The term acquired brain injury (ABI) injury encompasses all types of brain injuries that occur after birth and are not hereditary, congenital, degenerative or induced by birth trauma. ABIs can result from certain medical conditions, including strokes, from infections and from tumours.
Traumatic brain injury (TBI) is a subset of ABI, and is injury specifically caused by an external force impacting the head. This can occur due to accidents, falls, violence or any situation where the brain is jolted or penetrated. TBI can also result from non-fatal strangulation and choking where oxygen is cut off and the brain is deprived of oxygen.
This article focusses on traumatic brain injury from partner violence.
My TBI is domestic violence related. During an MRI unrelated to past assaults, two brain aneurysms were found – 30 years after the head injuries suffered through partner violence.
I had neurosurgery to clip these aneurysms and the surgeon’s consensus was the TBI arose due to severe knocks to the head during assaults perpetrated by my then partner. Damage resulting from surgery has negatively impacted my quality of life.
Engender Equality, a not-for-profit Tasmanian organisation for victims of intimate partner violence, has collaborated with UTAS to research and implement the Primary Care Family and Sexual Violence support program. This program is being developed to inform medical practitioners on best practise that meaningfully supports victims.
This pilot program will educate GPs and other medical professionals on recognising and diagnosing possible TBIs, not just attributing symptoms the patient presents with to alcohol and substance abuse.
A TBI is not obvious and those seeking help from medical practitioners are often not perfect victims. They may be judged and dismissed as hysterical or unmanageable; the victim may be unable to articulate symptoms or the circumstances leading to their seeking medical interventions.
The Engender/UTAS program, once developed. is crucial to medics understanding that a victim may have a TBI; they can then make an appropriate diagnosis quicker and the correct treatment can be applied.
Advice I would give to victims of traumatic brain injury caused by partner violence is that there is no shame in coming forward to disclose domestic violence. The sooner you seek help after an assault, the earlier medical interventions can be put in place.
Victims are often pressured by their perpetrator and his close family to keep abuse secret and remain silent about the violence inflicted on them. If silence is maintained, the perpetrator isn’t held accountable and the violence can escalate the longer they continue abusing.
Continuation of violence can lead to a victim’s death. Certainly, there is a heightened risk of brain injury.
What’s lacking in the way of support for a victim with a TBI is training for first responders such as a GP or police to recognise a victim possibly sustaining a traumatic brain injury.
Also needed are support workers on call to accompany victims to medical settings, especially emergency departments. A support worker generally has a clearer mind than a traumatised victim and can better explain the situation that propelled the victim to seek medical help.
We need a greater media focus on domestic violence-related traumatic brain injury. These days, a lot of attention is being to sports-related brain injuries, but little to those caused by assaults, non-fatal strangulation and choking arising from domestic and sexual violence.
Another need is greater public information on how to find the educational resources currently available to those who think they have an acquired traumatic brain injury due to abuse they have experienced or someone they know who may have such an injury. Websites such as Brain Foundation and Brain Injury Australia are excellent places to start when one seeks information on TBIs. Navigating these sites may lead to discovering more organisations and systems for resources accessible to victims of TBI.
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Little was said in the public domain regarding domestic and family violence when I sustained head injuries from assaults perpetrated in the 1980s by my then partner.
Society has opened up to greater discussion around domestic violence, yet traumatic brain injury is not talked about to the same degree.
Because I could not bring myself to disclose the severe assault leading to brain injury, I was not diagnosed with brain aneurysms for decades. If I had been diagnosed earlier, by coming forward and disclosing the head assaults, I would have had neurosurgery to clip the aneurysms earlier. The aneurysms would have been smaller and the operation site smaller. I may have experienced better post-operative outcomes, and perhaps avoided damage to my right eyelid and optic nerve and fewer dead brain cells around the site of the operation. The dead cells from my surgery resulted in loss of mobility and memory.
If there is still a lack of discourse regarding TBIs and the types of abuse that precede a brain injury, then victims may find, as I did, that a TBI isn’t discovered in a timely manner. Not being treated may lead to an unnecessary death.
