Brain Waves: UAB Traumatic Brain Injury Model System Newsletter Volume 15 | Number 2 | Page 3

along with a TBI. When someone
sustains a TBI, the injured brain is
more prone to the negative effects
of a lack of oxygen. If there’s blood
loss or injuries to the lungs at the time
of the TBI, that blood loss or lung
damage can lead to hypoxia or anoxia
and cause even more brain damage.
What happens to the brain without
oxygen?
When hypoxia or anoxia happens,
it only takes a few minutes to start
a chain reaction that disrupts the
brain’s web of communication. Nerve
cells can no longer maintain normal
cell membranes. The molecules
and neurotransmitters become
imbalanced, which damages or kills
nerve cells.
Nerve cell damage and cell death
can happen throughout the brain
when there’s hypoxia or anoxia.
However, some areas of the brain
are more susceptible to the chemical
effects caused by low oxygen. This
puts the nerve cells in those areas of
the brain at a higher risk for damage
and death. The areas of the brain at
the most risk are the:
• Hippocampus – involved in
short- and long-term memory.
• Basal ganglia – involved in
voluntary motor movements,
learning, behavior, and emotion.
• Cerebellum – involved in motor
control and cognitive functions
like attention and language.
How does hypoxia and anoxia brain
injury impair physical and cognitive
abilities?
Some people die or never regain
consciousness when there’s too much
damage to the brain’s nerve cells.
Those who do regain consciousness
will have damage to those areas
of the brain where the hypoxia or
anoxia occurs. That damage impairs
whatever actions that region of the
brain is involved in doing.
For example, damage to the
hippocampus causes memory
problems. The most common
problem is anterograde amnesia. This
means the person cannot record new
information into memory, so there is
little or no ability to recall events that
happen after the damage occurs.
In some instances, multiple areas
of the brain have to work together to
accomplish tasks. A good example
is the basal ganglia and cerebellum
working together to coordinate
movements. Damage to one or both
areas will lead to uncoordinated
movement. For example, there might
be poor balance. There might be
difficulty using legs and hands, or
movement might be jerky or shaky.
Can the Brain Recover?
Everyone hopes for full recovery,
but it’s rare. This is because the brain
doesn’t have the ability to effectively
repair damaged nerve cells or replace
them with healthy cells.
However, there’s hope for
improvement of physical and
cognitive abilities. This is because
the brain does try to generate new
connections between those nerve
cells that were not damaged.
Chances for improvement depend
on how long oxygen to the brain was
limited and how much nerve cells
are damaged. People with mild brain
damage can usually recover most
of their lost physical and cognitive
abilities. People who have severe
damage might recover only a portion
of their lost physical and cognitive
abilities. It simply takes time see what
improvements are made.
Long-Term Outcome
Although full recovery is rare, there
may be improvements in physical
and cognitive abilities. If those
improvements happen fast within
the first month of injury, it’s usually
a good sign for a better long-term
outcome. Other times, improvements
can take months, or even years.
Simply put, the sooner rehabilitation
starts, the better the outcome.
Rehabilitation and repeated practice
of learning new behaviors promotes
new brain connections. This can help
people return to independent living,
school, or work when possible.
Editor’s Note: References for this
article are available upon request.
Questions and Answers: Smart Home Devices as Assistive Technology
Is a smart home device assistive technology?
A smart home uses internet-connected devices to
remotely monitor and manage things in the home, like
electronics, appliances, lighting and heating. Assistive
technology is a term for a technology or device that helps
people with disabilities perform a tasks easier and more
independently. So smart home device are also assistive
devices when they’re used to enhance independence.
How can smart home technology enhance
independence?
For people with limited mobility, smart home devices
can be used to verbally control devices like a TV,
thermostat, and basically anything controlled by a switch
or plug, like appliances, lights and fans. You can even
make hands-free phone calls and voice activate robotic
vacuums and door locks. For someone with cognitive
limitations, smart home devices can be used to create to-
do lists, keep calendar events, and set reminders.
Is smart home technology affordable?
It once cost thousands of dollars for “environmental
controls” to be set up in your home. It’s now a fraction of
that cost, and it’s not hard to set up on your own.
A voice-assistant to control all your smart devices
as well as manage your to-do lists, calendar events,
and reminders is about $50. A hub to control TV and
entertainment devices is about $100. Smart thermostats
are $100 to $250. Smart switches or plugs are $20 to $50.
New devices are being added every day. Prices
continue to fall. But if you want to enhance your
independence, get smart home connected.
UAB Traumatic Brain Injury Model System Information Network
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