Traumatic Brain Injury Recovery

A person breaks his or her leg in a car accident, which necessitates a trip to the emergency room. Medical personnel set the bones--sometimes with pins and plates if the break is severe. The leg is put into a cast, and the patient stays in a hospital for a while. As the bones knit, the hard cast is traded in for a walking cast and a wheelchair for a walker or crutches. The muscles strengthen, pain recedes, and soon the accident victim is up and walking around as if nothing ever happened. In cases like these, the process of recovery is fairly cut and dried.

When the accident results in a traumatic brain injury (TBI), the process still begins with a trip to the emergency room. This is followed by time in the intensive care unit before the patient is considered stable enough to be transferred to a regular hospital bed. With milder forms of TBI, the bruising of the brain can heal, and either the brain cells can regain their function or other brain cells can take over for cells irreversibly damaged. With more serious brain injuries, however, the process of recovery is more nebulous, and this can cause misunderstandings and frustration for both the head-injury patient and those closest to him, who may expect the healing process to continue to full function and a return to normalcy. In actuality, such functions as speech, walking, and decision-making skills may have to be relearned and may never return to their pre-TBI level. Instead, goals and plans must be realigned in consideration of what the head-injury patient is capable of achieving post-TBI.

TBI symptoms can include pain, usually headache; post concussion syndrome, with symptoms similar to ADHD; seizures; hydrocephalus, a buildup of cerebrospinal fluid in the brain; infections; damaged blood vessels in the brain, which can clot and lead to strokes; and cranial nerve injuries.

Individual patients follow different paths in their treatment, depending on the kind and severity of the TBI and the specific needs of the patient. Options may include home-based rehabilitation, outpatient rehabilitation, inpatient centers, day programs at rehab centers, and supportive living programs. For patients with severe TBIs, the goal of rehabilitation is to improve the survivor's ability to function, both at home and in the community, even when full normalcy isn't possible. Therapists will help the patient adapt to his disabilities or help make modifications to the home so that day-to-day activities become as straightforward and trouble-free as possible.

The cost of TBIs to society and to the families of TBI victims is huge. Financially alone, TBIs requiring hospitalization cost the nation around $56 billion a year. Twenty-five percent of adults with TBI are still unable to return to work after a year. The full human cost to TBI sufferers and their loved ones, in terms of disabilities and long-term impairments, cannot be calculated.

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