Traumatic Brain Injury: A Case Study

Music therapy is used in a wide variety of populations such as PTSD, children with autism and other developmental problems, addiction, geriatrics, emotionally disturbed teens, and in the medical setting (medical music therapy). One population that doesn’t receive as much attention as others is traumatic brain injury (TBI). Traumatic brain injury is defined by the DSM-V as “an impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull (DSM-V 2013).” If an injury is severe enough, a mild or major neurocognitive disorder due to the TBI can develop. The diagnostic criteria for a mild or major neurocognitive disorder due to traumatic brain injury is:
A. The criteria are met for mild or major neurocognitive disorder.
B. There is evidence of a traumatic brain injury—that is, an impact to
the head or other mechanisms of rapid movement or displacement of the brain within the skull, with one or more of the following:
1.
Loss of consciousness.
2. Posttraumatic amnesia.
3. Disorientation and confusion.
4. Neurological signs (e.g., neuroimaging demonstrating injury; a new onset of seizures; a marked worsening of preexisting seizure disorder; visual field cuts; anosmia, hemiparesis).
C. The neurocognitive disorder presents immediately after the occurrence of the traumatic brain injury or immediately after recovery of consciousness and persists past the acute post-injury period (DSM-V 2013).
Approximately 500,000 to 700,000 people sustain a traumatic brain injury each year (Gervin 1991, pg. 87). Of that number, the National Head Injury Foundation estimates that between 50,000 and 70,000 sustain injuries severe enough to keep them from returning to their premorbid levels of function (Gervin 1991, pg. 87). According to the Center for Disease Control and Injury Prevention, the leading causes of TBI are: falls, being struck by
something or against something, motor vehicle/traffic crashes, and assaults (Brain Injury Association of America 2015). TBI can affect the right side of the brain, the left side of the brain, or both sides of the brain. The left side of the brain is responsible for the following functions: analytical, logical, precise, repetitive, organized, details, scientific, detached, literal, and sequential. The right side of the brain is responsible for the creative, imaginative, general, intuitive, conceptual, “big picture”, heuristic, empathetic, figurative, and irregular functions (BIAA 2015). Injuries to the left side of the brain can cause difficulties in understanding language, difficulties in speaking or verbal output, catastrophic reactions, verbal memory deficits, impaired logic, sequencing difficulties, and decreased control over right-sided body movements (BIAA 2015). Injuries to the right side of the brain can cause visual/special impairments, visual memory deficits, inattention to the left side of the body, decreased awareness of deficits, altered creativity and music perception, loss of the “big picture” type of thinking, and decreased control of left-sided body movements (BIAA 2015). Traumatic brain injury can also affect both sides of the brain at once, which is called diffused brain injury. Diffused brain injury can cause reduced thinking speed, confusion, reduced attention, fatigue, and impaired cognitive skills (BIAA 2015).