Traumatic brain injury (TBI) is a head injury causing cognitive, sensory, emotional or motor skills impairment to some degree. Recovery from traumatic brain injury depends on the severity of the injury, the part of the brain affected, the age of the patient, and the quantity and quality of treatment. Early and intensive treatment focusing on the recovery of cognitive functions and other skills is essential. Cognitive rehabilitative services work on memory, learning and problem solving skills. Other treatments focus on speech and motor skills if these have been impaired.
Doctors and researchers recognize that the first six months to two years after the injury is a critical time for intensive recovery treatments. This time period is generally when the most progress is made in recovering brain function. Depending on the severity of the brain injury, treatment might continue for years. Some patients continue recovering pre-injury functioning years after the injury occurred. Persistence, frequent practice and therapeutic support during remediation help the patient recover functioning.
For many years, doctors and researchers believed the brain had no capacity for change or substantial recovery from trauma. This belief influenced treatment, as it was thought that restoring lost functioning was impossible, so little effort was made in this area. Now, the concept of brain plasticity — the brain’s ability to restore many aspects of functioning — is widely accepted. Plasticity recognizes the brain’s capability of forming new neurons and new connections after brain injuries. Different areas of the brain are able to assume functions that were once carried out by the damaged area.
As the concept of brain plasticity increases in acceptance, treatment options are also changing. Rather than concentrating solely on life support, long-term treatment now focuses on retraining the brain. Younger brains have a larger capacity for regeneration and recovery, but patients of all ages can experience some recovery with rehabilitation treatment. In the past when there was no attempt at rehabilitation, areas of the brain that weren’t used completely lost their functioning. Now, rehabilitation to retain and retrain brain functions is a major focus during recovery from traumatic brain injury.
Emotional stages have been identified during the recovery from traumatic brain injury. Each person’s injuries and personalities are different, so the length and severity of the stages may vary greatly from one individual to the next. Confusion and agitation are the first stage and generally occur as soon as the patient becomes aware of the brain injury. Denial involves not accepting the new behaviors or limitations the person is experiencing. People with traumatic brain injury frequently become angry or depressed when the realities of the injury and its consequences continue to alter their lives.
Changes in the brain itself and emotional coping capabilities influence many aspects of the emotional stages. A testing phase occurs as recovery from traumatic brain injury leads to noticeable improvements in brain functioning. During this stage, the limits of abilities may be pushed too far, resulting in disappointments. Acceptance is the final stage. The degree of acceptance varies, with some patients fully accepting and others remaining emotionally uncomfortable.
