Traumatic Brain Injury: Treatment and Recovery

Traumatic brain injury (TBI) can mean different things depending on the severity of the injury and the recovery course. Mild TBI, otherwise known as concussion, can produce physical, cognitive and emotional symptoms that many times heal quickly. However, sometimes these symptoms become chronic and can affect you in many ways, causing a significant impact on your family, job, social life and community interactions. More severe brain injuries usually take longer to heal. Common chronic TBI symptoms include difficulty with fatigue or lethargy levels, changes in sleep patterns, behavioral or mood changes and trouble with memory, concentration, attention or thinking.

What is Traumatic Brain Injury?

Service member viewing computer screens of brain scans

Photo by Senior Airman Julianne Showalter

Traumatic brain injury (TBI) can mean different things depending on the severity of the injury and the recovery course. Mild TBI, otherwise known as concussion, can produce physical, cognitive and emotional symptoms that many times heal quickly. However, sometimes these symptoms become chronic and can affect you in many ways, causing a significant impact on your family, job, social life and community interactions. More severe brain injuries usually take longer to heal. Common chronic TBI symptoms [1] include difficulty with fatigue or lethargy levels, changes in sleep patterns, behavioral or mood changes and trouble with memory, concentration, attention or thinking. These injuries can also cause physical symptoms that include headaches, weakness in your arms or legs and balance problems. Seeking medical help for recovery from mild TBI or other types of TBI is essential. You can obtain help by reaching out to one or several of the following:

Contact your health care professional.
Find your nearest Department of Veterans Affairs (VA) hospital [2] by calling 877-222-VETS.
Contact the nearest Defense and Veterans Brain Injury Center [3] site or regional coordinator.
Call Military OneSource [4] at 800-342-9647 for confidential information.
Contact the VFW [5] Military Assistance Program by calling 816-756-3390 or emailing map@vfw.org [6].
Contact the American Legion Veterans Affairs and Rehabilitation Commission by calling (202) 861-2700 or email var@legion.org [7].
Contact the DCoE Outreach Center at 866-966-1020 or e-mail at Resources@DCoEOutreach.org [8].

Care for Service Members with TBI

Active duty service members with TBI recognized at the time of injury can receive care at specialized Department of Defense (DoD) and VA TBI Centers. These are multisite medical facilities that represent a collaboration between the DoD and VA to provide specialized help to service members and their families while dealing with traumas in the military. They include the Defense and Veterans Brain Injury Center [9] and the VA Polytrauma Rehabilitation Centers [10]. Less severe brain injuries, sometimes called “invisible wounds,” may not become evident until military personnel return home to the care of their community physicians, DoD or VA medical centers.

Recovering from TBI

Diagnosis and treatment options differ for concussion [11] or moderate to severe TBI. Patients with mild to moderate injuries may receive skull and neck X-rays to check for fractures or spinal trauma. For moderate to severe cases, the imaging test is a computed tomography (CT) scan.

Recuperation from TBI requires patience and the support of loved ones and health care providers. To help the brain heal and manage symptoms following a concussion make sure to:

Get plenty of rest and sleep.
Increase activity slowly.
Carry and use a notebook – write things down if you have trouble remembering.
Establish a regular daily routine to structure activities.
Do only one thing at a time if you are easily distracted – turn off the TV or radio while you work.
Check with someone you trust when making decisions.

Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), neurology, psychology/psychiatry and social support.¹ [12]

For patients diagnosed with TBI, it is also important to be mindful of factors that can slow the recovery or cause another brain injury:

Avoid activities that could lead to another brain injury – examples include contact sports, motorcycle riding and skiing.
Avoid alcohol because it may slow healing of the injury.
Avoid caffeine or “energy-enhancing” products because they may increase symptoms.
Avoid pseudoephedrine-containing products because they may increase symptoms – check the labels on cough, cold and allergy medicines.
Avoid excessive use of over-the-counter sleeping aids because they can slow thinking and memory.² [13]

TBI Statistics

Males are 1.4 times as likely as females to sustain TBI.
Military duties increase the risk of sustaining TBI.
An estimated 3.2 million Americans currently live with disabilities resulting from TBI.
1.7 million Americans sustain TBI each year.
More than 52,000 people die every year as a result of TBI, 275,000 are hospitalized and 1.36 million are treated and released from an emergency department.² [13]

Additional Resources:

National Resource Directory [14]
TRICARE [15]
Veterans Health Administration [16]
brainline.org [17]
Deployment Health Clinical Center [18]
Health Resources and Services Administration [19]
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury [20]
National Institute of Neurological Disorders and Stroke [21]
Brain Injury Association of America [22]
Under Secretary for Health’s Information Letter, “Screening and Clinical Management of Traumatic Brain Injury [23]” [DOC 52.5KB]

Sources:

¹"Frequently Asked Questions [24]," Brainline. Last accessed on Sept. 12, 2011.
²"Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006 [25]" [PDF 2MB], Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Last accessed on Sept. 12, 2011.

Mon, 2011-09-12