There are many different kinds of treatments available for patients with Traumatic Brain Injury (TBI). Initial treatment seeks to stabilize the individual immediately following a traumatic brain injury.  Acute treatment of a traumatic brain injury involves life support procedures and is aimed at minimizing secondary injury. Rehabilitative care center treatment helps restore the patient to daily life. 

Initial Treatment of Traumatic Brain Injuries

Initial treatment of a traumatic brain injury begins upon arrival to a hospital. At the hospital, a team of medical professionals, generally led by the trauma surgeon, will meet the patient.  The trauma surgeon, acting as the leader, will direct the team. The trauma staff will initiate resuscitation procedures, monitor the body's vital functions, respond to potential life-threatening changes and coordinate care with other hospital personnel. At this time, the primary concern is assesing and minimizing the effects of the initial injury, and preventing additional problems.

While the physicians are assessing the patient's level of injury and response, the trauma nurse provides resuscitation, stabilization and supportive care. In most cases, the nursing staff will be charged with communicating between the doctors and the family.

Brain Surgery

The patient may need surgery either as an emergency care option, or later, as a corrective or preventative measure.  Brain surgery typically involves either removing blood from the skull cavity if there has been internal bleeding, repairing skull fractures, and removing damaged tissue.  In extreme cases where there is excess swelling or a lot of damaged tissue, a portion of the brain may be removed in order to make room for healthy living brain tissue. 

Critical Care for Brain Injury

Once stabilized, the brain-injured patient will be moved to a trauma care unit where acute treatment will be adminstered. Here the patient will be monitered closely for signs of secondary injury, changes in vital functions, and response levels.  The patient may or may not be conscious at this time.  Medications and monitoring devices may be used to help maintain blood flow and oxygen to the brain and minimize swelling and pressure. Family will be updated at regular intervals and a psychologist may be available to help the family understand the condition of the patient and make critical decisions regarding the need for surgery and realistic approaches to current and future care.  The psychologist will also evaluate the patient's cognitive skills regularly during this stage of brain injury treatment.

A social worker is also likely to be assigned to trauma cases.  This person will help to prepare the family for the condition of their loved one, help to develop recovery and treatment plans, and encourage the family to consider changes in their daily lives that will be necessary to provide the proper care for the patient.  A social worker may also assist with plans to move the patient to a rehabilitative care facility upon discharge from the hospital.

Additional information on how families can cope with and care for a loved one in the aftermath of a traumatic brain injury is offered in this article: Improving Traumatic Brain Injury Outcomes: A Family Guide.

Traumatic Brain Injury Rehabilitation

When a patient enters rehabilitative care following a traumatic brain injury, the primary goal of the care center is to help that patient recover to pre-injury functionality as best they can.  A full recovery is often not possible, but rehabilitative care goes a long way to restore lost functionality to a great degree and to help the patient find ways to adapt to losses and changes. 

Rehab is an emotional and difficult time for both the patient and his loved ones.  There is often a sense of confusion, anger and frustration associated with this step in the recovery process.  This is especially true if there has been memory loss.  In addition to calming the fears of the patient and easing the anxiety of the family, the rehabilitation staff will work to:

• Create a personalized rehabilitation plan for the individual; no two brain injury patients are alike and their needs and abilities will vary
• Prevent additional injury via infection, contraction or falling
• Help the patient relearn things; this can range from the ability to speak and walk, to more advanced relearning
• Provide resources to help the patient understand and cope with the situation
• Educate the patient and family on devices and strategies that will assist with activities and actions that the patient cannot perform due to permanent damages
• Create treatment and recovery plans for the family to follow after the patient leaves the rehabilitation care center
• Overall, maximize the patient's independent living capability

It is important to understand that each patient has a different set of challenges.  What works for one patient may not work for another.  Rehabilitation can be a long process and the patient's response to the therapy given will vary in terms of time and progress.  The care center staff will help the patient and the family understand when their services have reached the greatest possible level of recovery, and it is time to continue at home and make adjustments to the every day living situation of the individual.  Rehabilitation is ongoing - even at home, and for the rest of his or her life, a brain injury patient will continue recovering.  In most cases, it will be a long-term waiting game to see how far the patient will come.  Some may continually improve, and some may not improve much more than when they were released from rehabilitative care. 

The TBI Rehabilitation Team

• The physiatrist specializes in physical medicine and rehabilitation. This is the doctor that will assess the patient  and prescribe a treatment plan for the rest of the care center staff to follow.
  
• The neuropsychologist specializes in understanding the structure and function of the brain.  This is the doctor that will evaluate the patient's cognitive thinking skills, emotional well-being, communicative skills, and behavorial issues.  The changes that could include:
  • Poor memory
  • Poor attention and concentration
  • Poor decision-making
  • Impulsivity
  • Disorientation
  • Language and communication abilities
  • Inability to speak
  • Inability to understand when spoken to
    
• The rehabilitation nurse provides general nursing care for maximum health and assistance adapting to an altered lifestyle. The focus of nursing care is on:
  • Health maintenance
  • Nutrition
  • Potential for aspiration
  • Impaired skin integrity
  • Bowel and bladder incontinence
  • Impaired physical mobility
  • Impaired or limited ability to take care of self
  • Ineffective airway
  • Sleep pattern disturbance
  • Chronic pain
  • Impaired cognition
  • Impaired verbal communication and comprehension
  • Sexual dysfunction
    
• The physical therapist (PT) specializes in orthopedic problems, such as low back pain, knee injuries or hip dysfunction.  In terms of traumatic brain injury, the PT's job is to minimize or overcome paralyzing effects related to the brain injury.  Physical therapists focus on the examination and treatment of musculoskeletal and neuromuscular problems that affect a patient's ability to move and function.  PT's also help with transfers to and from the bed when a patient cannot walk alone. Their primary goal is to train a person to begin to walk and move more normally and without pain and discomfort. Physical therapists will assess:
  • Balance
  • Posture
  • Strength
  • Need for a wheelchair, brace or cane
  • Quality of movement
  • Spontaneous movement
  • Coordination of movement
  • Increased sensation of sensory-motor activities
  • Pain management
    
• The occupational therapist (OT) specializes in helping patients perform roles, routines and tasks that contribute to daily living skills.  This doctor is concerned with cognition, vision, perception, and movement.  OTs help the patient with simple things such as showering and personal hygiene, as well as complex things such as using a computer, writing and math.  The OT will also teach the patient how to use equipment that may assist brain injury victims with tasks that have become more difficult, such as eating and dressing themselves.  Some of the skills that an OT might help a patient work on in anticipation of returning home include:
  • Grocery shopping
  • Cooking
  • Banking
  • Budgeting
  • Readiness for returning to work by assessing prevocational and vocational skills

Are you experiencing undue financial and emotional distress from a TBI?

All types of treatment for brain injuries - initial, rehabilitative and long-term - entail a great deal of emotional and financial stress. If you or a loved one has suffered from a traumatic brain injury, you may wish to contact an experienced brain injury attorney to discuss details of your potential brain injury claim. Your traumatic brain injury lawyer has the experience and information you need to learn your rights and obtain compensation for expenses such as pending medical bills, future medical care, and medications and treatment, in addition to pain and suffering. Use the contact form on this page to submit an inquiry to LegalView and receive a referral for an expert TBI lawyer.