Acquired Brain Injury Overview

Acquired brain injury can result from a stroke, or trauma to the head, which is termed ‘traumatic brain injury’. Some people can fully recover from their acquired brain injury, some recover partially, and some may never come out of a coma. Around 350,000 people a year are hospitalised with an acquired brain injury.

What are the signs and symptoms of an acquired brain injury?

Symptoms of an acquired brain injury from trauma include:

  • Concussion (a sudden and brief loss of mental function, presenting primarily as confusion)
  • Fits or seizures
  • Hearing loss
  • Double vision
  • Repeated vomiting
  • Memory loss (amnesia)
  • Difficulty with coordination
  • Loss of consciousness, either brief or for a longer period, which may be classed as a coma

Someone with a brain injury may be in a coma for days, weeks or months. They may then appear to awaken, but remain unresponsive, which is classed as a vegetative state. Again, this can last for weeks and some people with a very severe brain injury may never regain full consciousness. 

If someone does regain full consciousness, they may experience post-traumatic confusion or amnesia. They may struggle to talk, walk and form new memories, as well as becoming agitated.

Someone who has acquired a brain injury as a result of a stroke may have subsequent weakness or numbness in their limbs or face. 

Speech, concentration, spatial awareness and performing everyday tasks may also be affected in people with brain injuries.

How does an acquired brain injury get diagnosed and treated?

The Glasgow Coma Scale is used by an emergency medical professional to determine the extent of someone’s brain injury following head trauma. Scoring 8 or lower on the scale means that the person is unconscious and has likely sustained severe head injury, with injury to the brain.

A score of 3 indicates that someone is in a coma and they are not likely to recover.

CT scans of the brain can determine whether someone’s brain has been injured by a stroke or trauma.

Surgery may be required if the person has bleeding on the brain (a haemorrhage), a blood clot or bruises, all of which could lead to severe brain injury.

Provided someone has come round from a state of unconsciousness or come out of their coma, they will then be treated in accordance with the severity of their brain injury.

Physiotherapy can help with coordination problems and stiffness, particularly if the person has been bed-bound for a long period.

Occupational therapy can enable the person to regain day-to-day skills, such as getting dressed.

Speech and language therapy, or psychological therapy may also be required if the person’s brain injury has impacted their speech or their mental wellbeing.

There are a few ways to determine whether an employee with an acquired brain injury might require reasonable adjustments:

The employee may or may not wish to disclose their acquired brain injury, depending on its severity. Regardless, questions regarding the nature of any additional needs and what extra support may be required can be broached sensitively. For example:

  • Have they required adjustments in the past? For example, allowances for extra time to complete tasks if someone’s range of motion has been affected.

What reasonable adjustments are possible for employees with an acquired brain injury?

Employers have a legal duty to make reasonable adjustments for employees with an acquired brain injury if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has an acquired brain injury. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of an acquired brain injury:

  • Extra time to complete tasks to accommodate difficulties the person may have moving, concentrating, or remembering things.
  • Adjustment to duties so that the person with acquired brain injury can keep themselves and others as safe as possible. For example, people with acquired brain injuries are required to inform the DVLA in case their ability to drive safely has been impacted. An employee may, as a result, be unable to commute, or operate machinery at work. This would also apply if there were any scenarios or duties which may trigger a flashback to the traumatic event which caused the brain injury, such as loud noises reminiscent of gunfire, as PTSD may be a side effect.
  • Time off to attend appointments, so that the person can work on recovery and rehabilitation while staying in work.
  • Flexibility regarding working from home if the employee has difficult commuting or moving around their normal place of work.
  • Raising awareness so that colleagues understand the employee’s acquired brain injury and why their colleague may no longer be able to speak or do the things that they used to.

Acquired brain injury Signposting

Headway – charity supporting people after a brain injury through the provision of services such as information and factsheets on the website, an emergency fund to help people in financial difficulty as a result of their brain injury and specially trained nursing services (0808 800 2244).

The Brain Injury Rehabilitation Trust – charity offering specialist rehab services for people who have suffered a brain injury, including following a stroke, so that life after a brain injury can be lived as independently as possible (01924 266 344).

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