After the Bike Fall

Arjun, twenty-two, rode his motorbike to a call centre in Hyderabad. One rainy night he skidded and hit his head. He had no helmet on. He was unconscious for a few minutes, spent two days in hospital, and was told that s…

Arjun, twenty-two, rode his motorbike to a call centre in Hyderabad. One rainy night he skidded and hit his head. He had no helmet on. He was unconscious for a few minutes, spent two days in hospital, and was told that scans looked 'mostly fine' and that he could go home.

Over the next weeks his family noticed changes. Arjun, who had always been careful, now made rash decisions and spent his salary in a day. He lost his temper over small things, shouted at his mother, and then did not seem to understand why people were upset. He could not plan his shift, forgot appointments and often could not find the right word. He also complained of headaches and told them he felt 'not like myself'.

His mother Shanta first thought he was being lazy or rebellious. His sister, who had read about the brain, said, 'The front part of the brain handles planning, self-control and judgement. If that was hurt, he may not be doing this on purpose.' They went back to the hospital and asked for a neurologist.

The neurologist examined Arjun, arranged tests and explained that changes in behaviour after a head injury are real and need follow-up. A neuropsychologist tested his memory and planning, and Arjun began rehabilitation with simple routines, written reminders and slower days. The family agreed that he would always wear a helmet from now on. He improved slowly, and understanding turned the family's anger into patience.

How to recognise it

• New changes in personality, such as impulsiveness, anger or poor judgement, after a blow to the head.

• Trouble planning, remembering or finding words.

• Headaches, dizziness or tiredness that continue after the injury.

• The person seems unaware of changes or cannot explain them.

• Changes that last or get worse rather than settling in days.

What this story explains

This story shows how the frontal lobe helps with planning, decision-making and self-control, and how injury to the brain can change behaviour. It also stresses brain protection, such as wearing helmets and seat belts.

Probable root causes

• Injury to the frontal and other regions of the brain during the fall.

• Swelling or bruising that can affect brain function for weeks.

• Poor sleep, pain and stress that make symptoms worse.

• Emotional reaction to the accident and to changes in abilities.

• No helmet, which allowed a more serious injury.

What to do

1. Seek medical review after any head injury, and again if new behaviour changes appear.

2. Ask for referral to a neurologist and, if needed, a neuropsychologist who tests thinking and memory.

3. Use written reminders, lists and a steady daily routine to reduce strain.

4. Make sure the person sleeps well, avoids alcohol and returns to activity gradually.

5. Educate the family so that behaviour is understood as part of the injury and not wilfulness.

6. Always wear helmets and seat belts in the future.

Whom to consult

• Neurologist for assessment of brain injury and ongoing symptoms.

• Neuropsychologist or rehabilitation team for memory, planning and behaviour changes.

• Family doctor for follow-up and coordination of care.

• Psychiatrist or clinical psychologist if mood, anger or anxiety become strong after the injury.

Do and don’t

How to behave and communicate

• Speak slowly and clearly, with one instruction at a time.

• Try 'I know this is hard. We will work out a plan together.'

• Stay calm during angry outbursts and talk when things settle.

• Avoid sarcasm and blame.

• Offer written notes and gentle reminders rather than repeating criticism.