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Treatments for Traumatic Brain Injury: What They Are & How It Works

ER doctors with brain scans discussing treatments for traumatic brain injury and the aftermath

There are a variety of treatments for traumatic brain injury (TBI) that can help survivors boost recovery. However, treatment depends on many factors, such as the severity and location of the injury. Medical teams first assess the injury using a test or evaluation to determine the type of TBI and provide the necessary treatments, which may include surgery, medication, and/or rest.

After initial treatment, survivors may sustain lasting secondary effects of traumatic brain injury. To treat these effects, survivors engage in rehabilitation therapy to strengthen and restore functions that may have been affected.

This article will discuss how treatments for traumatic brain injury are determined, the brain’s ability to repair itself, and the most effective rehabilitation exercises to help improve function and promote recovery.

Finding the Right Treatment for Traumatic Brain Injury

A traumatic brain injury is a medical emergency that requires immediate urgent care. To properly treat a traumatic brain injury, assessments are performed by a medical team.

Usually the first step is a Computerized Tomography Scan, or CT Scan. This scan uses x-rays to visualize the brain and look for signs of traumatic brain injury including:

  • Fractures
  • Bleeding (hemorrhage)
  • Blood clots (hematomas)
  • Bruised tissue (contusions)
  • Brain swelling

The other test is the Magnetic Resonance Imaging, or MRI. Radio waves and magnets are used to obtain a detailed image of the brain. This test can help determine:

  • If an individual is stable
  • If symptoms have improved or worsened
  • If further treatment is required

Along with a CT scan and/or MRI, a neurological exam may be performed on individuals to test for many abilities including: 

  • Motor skills
  • Sensory skills
  • Hearing and speech
  • Coordination and balance
  • Mood and behavior

The Glasgow Coma Scale (GCS) is another tool used to guide early treatment of individuals with a traumatic brain injury. The GSC measures the level of an individual’s consciousness based on:

  • Eye-opening to appropriate stimuli
  • Motor responsiveness
  • Verbal performance

To determine the severity of a head injury, the GCS uses a 15-point scale where a score of 13 to 15 is a mild injury, 9 to 12 is a moderate injury, and 8 or less is a severe injury.

Additionally, standardized instruments may be used for initial evaluation of mild brain injuries such as the Acute Concussion Evaluation (ACE). This provides the medical team with information and characteristics of the injury, as well as any physical, cognitive, or emotional issues that may occur. This can include:

  • Presence of amnesia (memory loss)
  • Seizures
  • Sleep-related symptoms

The ACE can also be used as a symptom tracker during recovery, taking into account risk factors that can impact how long survivors will take to recover.

How Is Traumatic Brain Injury Initially Treated?

The primary focus of emergency care is to stabilize the individual by ensuring the brain gets sufficient oxygen, controlling blood and brain pressure, and preventing further injury or complications.

For moderate to severe brain injury surgery may be needed, especially if there is intracranial pressure or bleeding that causes swollen tissue to push up against the skull. Surgery is performed to relieve intracranial pressure by removing blood clots, placing an external ventricular drain, or removing a section of the skull to allow the brain to swell without injury to its delicate tissues, or repairing skull fractures to help reduce further damage to the brain. Types of TBI that most often require surgery are subarachnoid hemorrhages, hematomas, or penetrating traumatic brain injuries. 

Steroids are another type of treatment that may be used to reduce swelling in TBIs like diffuse axonal injuries (DAI). Diffuse axonal injuries result in microscopic tears that can be hard to detect on an MRI. DAIs are one of the most severe types of TBI.

Milder brain injuries, including concussions, usually involve non-surgical treatment which can consist of rest, rehabilitation therapy, or medication. Some medications may be administered immediately after an injury to prevent further injury and lower risks of infection. These can include: anticoagulants, anticonvulsants, or diuretics. Other medication may be given later to help treat the secondary effects of traumatic brain injury. These can include antidepressants, muscle relaxants, and stimulants.

The Importance of Neuroplasticity During TBI Recovery

Initial treatment after a traumatic brain injury focuses on stabilizing the survivor. After this initial stage, survivors progress to the next stage of care: TBI recovery treatments.

One of, if not the most, essential elements for recovery after TBI is neuroplasticity. When the brain sustains trauma, neural pathways may become damaged causing survivors to experience various effects, such as impaired movement. 

Fortunately, neuroplasticity allows the brain to rewire itself, strengthen existing pathways, and create new ones to restore these functions. Thus, it’s important to activate neuroplasticity as much as possible during your TBI recovery treatment.

Neuroplasticity is best activated through high repetition, or massed practice. This can include a variety of rehabilitation exercises, both physical and cognitive exercises. It’s imperative to work with a physical therapist, occupational therapist, or speech-language pathologist to receive a suitable rehabilitation plan for your ability level.

How Is Traumatic Brain Injury Treated During the Aftermath?

Every brain injury is different, therefore survivors may experience different secondary effects of TBI. Still, no matter the effects or severity of the injury, engaging in rehabilitation therapy is crucial. Therapy is the best way to activate neuroplasticity, restore function, and promote recovery.

Recovery treatments for traumatic brain injury survivors may include a variety of rehabilitative exercises, such as:

Physical Therapy Exercises

TBI survivors may experience difficulty with motor functions such as movement and coordination, especially after damage to the primary motor cortex, cerebellum, or frontal lobe

Fortunately, physical therapy can help survivors improve mobility by utilizing various techniques that target the affected muscles. The primary goal of physical therapy interventions for traumatic brain injury is to retrain movement patterns. Physical therapy exercises can also help survivors rebuild coordination, strengthen muscles, and restore function. 

However, to recover motor control after a brain injury, survivors must engage in high repetition targeted exercises. For this reason, your physical therapist will encourage high-repetition by having you practice the same exercise consistently. The more you practice, the more neuroplasticity is activated, and the more movement restored.

Home Therapy Devices

Gamified neurorehabilitation devices are a great way to stay engaged in physical therapy in between sessions with your therapist. FitMi, for example, is a neurorehab device that provides full-body exercises tailored to your level of ability. Additionally, MusicGlove is a hand therapy device that helps improve fine motor skills through a fun, musical game. 

Both devices have the flexibility to be used from the comfort of your own home and are highly engaging, which enables you to achieve higher repetitions of movements.  This is what will stimulate your brain and activate neuroplasticity.

Occupational Therapy

Occupational therapy uses meaningful activity to facilitate rehabilitation since activities that are meaningful to the survivor will be repeated more often and therefore stimulate neuroplasticity better.  Let your OT know what activities you want to be able to do, and they can tailor their treatment to your interests. Often in the clinical environment, TBI occupational therapy exercises include activities of daily living such as dressing, bathing, and eating. Your occupational therapist will provide a creative rehabilitation plan with the most suitable exercises for you.

Speech Therapy

Speech-Language Pathologists, or speech therapists, also play an essential role in the rehabilitation process. For instance, if the areas of the brain responsible for speech and language were impacted, survivors may experience aphasia (difficulty with language), apraxia (difficulty with speech), or dysarthria (slurred speech). SLPs can provide numerous speech therapy exercises suitable for you. 

Cognitive Rehabilitation Exercises

After a TBI, survivors may also experience difficulty with cognitive functions such as attention, problem-solving, and executive function skills. Fortunately, there are many cognitive exercises for TBI survivors that can help activate neuroplasticity and improve cognitive function. And while their name may imply otherwise, SLPs can help survivors improve many functions aside from speech and language including executive dysfunction after brain injury.

Along with working with a Speech-Language Pathologist, you can use cognitive exercise apps, such as the CT Speech and Cognitive Therapy App to keep yourself motivated and engaged in consistent therapy. The app provides access to over 100,000+ cognitive rehabilitation exercises that help improve speech, memory, and critical thinking skills. The more consistently you practice, the sharper your skills will become.

Participating in rehabilitation therapy is the best way to treat the after effects of a TBI and maximize recovery. Whatever function you wish to improve, a physical therapist, occupational therapist, or speech-language pathologist can help you get there.

Understanding Treatments for Traumatic Brain Injury Survivors

Treatments for traumatic brain injury depend on various factors including the severity and location of the injury. Your medical team will first assess and diagnose a TBI in order to provide proper treatment. For moderate to severe injuries, emergency care such as surgery, may be needed. In milder cases, doctors may prescribe medication or suggest getting sufficient rest for the brain to heal. 

After stabilization, TBI survivors may experience a variety of secondary effects.  To treat these effects, survivors must engage in rehabilitation to activate neuroplasticity through massed practice of therapeutic exercises. Gamified neurorehabilitation devices, like FitMi and MusicGlove, are also great ways to stay engaged and get more repetitions while having fun in between therapy sessions. 

We hope this article helped you understand treatments for traumatic brain injury and the importance of rehabilitation thereafter. With enough practice and consistency over time, you can restore function and maximize independence.

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