A Look at How the Human Brain Recovers After Traumatic Injury

The human brain is a remarkable organism. Not only does it have the capacity to innovate, create, and control, but it also has the incredible ability to recover from injury. While thousands of people who suffer traumatic brain injury (TBI) each year never make a full recovery, many are able to regain some semblance of their former lives. When you think about it, that’s an incredible testament to just how quickly science has advanced and how resilient the human brain is.

Understanding TBI

TBI officially refers to damage to the brain caused by some sort of external physical force. Common causes include car accidents, falls, gunshot wounds, or contact in physical sports like football and basketball. Whereas internal issues like strokes and tumors cause brain damage, they can’t cause traumatic brain injury. TBI is specifically the result of external force.

While the majority of people lose consciousness during a TBI, it is possible for the individual to remain aware throughout the injury. For example, there have been cases where gunshot wounds penetrated the head and the victim never lost awareness.

When doctors diagnose a patient with TBI, they follow the commonly accepted criteria known as the TBI Model Systems (TBIMS). Under this system, the individual must have damaged brain tissue caused by an external force, and at least one of the following:

• Inability to recall the traumatic event (amnesia)
• A loss of consciousness (as documented by someone else)
• A skull fracture, abnormal brain scan, or post-traumatic seizure

According to available data for the United States, TBI is the leading cause of disability and death in people ages 1 to 44. Each year, more than 52,000 deaths occur from TBI and an estimated two percent of the U.S. population currently lives with disabilities that resulted from TBI. Males are twice as likely to experience a TBI and approximately 1.6 million to 3.8 million sports-related TBIs occur on an annual basis.

The Stages of Recovery

The road to recovery is a long one for TBI patients, but it’s incredible to see how some individuals are able regain functionality and memory in a relatively short period of time. There are generally considered four stages of recovery, and each is a living, breathing testament to the remarkability of the human brain.

• Coma. During this initial stage, the patient is stabilized, yet unaware and unresponsive. At this point, TBI patients are unable to speak, open their eyes, or follow commands. Gradually, recovering patients will be able to open their eyes or show signs of a sleep cycle.

• Vegetative state. During the vegetative stage, the patient may open their eyes, but they’re still considered unconscious. They are unaware of their surroundings – even if there appear to be reflexes to those surroundings.

• Minimally conscious state. During this stage, the patient is able to demonstrate some awareness and responsiveness to their surroundings. Responses are inconsistent, though. Occasionally the patient will show emotion or be able to vocalize requests.

• Recovery of consciousness. Finally, if the patient is recovering well, they’ll regain consciousness. This is where rehabilitation begins.

Advancements in Healthcare and Technology

Thanks to advances in healthcare and technology, patients who are able to regain consciousness after a TBI face a better chance than ever of regaining functionality. This takes place through acute, post-acute, and sub-acute rehabilitation, outpatient therapy, and community re-entry programs in which the patient regains some level of cognitive, social, and motor skills.

One of the most incredible things we’ve learned about the human brain over the last few decades is that brain areas actually shrivel away if not used. As a result, rehabilitation strategies have become much more intensive. It’s essentially a “use it or lose it” situation. For example, if you don’t use your left arm, that part of the brain corresponding to its usage will deteriorate and ultimately be rendered useless.

“That’s why rehabilitation to relearn how to move limbs and speak again is so important,” says CNN reporter Elizabeth Landua. Thankfully, science has enhanced the rehabilitation process and many patients are able to regain at least part of the freedoms they enjoyed prior to experiencing a traumatic brain injury. It will be interesting to see how science continues to progress in terms of understanding the brain, and how that translates to better healthcare for the millions of patients affected by horrible TBI tragedies.