Offering Help | Hope | Education
CALL US : 1-866-327-1998



Acquired Brain Injury (ABI) includes traumatic brain injuries (TBI’S), strokes, brain illness, and any other kind of brain injury acquired after birth. However, ABI does not include what are classified as degenerative brain conditions such as Alzheimer’s disease or Parkinson’s disease.

What are the most common causes of ABI?

  • Traumatic brain injury, like a blow to the head or hitting one’s head
  • Brain tumours;
  • Brain infections like meningitis and encephalitis;
  • Drug and alcohol abuse ( long-term);
  • Aneurysm ( if there’s rupture and bleeding);
  • Arteriovenous malformations (AVM) , a collection of abnormal blood vessels;
  • Lack of oxygen, like what happens when someone almost drowns;
  • Stroke ( blockage of blood vessels);
  • Violent shaking or some whiplash injuries.

Who is at highest risk for ABI?

  • Males are about 1.5 times as likely as females to sustain a TBI.

What is Concussion?

concussion is a mild brain injury resulting from a blow to the head that causes changes in brain function. It is important to note that not all concussions lead to unconsciousness. Depending on the severity of the blow and which area of the brain is injured, changes may be temporary. A number of symptoms can be identified, including:

  • Memory loss
  • Behaviour changes
  • Lack of concentration
  • Loss of balance/dizziness
  • Blurred vision
  • Headaches
  • Ringing in ears
  • Nausea/vomiting
  • Slurred speech
  • Sleepiness

It is important to follow a physician’s orders of care when returning home, as you or your loved one may be at risk for second impact syndrome following a concussion. Second impact syndrome refers to the fact that there is a high risk for re-injury even with minimal impact to the head. It is for this reason that returning to physical activity involving direct contact such as sports needs to be reintroduced into an individual’s life style slowly after a physician has completed a full assessment.

Here is a video from by Sanjay Gupta on Concussions

What is Concussion?- Sanjay Gupta (CNN)

How is ABI classified into mild, moderate or severe?

ABI classification is based on the length of time a person is unconscious, the presence of memory loss or post-traumatic amnesia (PTA), and the Glasgow Coma score:

TBI Classification Loss of consciousness Memory loss or PTA Glasgow Coma Score
Mild/concussion None — less than 30 min. Lasting less than 24 hrs. 13 – 15
Moderate More than 30 min., but less than 24 hrs. Lasting 24 hrs up to 7 days 9 – 12
Severe More than 24 hrs. Lasting 7 days of more 8 or less


What is the Glasgow Coma Scale?

Glasgow Coma Scale

The Glasgow Coma Scale is used in the emergency room and intensive care. It measures level of awareness, how bad the brain injury is and coma level. There are three things are looked at:

–           eye opening

–           amount of movement

–           speech ( making sounds)

Scores can range from low of 3 to a high of 15. As the person comes out of coma, the score goes up. A score of 9 or more means the person is no longer in coma. Below is a table of the scale:

What are the signs and symptoms of moderate and severe ABI?

Mild Brain Injury:

A mild brain injury can be described as a concussion in certain situations; depending on the circumstances it is possible an individual may lose consciousness.

Mild brain injuries can also be assessed using the Glasgow Coma Scale, using this tool the injury is classified at a score of 13-15. In the event of a mild brain injury the individual affected is usually released from hospital to the care of a responsible adult. The physician will have provided instructions on how to provide care and when it is necessary report back to the hospital if behaviour has changed or symptoms persist.

Moderate Brain Injury:

A moderate brain injury is also described as a concussion of a more severe level than a mild brain injury; it is classified as a score of 9-12 on the Glasgow Coma Scale and can be acquired in the same or similar circumstances. It is possible that this type of injury can lead to significant cognitive impairment; this is described as post concussion syndrome. Post concussion syndrome can last from 2 weeks up to 2 months following the injury, and show various symptoms that have an effect on an individual’s activities of daily living.

  • A persistent headache
  • Behavioural changes
  • Decreased short term memory
  • Lethargy (drowsiness)
  • Personality Changes
  • Shorter attention span
  • Changes in intellectual ability

It is a common assumption that concussions resolve themselves over time, however for those suffering from a moderate brain injury may be on a longer road to recovery over the course of many years. This is why it is important for the individual who suffered the injury and their main care provider to follow instructions and information offered by the physician. It is also much more likely for those who have already suffered a mild or moderate brain injury to suffer future concussions as well, returning to contact sports or activities should be avoided until all symptoms have been resolve and then gradually reintroduced.

Severe Brain Injury:

Severe brain injuries are classified at a score of 3-8 on the Glasgow Coma Scale and are characterized by a contusion (bruise) near the site of injury and lacerations (actual tearing of brain tissue). Some words you might hear from health care providers in care related to the site of a contusion are:

  • Hemorrhage (bleeding that lasts longer than a few minutes, can be life threatening)
  • Edema (gathering of excess fluid in internal spaces of the body)

When referring to lacerations and severe brain injuries tissue damage can be severe enough that surgical repair is impossible. The following are some terms you may hear from health care providers in this circumstance.

  • Hemorrhage
  • Hematoma (swelling of excess blood within tissue or internal space of the body)
  • Cerebral Edema (swelling of the brain)

CT scans are ordered in these circumstances to evaluate the severity of the individual’s injury based on the amount bleeding surrounding the contusion site. These allow the physicians to view and evaluate any internal damage that cannot be seen or predicted otherwise.

If my brain in injured, how will I ever recover? 

This is a question faced by many who sustain brain injuries.  Our mission is not only to provide you with information, but also to provide you with hope.  And there is hope for recovery.

The brain is very complex and so does brain injury. There are many things that can affect how recovery happens. These factors are different for each person and each injury is affected by the following:

  • patient’s age and health before injury
  • the presence of alcohol or other drugs at the time of injury
  • type and speed of emergency care received
  • type of hospital care received
  • support of family and friends
  • patient’s personality and ability to cope with stress and crisis
  • rehabilitation and good follow-up

Phases of Recovery

One of the earliest studies of brain injury recovery examined the stages a patient experiences as the brain heals. This study discussed eight stages or levels of recovery. This scale is called The Rancho Los Amigos Scale, named after the rehabilitation hospital that conducted the study.

 The following are the different levels widely used in North America. They describe a person’s thinking and behaviour.

LEVEL 1         No response (to any stimuli)

LEVEL 2         Generalized response (non-purposeful, inconsistent)

LEVEL 3         Localized response (purposeful, consistent)

LEVEL 4         Confused, agitated, inappropriate (short-term memory impaired, dependent on all aspects of care)

LEVEL 5         Confused, non-agitated, inappropriate (with direction and assistance can perform previously learned tasks

LEVEL 6         Confused, appropriate (memory problems, completes previously learned tasks with supervision)

LEVEL 7         Automatic, appropriate (can initiate and carry out tasks, more aware but lacks ability to problem solve)

LEVEL 8         Purposeful, appropriate (more responsible for self; able to learn new tasks; more aware of deficits; stress)

Levels 1-3 are the Acute Phase—the time after injury until the patient’s medical condition is on a stable course. Rehabilitation begins in this phase.

Even when the patient scores 3 on the Glasgow coma scale ( severe brain injury) and is completely unresponsive, it is possible that some degree of awareness may still exist. It is important that family, friends and medical staff assume this to be the case.

ü  Never speak in front of the patient as though he or she were not present.

ü  If the conversation is not one that you would ordinarily want the individual to hear, it is best to move this to a location beyond their hearing distance.

ü  Every effort should be made to speak in a way that includes the individual or at least acknowledges that you respect his/her presence.




In 1987, a small group of individuals recognized the value of education and mutual support for those affected by a brain injury and established the Manitoba Brain Injury Association.


TEL: (204) 975-3280
FAX: (204) 975-3027
TOLL FREE 1-866-327-1998

TEL: (204) 638-4702
TOLL FREE 1-866-327-1998

TOLL FREE 1-866-327-1998