A variety of treatments can help promote recovery from the physical, emotional, and cognitive problems TBI may cause. The types and extent of treatments depend on the severity of the injury and its specific location in the brain.
Mild TBI, sometimes called concussion, may not require specific treatment other than rest. However, it is very important to follow a health care provider's instructions for complete rest and gradual return to normal activities after a mild TBI. If a person resumes normal activities and starts experiencing TBI symptoms, the healing and recovery process may take much longer than if he or she had followed the health provider's instructions. Certain activities, like working on a computer and concentrating hard, can tire the brain even though they are not physically demanding. The person with the concussion might need to reduce these kinds of activities or might need to rest between periods of such activities to let the brain rest. In addition, alcohol and other drugs can slow recovery and increase the chances of re-injury.1
Children and teens who may have sustained a concussion during sports should stop playing immediately. They should not return to play until a health care provider who is experienced in evaluating concussion confirms they are ready. Re-injury during recovery can slow healing and increase the chances of long-term problems. On rare occasions in which a person gets another concussion before healing from the first one, permanent brain damage and even death may result.2
In most cases, emergency care focuses on stabilizing the patient and promoting survival. This care may include ensuring adequate oxygen flow to the brain, controlling blood pressure, and preventing further injury to the head or neck.3 Once the patient is stable, other types of care for TBI and its effects can begin.
Surgery may be needed as part of emergency care to reduce additional damage to the brain tissues. Surgery may include:
Medications may be used to treat symptoms of TBI and to lower some of the risks associated with it. These medications may include, but are not limited to:
Researchers continue to explore medications that may aid recovery from TBI. For example, an NICHD study investigated the effectiveness of citicoline, a drug meant to help protect neurological functioning. The study found, however, that patients with TBI who took citicoline did not have any greater improvement in function than those who took a placebo.7 Read more about the citicoline study.
Therapies can help someone with TBI relearn skills such as walking or cooking, or develop strategies for self-care, such as making lists of the steps involved in getting dressed. Rehabilitation can include several different kinds of therapy for physical, emotional, and cognitive difficulties. Depending on the injury, these treatments may be needed only briefly after the injury, occasionally throughout a person's life, or on an ongoing basis.
Most people with a moderate to severe brain injury will need some type of rehabilitation therapy to address physical, emotional, and cognitive issues from the TBI. Therapies will likely include relearning old skills or learning new ways to make up for lost skills. A treatment program should be designed to meet each person's specific needs and to strengthen his or her ability to function at home and in the community.8
Therapy usually begins in the hospital and can continue in a number of possible settings, including in a skilled nursing facility, at home, in a school, and in an outpatient program at a clinic. Therapy can be brief or long-term, depending on the type of injury, and it may need to change over time. Rehabilitation generally involves a number of health care specialists, the person's family, and a person who manages the team.8 When devising a long-term treatment plan, patients, their families, and their providers should be aware that moderate and severe TBI impairs patients’ ability to make sound medical decisions even a month after injury.9
Types of rehabilitation therapy may include:
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