Rehabilitation and Healing of Traumatic Brain Injuries

Home » Rehabilitation and Healing of Traumatic Brain Injuries
October 24, 2014
Edward Smith

As a Sacramento Brain Injury Attorney since 1982, I have handled hundreds of cases for people who suffered from concussions, fractured skulls, and other injuries impacting the brain resulting from auto, trucking, bicycle, motorcycle, or pedestrian accidents.

Often, the nature of the brain injury is not immediately apparent. Other serious injuries can take the limelight immediately after the accident. Only later do the cognitive, severe, emotional, and behavioral deficits and problems of a brain injury become apparent.

Every year, over 550,000 people are hospitalized with a traumatic brain injury, and 15% of those, more or less, suffer a long-term disability.

Anytime someone suffers a concussion or TBI ( Traumatic brain injury), if the injury arises from an accident, it’s essential to document the client’s baseline condition. I’ll talk more about that in a few paragraphs. All too often, however, people are treated in the Emergency Room, given a minimal examination to rule out broken bones or deficits( those which can be seen on MRI or CTI scan), and then sent home without any recommendation for follow-up.

At best, they may be seen by a neurologist, who can, if competent, diagnose injuries apparent on a CT scan or MRI. However, many brain injuries DO NOT show up on MRI or CT scans, and a Neurologist is generally not the best-qualified person to diagnose or document most brain injuries.

The person most highly trained in the deficits caused by brain injuries is a neuropsychologist. A neuropsychologist typically has a PhD and has long postgraduate training in neuroanatomy and psychology. The neuropsychologist will review the client’s school records (even high school and elementary school records), look at past academic testing, interview friends and family, and then do an extensive battery of tests known as a Neuropsych Exam.

A good rehabilitation plan can be formulated only after that exam is finished and the nature of the brain deficit is established.
A neuropsychologist can really be helped in analyzing the injury if he understands the course and progression of the symptoms.
A personal injury lawyer can help the client document the nature and extent of his or her symptoms by having a checklist filled out by the client soon after his or her initial appointment with the lawyer, in which the client is asked about the presence or absence of those symptoms typically associated with a head injury. The client’s spouse or significant other should also fill out a checklist at that time since the spouse or other close family member often will see signs or symptoms that the brain-injured person may not be aware of.

For example, one question may ask whether the injured party feels emotionally labile (all over the map) since the accident. He or she may check “no”, but if you ask the spouse or other family member, they may check a resounding “Yes”.
It’s widespread for a person with a traumatic brain injury to be unaware or not fully aware of cognitive or behavioral issues that appear straightforward to close family members.

If these checklists are filled out at the initial interview or shortly after that, they can be helpful to a neuropsychologist who sees the client perhaps many months or even years later. The checklists help document the baseline condition shortly after the accident, making it easier to diagnose improvement or deterioration. Generally speaking, the impairments ordinarily present after a brain injury can be classified as cognitive, physical, or behavioral. Cognitive impairments include memory, attention, concentration, and communication difficulties. There is often difficulty in taking in new information.

Physical problems can include difficulty with speech and muscular issues with arms, legs, or the trunk area. There may also be intense headaches, loss of taste or smell, or difficulties in swallowing. Behavior issues may include impulsiveness, distractibility, aggression, agitation, and inability to relax. There is no magic pill that will immediately cure a brain injury. Every injury is different and affects a person uniquely. Some injuries get better with time and much help, but some can linger, mainly if no action plan or rehabilitation is undertaken. Rehabilitation of brain injuries is typically costly, and this medical cost often frustrates people who want their pre-accident condition quickly restored. Rehabilitation often requires a multidisciplinary approach. Some experts include psychiatrists,  physical medicine and rehabilitation specialists, nurses, psychiatrists, therapists, speech therapists, social workers, and case managers.

Sometimes the rehabilitation can be on an outpatient basis, but often a stay in full-time rehabilitation facility is necessary.
The rehab team is focused on healing and prognosis and reviews neuropsychological testing, medical records, MRI and CT scans, and behavioral observations to chart the best path to recovery. The rehab team works very closely with the family of the injured person as well, as family members must know what to expect and how they can most help the brain-injured person in his recovery. One thing that helps almost everyone with a brain injury is diminished stress. Active participation in activities known to lower stress, such as Yoga, Meditation, Guided Imagery, or  Hikes in Nature,  have helped many of my clients in the past. A new modality called HeartMath, a type of biofeedback, is also helpful.
Feel free to contact me anytime for a referral to a good Yoga therapist or for Information on Guided Imagery or Heartmath.

The journey back from a traumatic brain injury is difficult, but like any other journey, it can be completed if a good guide and trusted advisers are there for you. I’m Ed Smith, and I’ve been a Sacramento brain injury lawyer since 1982. Feel free to call me anytime for free, friendly advice. In Sacramento, my number is 916-921-6400. Elsewhere, it is 800-404-5400. You can also reach me at my website at

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