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TBI: Social Behavior and Problems with Communication by Charles Watson


Posted on January 12, 2021

With a drastic change in lifestyle after TBI, patients become socially awkward and are unable to communicate their feelings well. As the severity of brain injury increases, the awareness of your social image and skills become worse. 

What happens in the brain?

First and most importantly, you should know why this happens. The part that is responsible for our speech and communication is the cerebrum. Since it’s the largest part of the brain, the cerebrum further divides into two parts, the hemispheres. A bundle of nerves known as corpus callosum connects the two halves. The left side of the cerebrum is primarily responsible for our speech.

The cerebrum is the center of processing, learning, and forming speech. The whole process of speaking, forming sentences, and understanding our thoughts before speaking out loud, is done with the help of other parts of the brain.

From cerebrum to Broca’s area, Wernicke’s area, cerebellum, and motor cortex, all parts perform a different role. The cerebrum, which is most of the brain, comprises of the frontal, parietal, temporal, and occipital lobes. The frontal and temporal lobes are mainly in charge of understanding and speech formation.

Broca’s and Wernicke’s areas work with converting the thought into articulated words, passing the signal to the motor cortex to match the words with the lip movement. The latter comes in when comprehending and processing verbal and written language. The two are connected with a group of nerves called arcuate fasciculus so that they can work in synchronization and avoid confusion.

The cerebellum and motor cortex are essential to execute speech while coordinating all necessary muscles involved physically. The movement of lips, tongue, and facial muscles with your limbs while maintaining balance.

Effect of brain injury on social behavior

Hence, damage to the above parts in an accident resulting in TBI can cause complications. To name a few, slurred speech, nonsensical blabbering (movement of mouth doesn’t match with thoughts), cannot repeat words, and have difficulty understanding and speaking. A few cases also report inappropriate behavior in public, nudity, using abusive language, and aggressive flare-ups. When asked by caretakers and guardians about their behavior, many came up with aphasia (loss of speech, understanding, expression, reading, etc.). A few severe cases of TBI have a complete loss of speech and language as well as other senses.

Test and scans immediately after injury widely illustrated bruised and torn brain tissues. Also known as contusions, they cause damage at a microscopic level, which includes veins and arteries that burst open, leading to excessive blood loss. This usually occurs at the frontal lobe but can be found anywhere in the brain.

Extreme bleeding can lead to an intracerebral hemorrhage (ICH), which can be removed with surgery, depending on the size and affected area.

Coping up

The best way to cope up with speech disorders and communication problems is speech therapy, tightening face muscles, and rehab for both physical and mental health. After getting discharged from the hospital, practice a few exercises and communication techniques with a close one. Don’t lose hope because there is always a chance of recovery and getting back to normal!