Suffering a traumatic brain injury can be a very harrowing time and it can be difficult for clients and their loved ones to see a way forward. At Ison Harrison our first priority is the patient’s rehabilitation.
The brain is a very sensitive and complicated organ, and when you consider the many variables that can influence the level of recovery, it is very difficult to predict when the brain will recover from a traumatic injury.
Until a patient is in a stable condition following a brain injury, you can’t assess with any certainty the severity of any brain disorder. The level of brain damage can still be changing in the first few hours after the injury, and of course the patient could still be in a coma for some time. Even after emerging from a coma there is a period of post-traumatic amnesia, but this can all be monitored to establish how severe the injury is.
What influences brain recovery after a traumatic brain injury?
Levels of recovery following brain injury are heavily influenced by the individual and how their body reacts. Even mild concussion can lead to lifelong effects, while people suffering moderate to severe brain injuries can make close to a full recovery. Predictions are so difficult because of the many variable factors which differ between individuals, such as:
- The severity of the injury
- The part of the brain that is damaged
- The individual’s attitude to rehabilitation
- The quality of the rehabilitation
- How the individual lives after the rehab programme has ended
- The quality of the support network of friends and family
Generally, the fastest recovery occurs over the first six months following the injury. Recovery will then taper off, and while some people may see no progress after one year, others can report gradual improvement for many years afterwards.
It is possible for the brain to heal itself, with new brain cells growing to replace damaged ones, but much of the ‘recovery’ we experience is actually due to the brain ‘re-wiring’ itself and finding new pathways to bypass recently-broken connections. In other words, remaining brain tissue can assume the functions of damaged areas, so we have to re-learn how to do certain things, such as walk, talk or drive. This is because the parts of the brain that told the nervous system how to do these things have been damaged, and other parts are having to take over.
How brain recovery occurs after a traumatic brain injury
Whilst there may be actual organic recovery in the brain, called cell regeneration, and there is plenty of evidence from the last 20 years to show that this happens, much of the recovery of the brain is through what is called ‘plasticity’. This is the process through which parts of the brain compensate for damaged or destroyed brain matter and so information is re-routed around the damaged areas.
Much of this recovery is therefore down to the discipline and attitude of the patient and the support they have around them, i.e. can they adapt to the brain telling them new ways to do the same functions? A good start is to build compensatory strategies, which are techniques to make up for lost abilities, such as writing things down to compensate for short-term memory loss, but this all forms part of a tailored programme specific to your individual needs.
Can The Brain Heal Itself After Brain Damage?
To answer the question of whether the brain can heal itself, yes it is possible that some brain cells repair themselves, but this doesn’t mean there will be a full recovery. It is also possible that much of the recovery you see or experience is down to other parts of the brain taking over functions from the damaged parts. Certainly you should never underestimate the degree of recovery that is possible, but often the most significant recoveries are made by people who are positive, determined, disciplined and have the right support around them who can help to adapt the home, or when at work or out in public, to assist the individual in using the brain to find new ways to function.
Severe Brain Injury Rehabilitation Advice by Simon Helliwell
A severe brain injury is classed as a traumatically-induced structural injury and/or physiological disruption of brain function as a result of an external force. This can manifest itself in many different ways, including loss of consciousness, loss of memory, alteration of mental state, neurological deficit and intracranial lesion. Undoubtedly, severe brain injury can be one of the most traumatic health issues you can suffer and the most complex to recover from. Of course this is due to the sensitive nature of this part of the body and the many different ways that your recovery can be affected.
In my many years of experience as a chartered legal executive I have fought several litigation cases where there has been a failure to properly diagnose and/or appropriately treat brain injuries, and this can lead to permanent conditions and disabilities, and of course can be fatal, so it is crucial that recovery is actioned immediately and is carried out in response to specialist advice.
The stages of recovery start straight after the injury has been suffered, known as the acute stage. While all stages of the recovery process are extremely important, this initial stage is critical in how the patient will recover long term and irreparable damage can be caused if anything is carried out incorrectly at this point, as the patient’s condition can still be changing.
It is likely that a patient who has just suffered a severe brain injury will be treated in an intensive care unit of a hospital. The aim here is simply to get the patient stable and ensure there is no further deterioration. The patient’s general health and the nature of the injury can of course mean that things can deteriorate further, and very quickly. Once a patient is stable, however, they will be transferred to another unit of the hospital to start their rehabilitation. But the length of this period in intensive care can be days, weeks or months.
Designing a rehabilitation programme for severe brain injury
At this point, the patient’s rehabilitation can take many diverse paths. There are a wide variety of options with regards recovery, and an individual rehabilitation programme will be designed by a specialist based on the patient’s strengths and capacities. This will be carefully monitored and amended as targets or timescales are met, or otherwise.
These individually-tailored treatment programmes will draw on the experience of many different specialists, having assessed and monitored the patient’s cognitive, communicative, emotional, behavioural and physical responses. Such a programme may include:
- Physical therapy
- Occupational therapy
- Speech therapy
- Psychological support
- Social support
It is important that family work with the team of specialists and a collective agreement is made on how a patient can and will recover. This team of specialists will be led by a team co-ordinator or administrator who will monitor progress and manage the programme accordingly. Family will build a special relationship with this person as the programme progresses and it is important that patience, trust and understanding is shown to support the specialist programme.
The objectives of rehabilitation
The objective of rehabilitation will change for each stage of the process, but the overall aim is for the patient to be able to function both at home and in society. It may be clear at a very early stage that this will not be possible, or progress may be slower than expected, or it becomes evident during rehabilitation that the patient won’t progress beyond a certain stage and will require specific levels of support for the rest of their lives.
At all times, specialist support is helping the patient adapt and working with their support network of friends and family to change the living space to suit their current status. Also, the patient may be prescribed medication to treat psychiatric or physical problems and great care must be taken in correctly prescribing this, as the patient is of course hugely sensitive to side effects that could slow, alter or reverse recovery.
As rehabilitation progresses, family can become more involved, and may even need psychological support themselves. But family are also key in agreeing rehabilitation programmes, particularly the physical setting, ie. Whether rehab is home-based, in a hospital outpatients setting, through independent or supportive living, or if it is a school-based programme where it involves children.
Ison Harrison has specialist staff who are experienced in providing sympathetic support at this time. This can be in assessing any claims you may feel you have for clinical negligence or personal injury, or for dealing with employment claims and how a patient’s rehabilitation is dealt with by their employer. We have dealt with many different scenarios relating to severe brain injuries, and our number one priority is always to ensure the patient is receiving the very best rehabilitation advice and support. From there, we can help you with any subsequent legal issues you may wish to pursue in response to the patient’s injuries.
For more advice, please contact our team or call 0113 284 5048, or alternatively email simon.helliwell@isonharrison.co.uk.
