Presenting Conditions

Headway accepts referrals regarding anyone with presenting conditions of an Acquired Brain Injury (ABI), including Stroke. Following the receipt of a referral/application form, our Referrals Coordinator will seek medical records and review the case, with input from transdisciplinary team where necessary. 

ABI refers to a neurological event that is not progressive and has been acquired during the person’s lifetime. Acquired damage to the brain can occur at the time of the injury (i.e. primary injury) or after the initial impact (i.e. secondary injury).

Included Presenting Conditions

Those directly affected by ABI and eligible for Headway’s services include individuals with: 

  • Traumatic Brain Injury (TBI), commonly resulting from a fall, road traffic accident, assault, or sport injury 
  • Stroke, including ischaemic stroke/cerebrovascular accident (CVA), intracerebral hemorrhage, subarachnoid hemorrhage 
  • Anoxia/ hypoxia (i.e. complete or partial lack of oxygen intake to the brain for example due to a heart failure, overdose or near drowning experience) 
  • Infections (e.g. encephalitis, meningitis, meningoencephalitis) 
  • Metabolic complications (e.g. hypoglycemia) 
  • Postsurgical damage (e.g. post tumour removal, epilepsy surgery) 
  • Brain damage caused by benign, non-progressive brain tumours 
  • Any other acquired brain injury that is not progressive  

Those indirectly affected by ABI, eligible for Headway’s services, include individuals who are experiencing psychological or adjustment difficulties as the result of their relationship with a person who has suffered an ABI. 

Excluded Presenting Conditions

We do not serve populations with degenerative (e.g. dementias, multiple sclerosis, Huntington’s disease), congenital (e.g. spina bifida, congenital hydrocephalus) conditions, or developmental disorders (e.g. ADHD) we attempt to signpost any ineligible referrals to appropriate services where possible. 

Considerations Regarding Specific Presentations 

Presenting Conditions Directly Caused by Substance Abuse 

Individuals with acquired brain injury precipitated by alcohol related syndromes, such as Wernicke’s encephalopathy/ Korsakoff’s syndrome, may be admitted to Headway services. However, total abstinence from alcohol is required to prevent progressive loss of brain function and damage to peripheral nerves. In case of alcohol related syndromes Headway requires evidence that the person no longer uses alcohol; this requires at minimum a letter from a relevant professional (e.g. a psychiatrist, addiction counsellor).

Headway recommends a minimum of 6 months period of abstinence before accessing its services. This is to ensure enough time to successfully address difficulties with addiction prior to re-engaging with Headway.

Dual Diagnosis 

The term dual diagnosis is used to describe a comorbid condition of a person. Examples of dual diagnosis commonly seen in Headway include ABI combined with addiction, chronic mental illness, intellectual disability, or progressive degenerative condition (e.g. multiple TIA’s that are currently stable but likely to develop into a progressive vascular disease over time). Headway provides services for people whose primary presenting clinical need is their or their family members neurological condition and associated recovery. Each referral will be considered on an individual basis, but we do not usually work with people whose primary difficulties are not related to their ABI. Where individual’s needs are better met in another service (e.g. addiction treatment programme, mental health services, intellectual disability service, older adult/dementia service) we aim to signpost these referrals to most appropriate agencies.

Clients with Forensic Background and/or Challenging Behaviour 

For persons with forensic history, as well as for those with previously reported challenging behaviour, risk assessment will be carried out by the transdisciplinary team in the context of a needs assessment to determine suitability for community-based services and safety of the person to him/herself and others. According to Headway’s person-centred framework decisions are made on an individual basis.