, Brain Injury Recovery, Care24

Brain Injury Recovery

Care24 Administrator Neuro, Nursing

Brain Injury Recovery

A traumatic brain injury, or TBI, is a type of injury in which your brain suffers through some form of damage because of some external force. It could be due to a vehicle accident, due to any would sustained to the head during a sport or a fight or through any other physical incident, or injury that is sustained to the head as a result of a fall.

This type of a brain injury does not happen due to any internal reasons such as a tumour or a stroke. In many instances, a person may suffer from a traumatic brain injury and still remain conscious, which could make it difficult to understand that something is wrong.

Early Signs Of A Traumatic Brain Injury

According to the TBI Model Systems, here are some of the most commonly accepted signs and symptoms that can help to identify whether or not a person is suffering from traumatic brain injury:

  • The person may lose consciousness after a sudden impact to the head.
  • The person will find it difficult to recall the exact traumatic episode that took place that led to the injury. In some cases, it can also result in short term memory loss or amnesia
  • The person can have a fracture of the skull or suffer from a post-traumatic seizure. Some patients can also show up some form of abnormality in the brain while having a brain scan.

Common Stages Of Patient During Brain Injury Recovery

After the initial few weeks of suffering the brain injury, the patient’s brain tissues show signs of getting affected as a result of swelling, changes in the brain chemistry or the amount of bleeding. As a result, some patients may not be able to open their eyes, while some may be in a deep state of unconsciousness.

As the bleeding and the swelling starts to go down, the patient’s condition will start to show a gradual improvement. This time that a patient spends in recovery will often differ from person to person. Here are some of the most common stages that a patient may go through while recovering from a brain injury:

  • The Coma Stage
    This is the stage when a patient is completely unconscious and has no awareness of the surrounding. The patient will not be able to respond to any form of audio or visual stimulation. The patient will also not be able to communicate in any form and will be unable to show any type of emotional response.
  • The Vegetative Stage
    This is the stage where the patient will go through a sleep and wake cycle. He or she may be able to relate to visual and audio stimulation for some time.
  • The Minimally Conscious Stage
    This is the stage where the patient is conscious partially and will be able to understand where the various sounds and visual stimuli are coming from. He or she may try to respond to the same, by trying to reach out towards it, or understanding and trying to respond to commands and queries, or even try to speak or express emotions in some form.

How Long Does It Take To Recover From A Brain Injury?

The amount of time it will take for a patient to recover from a brain injury will differ from person to person, and often the most determining factors are the type and severity of injury sustained, as well as the age of the patient.

Here is a look at the common indicators that the medical team will use to assess the prognosis:

  • Duration Of ComaThe time frame for which the patient has been in a coma. The shorter the patient stays in a coma, the better it will be for the patient to recover.
  • Post Traumatic Amnesia
    The lesser time the patient suffers from amnesia, or short term memory loss, the better chances will be there for recovery.
  • Age Of The Patient
    Those patients who are over the age of 60 or are under the age of 2 years have the most difficult chance of recovery. This will be true even if the patient suffers the same amount of injury as someone else who is not over 60 or under 2 years of age.

What Will Determine The Amount Of Recovery From A Brain Injury?

While doctors and the entire medical and care team will do its best to help a patient recover from a brain injury, the actual amount of recovery achieved may differ from patient to patient. While some patients may show a lot of improvement and may get back to their pre-injury stage, many may take much longer, as well as not regain control of a lot of abilities they had prior to the injury.

There are various mechanisms that go into determining the amount of recovery that can happen after a brain injury.

  • There are depressed areas in the brain that may not be directly affected with the injury sustained, but are somehow linked to the injured area. When these areas start to function again, it is referred to as diaschisis.
  • In many cases, the brain relocates its previous tasks to a new area. This means that, a particular action that was earlier carried out by a particular part of the brain will now be performed by another part of the brain that would not have originally done this task.
  • The areas of the brain that carry out a task start to become redundant. As a result, the brain transfers the task to another part.
  • The patient may experience something known as a behavioural substitution. This is a condition in which the person will learn to perform previously known functions in a new way to overcome certain disabilities.

A Basic Timeline Of Recovery From Brain Injury

The highest amount of recovery often happens in the first six months after the brain injury. Post the first six months, the speed of recovery can considerably slow down. Even though recovery from a brain injury is different for different patients, here is a brief timeline that most doctors and care team members will follow:

  • The First And Second Month After The Injury
    For the first and second month after the injury, the doctors will not have a clear idea of how long it will take for the patient to recover. Also, the doctors during this time will not be sure of how much recovery will happen and whether or not recovery will be complete. The only thing that the doctors will be sure of at this stage is that recovery may easily take anything between months and years, instead of weeks.
  • Six Months After The Injury
    By this time, the doctors will have a clearer idea of the patient’s overall reaction to the treatment and recovery process. However, the medical team will likely wait for at least a year after the injury to come to a more definitive idea about recovery and its outcome.
  • A Year After The Injury
    By this time, the doctors will be more certain about the patient’s overall health and also have a better understanding of how the patient is responding physically to treatment and recovery options. The one area that may still pose a concern is the psychological recovery of the patient. This usually takes longer than physical recovery and it is usually the cause of more long-term problems.

The Rancho Los Amigos Levels Of Cognitive Functioning (RLCF)

The Rancho Los Amigos Levels of Cognitive Functioning, or RLCF, is one of the most accurate and globally used methods that help to describe the recovery of a patient from brain injury. It talks about 10 different levels of cognitive recovery. According to research, the pace at which a patient moves through the different levels of RLCF during the recovery period after a brain injury will help the doctor determine how much recovery a patient will have.

Here are the 10 different levels of the Rancho Los Amigos Levels of Cognitive Functioning (RLCF):

  1. Level 1 No Response
    This is the stage in which the patient is in a state of deep sleep and is not able to give any response.
  2. Level 2 Generalized Response
    This is the stage in which the patient is not able to directly react to any stimuli, but is able to react only inconsistently. The responses in this stage are very generalized.
  3. Level 3 Localized Response
    This is the stage in which the patient reacts in a direct way to stimuli, but inconsistently. The responses in this stage are very localized.
  4. Level 4 Confused Or Agitated
    This is the stage in which the patient seems to be either confused or agitated.
  5. Level 5 Confused Or Inappropriate, Or Non-Agitated
    This is the stage in which the patient appears to be confused, but is not agitated. The patient may be able to respond to stimuli, but the responses are not always accurate or appropriate.
  6. Level 6 Confused Appropriate
    This is the stage in which the patient seems to be very confused, but is able to respond more accurately to various stimuli and commands.
  7. Level 7 Automatic Appropriate
    This is the stage in which the patient will be able to go through the routines of daily life with no or very less confusion.
  8. Level 8 Purposeful Appropriate
    This is the stage in which the patient is able to make use of a fully functioning memory and will be aware and responsive towards the immediate surroundings.
  9. Level 9 Purposeful Appropriate
    This is the stage in which the patient will be able to go through the routines of daily life while being aware of the need of assistance or support.
  10. Level 10 Purposeful Appropriate, Modified Independent
    This is the stage in which the patient will be able to go through the daily routines of life but may need more time to perform these tasks.

Tips To Help During Recovery Process

Here are a few lifestyle changes that can help the patient recover better from a brain injury:

  • Reduce the amount of work and responsibilities you take on. Instead of trying to get back to all responsibilities at once, try to gradually increase the amount of things you take up.
  • Rest as much as possible and make sure to get at least 8 to 10 hours of sleep at night, and nap during the day if possible.
  • Quit having alcohol or any form of non-prescription drugs. People who suffer from a brain injury have problems in handling alcohol or non-prescription drugs, as compared to those who take the same amount but have not been through a brain injury.
  • Stick to a daily routine to make sure your brain is able to learn and understand through repetitive patterns.
  • Try and do one task at a time, to help reduce confusion.
  • If you still have problems with concentration and memory, write down things as soon as you remember something important.
  • While performing a particular task, try to reduce the amount of distraction around you.
  • Eat healthy and fresh foods and make sure to include some or the other form of exercise in your daily life.