No two brain injuries are the same and every patient manifests a unique set of symptoms. In general, TBI increases many of the normal symptoms of aging.
Due to their proximity to bony structures and protuberances, the frontal and temporal lobes are most frequently injured in TBI, resulting in: (1) disruptions of planning, organization and concrete thinking, (2) distractibility, (3) decreased self-awareness, (4) poor judgment, (5) reduced initiation and (6) memory disturbances.
Repeat head injuries are exponentially cumulative eg 3rd injury has 23 or 8 times more severe results. It is highly possible that Randy’s brain was affected by his two severe motorcycle accidents earlier in his life.
Personality disorders often become worse (20% to 50%) between 1 and 10 years post recovery. Typically the patients are childish, stubborn, manipulative, uncooperative, depressed, poorly motivated and/or out of control. Loss of self control (sexual disinhibition, impulsivity, verbal and physical outbursts, poor judgment, aggression and restlessness) is believed to be cause of the fact that many if not most TBI patients become dependent on alcohol and other addictive substances upon returning home.
Non-convulsive seizures resulting from TBI can be minor and unnoticed, yet result in behavior changes often misdiagnosed with mental illness. Anti-seizure medications commonly cause osteoporosis in men, resulting in frail bones and greater propensity for injury and degeneration earlier in life. Medications can help maintain bone mass.
TBI patients are 8 times more likely to contract Alzheimer’s at a relatively early stage in life, especially if there is any family predisposition to the disease. One of the most common results of the personality changes is loss of relationships as friends and family turn away. A few close family members typically try to compensate for the loss by focusing more attention on the patient with one family member taking on the bulk of the responsibility. Typically, within the first year, boy/girlfriends and most fiancées turn away and spouses turn away in about 50% of the cases. They are replaced by a family member, such as a parent, as primary caregiver. Loss of self control and use or non-use of drugs or alcohol are the most critical factors in determining whether there is a change or loss of caregivers.
Loss of primary caregiver is often related to a higher level of functional abilities in TBI patients. Causal direction is not known, but believed that higher functionality may make personality disorders harder to deal with.
Primary caregivers lives are adversely affected and prematurely aged. Depression, exhaustion, and reduced social interaction are commonly experienced.