injuries occur to young people between the ages of 16 – 24; therefore, these individuals can expect a relatively normal life span and it becomes obvious that support systems are needed. This is where NBIS comes in to pick up the pieces