What is a Non-Traumatic Brain Injury?

Article by Moody Neuro

A non-traumatic brain injury (nTBI) refers to brain damage caused by factors other than external trauma. These causes can include exposure to certain toxins, complications of an infection, or a symptom of a medical condition. A stroke is usually the most common cause of an nTBI, and understanding the signs and symptoms is necessary for implementing prevention measures and assessing treatment options.

A brain injury can have life-altering consequences for patients, impacting their physical well-being, cognitive functions, and emotional state. The implications of these injuries can significantly affect a person’s ability to perform daily tasks, maintain relationships, pursue their careers, or enjoy their hobbies.

Coping with these new circumstances is a challenging and ongoing process. However, understanding the nature of the injury and its underlying cause can help patients acquire the best treatment to provide the best outcome.

Understanding Non-Traumatic Brain Injury

An nTBI is a complex medical condition that can significantly alter brain function and impact everyday functioning. It is caused by factors not involving external physical force to the head. These causes can include an illness, oxygen deprivation, aneurysms, metabolic disorders, or cardiac arrest, among many others.

It’s essential to differentiate nTBI from traumatic brain injury (TBI) as both types of brain damage are distinct in their etiologies (causation) and clinical presentations (treatment). While nTBIs arise internally, TBIs result from external forces impacting the head, leading to physical damage to the brain tissue. These can be events like a blow to the head, sports injury, or impact from a vehicular accident.

Implementing the proper diagnostic techniques is crucial in accurately diagnosing nTBI and developing appropriate treatment strategies for the injury. Comprehensive medical assessments of the condition can include taking detailed patient histories, neurological examinations, and advanced imaging techniques, such as magnetic resonance imaging (MRI) and computerized tomography (CT) scans.

By applying the appropriate diagnostic procedure, healthcare professionals can provide a timely and precise diagnosis of the injury and its underlying cause. This enables them to implement targeted interventions and rehabilitative measures that enhance patient outcomes and improve their overall quality of life.

Symptoms and Diagnosis

A non-traumatic brain injury can be characterized by a range of symptoms that can be difficult to detect. This is due to the fact that most of these symptoms are attributable to other conditions, while the possibility of a brain injury is almost never considered.

These symptoms need careful attention to provide a timely diagnosis for effective injury management. Several symptoms can be categorized as physical, emotional, cognitive, and perceptual symptoms:

Physical symptoms include:

Headaches
Fatigue
Paralysis
Seizures
Insomnia
Light sensitivity
Loss of consciousness
Speech difficulties

Emotional symptoms include:

Aggressive behavior
Sluggishness
Mood swings
Depression
Anxiety
Irritability and impulsiveness

Cognitive symptoms include:

Problems with memory
Difficulty concentrating
Impairment of decision-making skills
Shortened attention span

Perceptual symptoms result from a portion of the brain being affected by the injury, which alters the patient’s senses and changes how they perceive stimuli.

These include:

Blurred vision
Loss of balance
Increased sensitivity to pain
Smell and taste disorientation

Diagnosing an nTBI can be challenging as these symptoms might overlap with other neurological or psychological conditions. In many cases, the possibility of a non-traumatic brain injury may be considered late due to the absence of visible external injuries.

Nevertheless, seeking medical attention is still imperative if individuals experience any or a combination of the symptoms listed above to increase the likelihood of early intervention.

Common Causes of Non-Traumatic Brain Injury

nTBIs can result from a wide range of internal factors that impair the brain’s functioning. One of the most common causes of an nTBI is a stroke, which occurs when blood flow to the brain is disrupted, resulting in tissue damage and neurological impairments. Brain tumors can also lead to functional disturbances as a result of exerted pressure on the surrounding tissue, which can impair brain function.

Other causes of an nTBI include:

Aneurysm
Tumors
Seizure
Electric shocks
Neurotoxic poisoning (i.e., lead exposure, carbon monoxide poisoning)
Infectious diseases (i.e., meningitis, encephalitis)
Metabolic disorders (i.e., kidney failure, liver failure)
Drug abuse

Risk Factors Contributing to A Non-Traumatic Brain Injury

The risk factors for nTBI can vary based on individual circumstances and underlying health conditions. Identifying these risk factors associated with nTBI is vital for early recognition and appropriate management. Some of these risk factors include:

Advanced Age: The risk of nTBI increases with age as the individual becomes more vulnerable to various medical conditions.
Family History and Genetic Predisposition: Some individuals are more genetically predisposed to certain diseases and conditions, increasing the likelihood of nTBI. These include hereditary conditions such as neurodegenerative diseases and mitochondrial disorders.
Cardiovascular Disease: Cardiovascular conditions like hypertension (high blood pressure), atherosclerosis (narrowing of blood vessels), and heart disease can also impact blood flow to the brain, which increases the risk of nTBI. These conditions can also increase the risk of stroke, resulting in nTBI.
Lifestyle Factors: Unhealthy lifestyle choices, such as poor nutrition, a sedentary lifestyle, smoking, illicit drug use, and excessive alcohol consumption, can elevate the risk of nTBI.
Medical Conditions: Metabolic disorders, autoimmune diseases, and chronic infections may predispose individuals to experience an nTBI.

Treatment Methods and Management Strategies for Non-Traumatic Brain Injuries

Treatment for nTBIs will depend on several factors and must be tailored to the specific individual to produce the best outcome. These treatment methods can include addressing specific brain issues, treating the underlying cause, and providing supportive care, rehabilitation, and education:

Medications

Based on a patient’s condition and medical history, a physician may prescribe certain medications to treat the underlying condition causing nTBI or the symptoms that appear.

Some common types of medications used in nTBI management include:

Pain Relievers: For patients experiencing headaches and other forms of pain, the physician may prescribe over-the-counter (OTC) pain relievers like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). In more severe cases, prescription pain medications may be used under close medical supervision.
Anti-Inflammatory Drugs: Corticosteroids or other anti-inflammatory medications may be prescribed to reduce brain inflammation.
Anticonvulsants: When the condition triggers seizures or epilepsy, anticonvulsant drugs may be prescribed to control or prevent seizure activity.
Neuroprotective Agents: These medications help preserve brain function and prevent further damage to the brain.
Antidepressants or Anxiolytics: Patients who experience mood swings, depression, or anxiety can benefit from antidepressants or anxiolytics that help manage these symptoms.
Targeted Medications: Specific medications that target the underlying condition may be prescribed to treat the cause of the brain injury. These are done for infections, metabolic disorders, or vascular abnormalities that cause nTBIs.

Rehabilitation Therapies

Rehabilitation aims to improve a patient’s functional abilities, restore independence, and enhance their overall quality of life. The type of treatment they receive is tailored to the individual’s specific needs and can encompass different disciplines. Some of the most common types of rehabilitation therapies used include:

Physical Therapy: Aims to help patients resolve fatigue, regain their strength, and restore lost physical functions such as standing and walking.
Occupational Therapy: Helps patients regain independence when performing everyday functions, such as getting dressed and feeding themselves.
Speech Therapy: Helps patients improve their ability to understand and present information and restore their language and communication skills
Cognitive Rehabilitation Therapy: Teaches self-management skills to help the patient recover their memory, thinking, and problem-solving skills
Psychosocial Therapy: Focuses on addressing the emotional and psychological impact of nTBI through counseling, psychotherapy, or support groups.

Supportive Care

Supportive care refers to the comprehensive and compassionate approaches taken to meet the diverse needs of nTBI patients, especially those with chronic or progressive conditions. It does not directly target the underlying cause of the injury. However, it is still a critical aspect of its treatment and management.

Supportive care is given to enhance the patient’s overall well-being, comfort, and quality of life. These can be in the form of providing daily living assistance, emotional support, symptom management, palliative care, or end-of-life care.

Treatment of Underlying Conditions

In cases where an infection was the cause of the injury, metabolic disorder, or any other medical condition, targeted treatments can be provided to treat the underlying issue first. Addressing the main contributing factor is essential to slow down or halt the progression of the injury.

Lifestyle Modifications

Adopting a healthy lifestyle can be beneficial in managing symptoms of an nTBI. Practices like maintaining a balanced diet and engaging in regular exercise are beneficial for managing chronic conditions like hypertension and diabetes, which contribute to an nTBI.

Get Specialized Care at Moody Neurorehabilitation

Moody Neurorehabilitation recognizes the importance of providing exceptional medical care and unwavering emotional support and guidance to nTBI patients during this challenging journey. We are committed to providing personalized care that aligns with patients’ challenges and goals.

Since 1982, Moody Neurorehabilitation has been at the forefront of brain injury treatment and patient care. Working with a multidisciplinary team of experts, we develop a comprehensive treatment plan that addresses each patient’s unique needs and improves their quality of life.

If you or a loved one has suffered a non-traumatic brain injury, contact us today to arrange a consultation with our experts.

References:

Strokes are medical conditions that affect millions globally. In the United States, more than 795,000 people have a stroke each year, with about 610,000 cases being first or new strokes.

These can lead to a wide range of physical and cognitive impairments. Speech and language disorders are among the most common and most challenging consequences of strokes, occurring in about a third of stroke survivors.

Understanding Stroke-Induced Speech & Language Disorders

Stroke-induced speech and language disorders significantly impact communication abilities. Among these, aphasia, dysarthria, and apraxia of speech are prevalent. Understanding how they are diagnosed and their specific symptoms can aid in prompt and effective management.

Aphasia

Aphasia is a common outcome of stroke, manifesting as difficulty in speaking, understanding, reading, and writing. There are many different types of aphasia, depending on the affected brain area, and are categorized based on the symptoms present:

Expressive Aphasia (Broca’s Aphasia): Characterized by broken speech, limited vocabulary, and difficulty forming complete sentences. Patients often understand what is being said to them but struggle to verbalize responses.
Receptive Aphasia (Wernicke’s Aphasia): Patients can produce fluent speech but may lack meaning or include nonsensical words. They often have significant difficulty understanding spoken language.
Global Aphasia: A severe form of aphasia where individuals have extensive difficulties with both speech production and comprehension.
Anomic Aphasia: Individuals have difficulty finding words, particularly nouns and verbs, making their speech sound vague.

Dysarthria

Dysarthria is a speech disorder that affects 20-30% of stroke survivors. It occurs when stroke impacts the muscles responsible for speech, leading to slurred or slow speech that can be hard to understand. It is typically diagnosed through a physical examination and a series of speech evaluations conducted by a speech-language pathologist (SLP).

It is characterized by the following symptoms:

Slurred or slow speech that can be difficult to understand
Monotone or robotic-sounding speech
Difficulty controlling the volume of speech, which may be too loud or too soft
Challenges with the rhythm and flow of speech, including rapid speech that’s hard to interrupt or slow, drawn-out speech
Respiratory issues affecting the ability to speak loudly or for extended periods

Apraxia of Speech (AOS)

Apraxia of speech is a neurological disorder characterized by difficulty sequencing the movements needed for speech. This is caused by the impact of the stroke on the brain’s pathways involved in producing speech.

Patients with AOS know what they want to say but struggle to coordinate the muscle movements to articulate words correctly. This results in distorted speech, difficulty initiating speech, or the inability to accurately produce speech sounds or sequences of sounds.

How Long Is the Stroke Speech & Language Recovery Time?

According to one study on post-stroke speech and language therapy, approximately one-third of stroke patients experience speech problems after a stroke. Many of these individuals begin to recover within a few months, with significant progress typically observed within three to six months.

In another study, 62% of subjects had speech challenges after suffering from a stroke. By six months post-stroke, 74% were able to completely recover their communication abilities.

However, the figures above provide a general timeline for post-stroke speech and language recovery. Stroke speech recovery time is highly individualized and can vary depending on several factors. These can include the following:

Severity of the Stroke: More severe strokes often lead to extensive brain damage, resulting in longer and more challenging recovery periods for speech.
Location of the Brain Injury: The brain’s specific regions control different speech and language functions; damage to these areas directly impacts recovery complexity and duration.
Age and Overall Health of the Patient: Generally, younger patients with better overall health before the stroke tend to experience faster and more complete recoveries.
Pre-existing Conditions and Comorbidities: Conditions such as diabetes or hypertension can slow down recovery by complicating the overall health scenario and rehabilitation process.
Individual Variability and Resilience: Personal resilience, the support system’s strength, and the individual’s motivation significantly influence the pace and success of speech recovery efforts.

The first three months after a stroke is a crucial period for recovery, as a majority of stroke patients see the most significant improvement during this period. However, it’s also important to note that, although at a slower pace, recovery can continue well past the 6-month mark with continued therapy and practice.

This underpins the importance of early intervention and ongoing rehabilitation efforts, including speech therapy, to maximize each patient’s recovery potential.

What Does the Stroke Speech & Language Recovery Process Look Like?

The journey to regain speech and language after a stroke is multifaceted and varies significantly from one individual to another. Understanding the structured phases of recovery can provide insight into what patients and their families can expect during this challenging time.

Here’s a closer examination of each phase in the stroke speech recovery process.

Initial Assessment and Diagnosis

Before recovery can begin, a thorough evaluation is conducted by a team of healthcare professionals led by an SLP. This assessment aims to identify the type and severity of the speech and language disorder, be it aphasia, dysarthria, or AOS. The evaluation may include cognitive-linguistic assessments, comprehension tests, speech production analysis, and functional communication measures.

Based on this assessment, a personalized therapy plan is crafted to address the patient’s specific needs.

Acute Phase

The acute phase typically occurs within the first days to weeks following a stroke. During this period, medical stabilization is the primary focus, with healthcare teams working to manage the immediate effects of the stroke.

Speech therapy may begin with simple exercises or assessments to gauge the patient’s abilities. However, intensive therapy usually does not start until the patient is medically stable. During the acute phase, the goal is to support overall recovery and prevent complications immediately after the stroke.

Subacute Phase

The subacute phase generally spans from two weeks to three months post-stroke and is characterized by more intensive speech therapy interventions. As the patient’s medical condition stabilizes, the focus shifts to active rehabilitation. Therapy during this phase is tailored to the individual’s specific speech and language deficits and may include:

Exercises to improve articulation, fluency, and voice control for those with dysarthria.
Language therapy to enhance understanding, speaking, reading, and writing skills in patients with aphasia.
Motor speech exercises and strategies to improve speech planning and production in apraxia of speech.

The subacute phase is crucial for taking advantage of the brain’s natural recovery processes and neuroplasticity, where the brain begins reorganizing and adapting to the loss of function.

Chronic Phase

The chronic phase of recovery extends from several months to years after the stroke. It focuses on long-term rehabilitation and adjustment to any residual speech deficits. During this time, patients may continue to see gradual improvements in their speech and language abilities, although the rate of recovery may slow. Therapy in the chronic phase often includes:

Advanced communication strategies to cope with ongoing challenges in daily life.
Maintenance exercises to preserve and enhance speech gains achieved in earlier phases.
Supportive technologies and aids, such as communication devices, to assist in effective communication.
Community reintegration activities to help patients return to as normal a life as possible, engaging in social, vocational, or recreational activities.

What Is the Role of Neuroplasticity in Speech & Language Recovery?

Neuroplasticity refers to the brain’s fundamental property to change and adapt its responses to new experiences, learning, and environmental changes. This adaptive capacity enables the brain to reorganize itself by forming new neural connections.

When the brain, or a part of the brain, is damaged after a stroke, neuroplasticity is what allows the other parts of the brain to take over the functions of the damaged area. Through targeted rehabilitation and therapy, such as speech therapy for stroke survivors, patients can retrain other brain areas to perform the lost functions and facilitate recovery.

Enhancing Stroke Speech & Language Recovery Time

Adopting a comprehensive approach involving several key strategies is vital to enhance the stroke speech and language recovery time. This multifaceted approach can maximize the chances of regaining speech and communication abilities.

This comprehensive approach must incorporate the following strategies:

Early intervention to leverage the brain’s highest potential for neuroplasticity in the initial period following a stroke, significantly improving the chances for recovery.
Alternative communication strategies, such as gestures, writing, and visual aids, to help maintain communication during the recovery process.
Adopting technology, including speech-generating devices and software applications designed for speech rehabilitation, for personalized exercises and continuous practice, which is vital for progress.
Providing continuous support from psychologists, support groups, and therapy to help manage feelings of frustration, depression, and anxiety, fostering a positive mindset essential for rehabilitation.
A healthy diet and lifestyle to supply essential nutrients that support brain function, along with regular physical activity, adequate sleep, and management of medical conditions.

Begin Your Post-Stroke Recovery Journey With Moody Neurorehabilitation

Moody Neurorehabilitation understands the complexities and challenges that come with post-stroke rehabilitation. We are dedicated to supporting patients and their families through this critical time with specialized care and personalized treatment plans.

Since our inception in 1982, Moody Neurorehabilitation has been a leader in brain injury rehabilitation. Our approach centers on providing comprehensive care tailored to each patient’s needs and goals. We believe in treating the whole person, not just the symptoms, to improve overall quality of life.

We invite you to start your recovery journey with us. Contact Moody Neurorehabilitation today to schedule a consultation with our experts. Let us help you navigate the path to recovery with care, compassion, and expertise.