TBI can affect the body's central nervous system, that controls voluntary movement and sensation, and the body's autonomic nervous system, which controls the involuntary functions of internal organs and glands. The autonomic nervous system operates day and night, without any awareness or conscious control on your part. Depending on the TBI, there may be a variety of disorders in breathing, metabolism, nutrition, bladder and bowel function, the skin, and sexual function.

     There are two divisions of the autonomic nervous system -- the sympathetic and the parasympathetic -- which regulate involuntary functions. While the two divisions have opposing effects, they normally balance each other. One system predominates in certain situations, and the other predominates in other situations depending on the body's needs. Following TBI, the brain may no longer be able to regulate the functions of the autonomic nervous system and maintain the balance of the opposing sympathetic and parasympathetic divisions. This can result in changes in the functioning of the digestive tract, the sex organs, and/or the bladder.

Skin Management

     You must always watch your skin for the development of skin sores following a brain injury. In the section on Skin Management, we will teach you to check you own skin and prevent prolonged pressure, thus preventing skin sores from arising.

Urinary Tract Problems

     After a brain injury, you may no longer have control over your bladder. You may not know when your bladder is full, and the muscles in the bladder may no longer function normally. The Urinary Tract Management section will teach you how to control your bladder again and prevent urinary tract complications.

Bowels

     The bowel may be affected by a brain injury. You may have lost the sensation of having a bowel movement, and you probably cannot tighten your muscles to stop one from happening. You may get constipated because you aren't active. We will help you control your bowel in the Bowel Program section.

Lungs (Breathing)

     Your lungs are not injured by a brain injury, but the muscles which control your lungs and help you breathe deeply and cough may not work well. Inactivity also affects the health of your lungs. Therefore, some patients need to learn ways to breathe deeply and cough to clear out normal secretions. We will teach you how best to care for your lungs in the Respiratory Management section.

Swallowing (Dysphagia)

     Your mouth and throat are not injured by a brain injury, but the muscles which control chewing and swallowing may not work well. Therefore, you may need to learn ways to receive proper nutrition and relearn swallowing skills. Helpful information is available in the Swallowing (Dysphagia) section.

Sexual Function

     Sexual function may be affected in varying degrees by a traumatic brain injury. We will discuss this further in the section on Sexuality.

Heterotopic Ossification and Spasticity

     Other complications of TBI include:

• Heterotopic ossification (HO), which is the development of bone (hard tissue) where there is soft tissue, such as in areas of the hip and knee joints.
• Spasticity, which is the involuntary jerking of muscles, or exaggerated reflex activity.

     Further information on each of these conditions can be found in the section on Other Medical Complications.