Predicting the outcome of traumatic brain injury recovery can be difficult. While statistics can help give an overall picture, they are not always indicative of how any individual might fare.
Although it is not possible to predict every possible traumatic brain injury outcome, there are some objective measurements that doctors look at that can help people know what to expect.
Today you will learn what the statistics for brain injury recovery look like, and which factors can influence outcome. Then, we will also cover what you can do to promote the fullest TBI recovery possible.
Examining Some Brain Injury Recovery Statistics
According to the Glasgow Outcome Scale, a popular brain injury measurement scale, patients with mild brain injuries tend to have the best outcomes. They may experience subtle physical and cognitive changes, but these tend to fade as their brain heals.
On the other hand, those with moderate or severe TBIs are often less fortunate. Approximately 60% of moderate brain injury survivors will make a full and functional recovery, while the statistics for severe brain injury recovery are even lower.
For example, in one comprehensive study of 189 patients with a Glasgow Coma Scale score of 3 or less, only 13% achieved a good functional outcome after six months.
While these statistics can sound grim, please keep in mind two facts:
- These patients had one of the most severe brain injuries possible. A GCS score of 3 points means they had almost no brain activity whatsoever. The fact that 13% made a good recovery after having no function at all demonstrates that recovery is nearly always possible.
- The study only followed the patients for six months. Every person’s brain injury recovery journey is unique, and not everyone progresses at the same rate. It’s possible that those people who had not achieved a good recovery at the sixth-month mark achieved it after one year, or even five years.
In fact, in a separate study that followed severe TBI patients for four years, at the end of the study, 28% had achieved a good recovery, and 79% were living independently with only minimal assistance.
More TBI Statistics
Some statistics on severe brain injury recovery, however, reveal a more positive picture. For example, according to statistics gathered from the TBI Model System Program, at two years post-injury:
- 30% of moderate to severe brain injury patients need at least some assistance from another person. 70% live independently full time.
- Over 90% live in a private residence.
- 50% of patients learn how to drive after brain injury, though there may still be restrictions on driving at night or for long distances.
- 30% have a job, though it’s usually different from what they had before their injury.
In addition, there are also other factors that can help predict brain injury recovery. We’ll examine these in more detail below.
Factors that Influence Brain Injury Recovery Outcome
Statistics are not the only tools you can use to determine a brain injury patient’s chances of recovery. In fact, doctors have identified 5 variables that strongly influence a patient’s ultimate recovery:
1. Initial Glasgow Coma Score
The patient’s initial Glasgow Coma Score (GCS) upon arriving at the hospital is usually a good indicator of their ultimate outcome.
The GCS consists of 15 points total. The points measure various functions such as eye opening and verbal response. Based on the number of points, doctors will classify patients into four groups:
- Mild TBI: GCS score = 13-15 pts
- Moderate Disability: GCS score = 9-12 pts
- Severe Disability: GCS score = 4-8 pts.
- Persistent Vegetative State: GCS score = 3 pts.
The higher the points, the higher the level of function, which means a higher likelihood of a good outcome. Even with a low GCS score, however, it is still possible for the person to achieve a good recovery.
2. Duration of Post-Traumatic Amnesia
Another sign that points to a favorable outcome is a short period of post-traumatic amnesia.
Post-traumatic amnesia refers to the period after a brain injury when the brain can’t form any new short-term memories.
It is characterized by a state of confusion and disorientation regarding time, place, and person. In other words, the patient has no memory of where they are or how they got there, and they have no continuous memory of day-to-day events.
There are several studies that suggest that the longer post-traumatic amnesia lasts, the more severe a person’s disability after injury will be. However, these findings are not definitive.
3. Neurological Reflexes
The presence (or lack) of certain neurological reflexes is another factor that can determine brain injury recovery. Some neurological signs that doctors look for in TBI patients include:
- Pupillary reactivity. If the patient’s pupils shrink in response to bright light, then their brain stem is intact. This is an excellent sign.
- Oculocephalic response. When the person’s head is turned to the left, their eyes should turn the opposite direction, to the right.
- Eye deviation. Both pupils should look straight ahead. If one pupil is looking up and the other looking down, that is a sign of serious brain damage.
- Gag reflex. The person should gag or cough if a cotton swab or endotracheal tube is placed down their throat.
The presence of these reflexes is an excellent indicator of recovery. Unfortunately, if these reflexes are absent, the patient’s prognosis is grim. For example, in an analysis of data from over 50,000 severe brain injury patients, only 8% of those who displayed no pupil response went on to achieve a functional recovery.
With that said, the absence of these reflexes does not always indicate a poor outcome. Some patients with no initial brain stem reflexes do go on to make a functional recovery.
4. Arterial Hypotension
Low blood pressure after initial brain injury is another indicator of poor TBI outcome.
A systolic blood pressure of less than 90 mmHg measured on the way to the hospital has been associated with a 67% chance of a poor result.
Fortunately, hypotension can be treated almost immediately if it is caught early enough. This makes it the only prognostic factor that can be significantly changed, which can improve the patient’s outcome.
Finally, age can have a strong influence on whether and how well a person recovers from TBI.
In a study involving 244 brain injury patients, those between the ages of 20 and 30 had the most favorable outcomes. People over the age of 30 had more serious disabilities.
In general, people over 60 or under the age of two have the lowest chances of achieving a good recovery from brain injury.
How to Increase Your Chances of Making a Full Brain Injury Recovery
While not all the statistics on brain injury recovery are negative, it can still feel quite depressing to look at some of these facts.
This is why we argue that focusing on generalizations or percentages is ultimately counterproductive for brain injury recovery. Instead, it’s more productive to focus on maximizing your own recovery. The following are a few tips to help you accomplish this:
- Stay positive. Don’t look at yourself as just another statistic. This leads to limiting beliefs that prevent you from reaching your full potential. Staying positive, in contrast, can give you the motivation you need to persevere with treatment.
- Practice therapy at home. Your brain possesses a natural healing mechanism that allows it to rewire itself. And the best way to engage it is through daily therapy exercises. Therefore, make sure you exercise every day at home.
- Stimulate Your Brain. In addition to repetitive exercise, you should focus on stimulating your brain through activities such as puzzles, art, and music therapy. Stimulation increases the production of certain neurotrophic growth factors such as BDNF. These aid in the process of neurogenesis which helps your brain generate new nerve cells.
- Push through plateaus. After a while, you might notice your progress slowing down. Therapists call this a plateau, and it is a normal part of recovery. The key is to not give up when they occur and to keep exercising. Eventually, you will start improving again.
No matter how long it has been since your brain injury, it is always possible to improve your abilities. Following these steps can help boost your odds of making a fuller recovery from TBI.
Brain Injury Recovery Statistics: Conclusion
In the end, because every TBI is unique, it’s not possible to fully predict every outcome. While doctors try to be as accurate as possible, there are variables that they cannot always see.
Every day we hear stories of brain injury patients surprising their doctors with their achievements. And in every single case, these people were the ones who ignored negative predictions and persevered through overwhelming odds.
There’s no reason why this can’t be your story as well.
Featured Image: ©iStock/gorodenkoff