Traumatic Brain Injury - Treatment and Rehabilitation

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Traumatic Brain Injury: Treatment and Rehabilitation

Rehabilitation from traumatic brain injury seeks to help patients regain the ability to live on their own with as little help as possible. Treatment focuses on a number of areas; while the specifics depend on the injury, it generally concentrates on the healing abilities of the body, and on re-teaching the body how to learn. The latter also includes teaching the body how to deal with permanent changes that result from the brain injury in question.

Treatment focuses on the following specific areas:

  • changes in behavior
  • memory
  • headaches
  • spasticity
  • speech
  • drug therapy
  • pain

There are three stages of rehabilitation: acute, sub-acute, and chronic:
Acute: treatment administered immediately following injury, beginning with life saving measures, followed by measures aimed at stabilizing the patient.
Sub-acute: rehabilitation aimed at helping patients regain the ability to live on their own
Chronic: continuing treatment and rehabilitation for permanent damage

Acute Rehabilitation

Acute rehabilitation can be defined as the period of treatment between the time of injury and stabilization.

The first step in acute rehabilitation often consists of life saving measures administered immediately following a traumatic brain injury. This treatment varies depending on the injury, but can include unblocking the airway, maintaining blood circulation and body fluid levels, and the preventing infections and other post-injury problems.

TBI can also cause edema (swelling of the brain). Edema can cause intracranial pressure (ICP) to increase, which is extremely dangerous. If a TBI patient experiences edema, a number of measures may be taken during the acute rehabilitation to counter its effects.

Another symptom that may cause increased intracranial pressure is the buildup of fluid in the brain. An ICP monitor may be inserted to monitor the pressure. When ICP becomes a problem, medications may be prescribed, and in some cases surgery will be required.

Sub-acute rehabilitation

Once a patient stabilizes from a traumatic brain injury, he or she may be admitted to a facility designed to treat TBI, where a sub-acute rehabilitation program will be tailored their specific needs. Patients entering a sub-acute program are generally still experiencing some level of post-traumatic amnesia (PTA). The sub-acute rehabilitation program lasts from the time a patient is deemed medically stable to the point at which he or she is ready to:
a) re-enter the community and be able to function, or
b) enter a chronic care center
The main objectives of sub-acute rehabilitation are to ease the process of recovery, prevent further injury as a result of the patient's condition, and to spot any potential problems that may lead to such injuries. Other areas addressed by sub-acute rehabilitation include hygiene, depression, nutrition, and counseling for both the patient and his or her family. Rehabilitation Professionals also work side by side with family members to help them understand the neurological problems a victim of TBI will face.

Chronic Rehabilitation

For some victims of traumatic brain injury, treatment will be necessary for the duration of their life. Ongoing treatment following the acute and sub-acute stages is referred to as chronic rehabilitation. Chronic rehabilitation can come in the form of individual care or in the form of a program created by a number of specialists, similar to the programs designed for acute and sub-acute treatment. In the past, most rehabilitation was based in a medical facility. But in recent years, the popularity of community-based programs has been on the rise.

Forms of community-based rehabilitation:

  • Community Re-entry programs - designed to prepare patients for re-entry into society, where they may have to live and work on their own.
  • Neurobehavioral programs - for patients with nervous or explosive behavior.
  • Outpatient facilities - outpatient rehabilitation designed to address specific, ongoing problems.
  • Home-based Rehabilitation - rehabilitation firms exist to provide home-based rehabilitation for those who need it.
  • Transitional programs - programs that provide accommodation for victims of TBI while they attempt to prepare themselves to live independently.

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