Changes in Memory after Brain Injury: FAQs

Memory Problems after Brain Injury

By DeAnna Frye, Ph.D. and JoAnn M. Ovnic, M.A.,CCC/SLP

What are common memory problems following TBI?

Short term memory loss is a common impairment following TBI.  Generally long term memory, such as recall of historical information, childhood and other events prior to injury are preserved.  The degree and location of injury affects the severity of memory problems.  Some examples of short term memory loss include:

  • forgetting what happened during the day
  • forgetting placement of items
  • forgetting tasks completed throughout the day
  • losing train of thought during a conversation
  • having trouble with note taking
  • difficulty retaining information in class
  • difficulty recalling the main details of a recently read article or book chapter

What is the difference between short term memory, long term memory and post traumatic amnesia?

In general, most neuropsychologists define short term memory as an individual’s ability to remember information over the course of a few hours or across a day or week after a TBI.  For example, the ability to recall what you did this morning is an example of short term memory.

Long term memory is generally reserved for recall of events that occurred prior to the injury.  Remembering an incident from childhood is an example of a long term memory for an individual injured in their 30s.

Post traumatic amnesia is the period of time that the individual is unable to recall events following the injury.  For example, some individuals may not recall the events of the day their injury occurred or being in the hospital for the next month after the injury.  Post traumatic amnesia is then estimated to be about 30 days long.

Please tell me about post traumatic amnesia – how long does PTA last?

Post traumatic amnesia refers to a disruption in the memory system of the brain as a result of an injury.  PTA begins at the time of the injury and includes the coma period.  It does not end until the individual is able to continuously report events that have occurred. In other words, a person may be out of coma and talking with their family members but has no recall of the conversations.  This individual is still experiencing PTA.  As a general rule of thumb, PTA usually lasts 4 times the length of coma.  So an individual who is in a coma for two weeks typically experiences PTA of eight weeks.

As an individual recovers from the injury, he/she will begin to remember events of the day and days before.  However, the person will have no memory of the events immediately following the injury.  This is not due to psychological trauma, but the neurological injury itself.

The inability to remember hours, days or weeks of your life can be stressful and uncomfortable.  Reassuring the individual repeating what happened during this period may be helpful.  Most important, however, is acknowledging that their PTA has resolved and that they can remember events now.

My CT scan of the brain was normal, yet I am still having problems with my memory.  How is this possible?

CT scans are helpful diagnostic tests used by physicians to identify physical changes to the brain.  CT scans can identify tumors, bleeding, swelling or bruises involving the brain.  They are not sensitive enough to identify the microscopic tearing and shearing that commonly occurs after a traumatic brain injury.  Therefore it is not unusual for a CT scan to be normal following a brain injury.  This simply reflects the CT scan’s limitations with regard to identification of the physical changes in the brain

A survivor of TBI may initially demonstrate abnormalities on CT scan, such as swelling or bleeding.  A repeat CT scan several months later, however, may be considered normal. However, the survivor may still be experiencing functional changes such as memory problems

My doctor has recommended a functional MRI. How is this different from a CT scan or MRI?

A functional MRI or fMRI is an image of brain activation as a function of change in cerebral blood flow or blood oxygenation. Usually the analysis is based on blood oxygenation changes.  When a part of the brain is activated there is an increase in oxygen rich blood.  Changes in neural activity are evaluated by measuring changes in local blood oxygen levels in the brain during performance of a specific task.

During the completion of an MRI, the individual is required to complete some cognitive activities, such as memory tasks.  The scan then reveals the changes in blood oxygen levels in the brain during the completion of the task.  This allows your doctors to determine how your brain is processing specific types of information.  Individuals who have had normal CT or MRI scans have shown abnormalities on fMRI.

I have been discharged from therapies but want to continue to work on improving my memory and other cognitive skills.  What are some things I can do to continue to work on my cognitive abilities?

Just as physical exercise is good for the body, mental activity is good for the mind.  Continuing with any strategies or home exercise activities that your therapists have recommended is important.  In addition, continuing to challenge yourself with mental activities every day will help you maintain the abilities you gained in therapy and help you continue to improve.  Reading the newspaper, magazine or a book can help with concentration, reading and memory.  Watching the news keeps you up to date on what is happening in the world.  There are many games that you can purchase that are not only good family entertainment but also require reasoning skills.  Doing crossword puzzles or word searches can help if you have difficulty with language skills.  The most important thing is that you find activities that you enjoy doing, as you will be more likely to continue them.  Consistently applying the strategies you learned in therapy to your daily life will allow you to adapt more quickly and accomplish your goals. 

How can I help my family member remember appointments and day-to-day events?

Daily routines are helpful.  Encourage your family member to keep a calendar and write down appointments.  If he can not do this himself, set aside a time during the day to review and write down information.  Keep a notepad and pen near the phone to write any phone messages.  Create a “To Do” list for the day.  Have your family member check off each task or activity as it is completed.

Dr DeAnna Frye has a B.S. in Psychology, M.S. in Counseling Psychology, Ph.D. in Counseling Psychology. She is currently employed by Neurology Neuroscience Associates of Akron. Her special interests are psychotherapy and counseling to patients with neurological disorders with special expertise in brain injury. She is a founding member and the current co-chair of the Summit County Traumatic Brain Injury Collaborative located in Akron, Ohio.

For more information, see:

After Brain Injury: Telling Your Story, A Journaling Workbook

By Barbara Stahura and Susan B. Schuster, M.A., CCC-SLP

This workbook guides survivors of brain injury and blast injury through the powerful healing experience of telling their own stories with simple journaling techniques. By writing short journal entries, survivors explore the challenges, losses, changes, emotions, adjustments, stresses, and milestones as they rebuild their lives.

 

The Memory Workbook

By Douglas Mason, Psy.D. and Michael Kohn, Psy.D.

Workbook for families and adults explains types of memory and effects of aging, brain injury, and brain damage on memory.  Includes practical exercises and tips for adults, family members and caregivers for brain injury rehabilitation. Recommended for persons with mild brain injury or mild cognitive impairments due to trauma, aging, or disease.

 

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6 Responses to “Changes in Memory after Brain Injury: FAQs”

  1. Bepin says:

    I would like to know if there is an impact of brain injury after years like short teem memory and things that effect the everyday living. How could I overcome this please help./

  2. Demetra says:

    I’m extremely pleased to find this great site. I need to to thank you for ones time for this wonderful read!! I definitely liked every little bit of it and i also have you saved as a favorite to check out new things on your site.

  3. l says:

    Got written questionnaire and verbal memory test sitting at drs desk 1-2 months after accident, but now 3.5 months later, I’m starting to get concerned, my shrt term memory is very bad, to the point now I’m dependant on people telling me what we are doing and where we are going, and even if I verbally made a decision, to remind me of that decision….I have about 10 examples just from the last week.

  4. jason hansen says:

    i have a tbi and it did not pop up until 15-20 yrs after the gulf war and now im like a brain dead no memory and its effecting my daily living…. why now? why does it feel like its closing and i cant remember nothing no child hood no school years and now i cant remember what i did today? OK panic attack….

    why?
    please let me know……

  5. Marilyn Lash says:

    Dear Brenda,
    I suggest using some of the exercises found in the Functional Rehabilitation Activity manuals to demonstrate the behavioral, cognitive and communication challenges – you will find them at http://www.lapublishing.com/brain-injury-rehabilitation-manuals/

    Barbara Stahura’s Journaling Workbook at http://www.lapublishing.com/tbi-survivor-journal/
    would also have some great exercises. She also has many on her blog at http://journalafterbraininjury.wordpress.com

  6. Belinda Sauer says:

    Hello,
    I will be teaching adults within a State Instituion who have severe brain injury Adult through Seniors. The class is about Cultural Diversity. What suggestions do you have I how I could most sucessfully present to them and have great interaction, sharing et. Ideas wanted. B.

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