Connect
MJA
MJA

4: Rehabilitation after traumatic brain injury

Fary Khan, Ian J Baguley and Ian D Cameron
Med J Aust 2003; 178 (6): 290-295.

Summary

  • Traumatic brain injury (TBI) commonly affects younger people and causes life-long impairments in physical, cognitive, behavioural and social function. The cognitive, behavioural and personality deficits are usually more disabling than the residual physical deficits. Recovery from TBI can continue for at least 5 years after injury.

  • Rehabilitation is effective using an interdisciplinary approach, and close liaison with the patient, family and carers. The focus is on issues such as retraining in activities of daily living, pain management, cognitive and behavioural therapies, and pharmacological management.

  • The social burden of TBI is significant, and therefore family education and counselling, and support of patient and carers, is important.

  • General practitioners play an important role in providing ongoing support in the community, monitoring for medical complications, behavioural and personality issues, social reintegration, carer coping skills and return-to-work issues.

Please login with your free MJA account to view this article in full

  • Fary Khan1
  • Ian J Baguley2
  • Ian D Cameron3

  • 1 Department of Medicine, University of Melbourne, Melbourne, VIC.
  • 2 Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, NSW.
  • 3 Rehabilitation Studies Unit, University of Sydney, Ryde, NSW.

Correspondence: 

  • 1. US National Institutes of Health. Rehabilitation of persons with traumatic brain injury. NIH Consensus Statement 1998 Oct 26-28; 16(1): 1-41. Available at: http://consensus.nih.gov/cons/109/109_statement.htm (accessed Jan 2003).
  • 2. Rosenthal M, Griffith ER, Bond MR, et al. Rehabilitation of the adult and child with traumatic brain injury. 2nd ed. Philadelphia: FA Davis, 1990.
  • 3. Kay T, Harrington DE, Adams R, et al. Definition of mild traumatic brain injury. J Head Trauma Rehabil 1993; 8: 86-87.
  • 4. Fortune N, Wen X. The definition, incidence and prevalence of acquired brain injury in Australia. Canberra: Australian Institute of Health and Welfare, 1999. (Catalogue DIS 15.)
  • 5. Tate RL, MacDonald S, Lulham JM. Incidence of hospital treated traumatic brain injury in an Australian community. A N Z J Public Health 1998; 22: 419-423.
  • 6. Kraus JK, Black MA, Hessol N, et al. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol 1984; 119: 186-201.
  • 7. Bell KR, Sandell ME. Brain Injury rehabilitation. Post acute rehabilitation and community integration. Arch Phys Med Rehabil 1998; 79: S21-S25.
  • 8. Sandell ME, Bell KR, Michaud LJ. Brain injury rehabilitation. Traumatic brain injury, prevention, pathophysiology and outcome prediction. Arch Phys Med Rehabil 1998; 79: S3-S9.
  • 9. Olver JH, Ponsford JL, Curran CA. Outcome following traumatic brain injury: a comparison between 2 and 5 years after injury. Brain Injury 1996; 10: 841-848.
  • 10. Shores EA, Marosszeky JE, Sandanam J, et al. Preliminary validation of a clinical scale for measuring the duration of PTA. Med J Aust 1986; 144: 569-572.
  • 11. Katz DI. Neuropathology and neurobehavioural recovery from closed head injury. J Head Trauma Rehabil 1992; 7: 1-15.
  • 12. Horn LJ. Systems of care for the person with TBI. Phys Med Rehab Clin North Am 1992; 3: 475-492.
  • 13. Jennet B, Bond MR. Assessment of outcome after severe brain damage. Lancet 1975; 1: 480-484.
  • 14. Powell J, Heslin J, Greenwood R. Community based rehabilitation after severe traumatic brain injury: a randomised controlled trial. J Neurol Neurosurg Psychiatry. 2002; 72: 193-202.
  • 15. Schierhout G, Roberts I. Anti-epileptic drugs for preventing seizures following acute traumatic brain injury (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
  • 16. Chesnut RM, Carney N, Maynard H, et al. Rehabilitation for traumatic brain injury. Rockville, Md: Agency for Health Care Policy and Research. Evidence Report/Technology Assessment 2, 1999: 1-176. Available at: http://hstat.nlm.nih.gov/hq/Hquest/screen/DirectAccess/db/3309 (accessed February 2003).
  • 17. Stevens M. Post concussion syndrome. Framingham, Mass: National Head Injury Foundation, 1982. 82-001.
  • 18. Mateer CA, D'Arcy RCN. Current concepts and aproaches to management. In: Raskin SA, Mateer CA, editors. Neuropsychological management of mild traumatic brain injury. New York: Oxford University Press, 2000: 3-22.
  • 19. Ponsford JL, Willmott C, Rothwell A, et al. Factors influencing outcome following mild traumatic brain injury in adults. J Int Neuropsychol Soc 2000; 6: 568-579.
  • 20. Joseph AB, Wroblewski B. Depression, antidepressants and traumatic brain injury. J Head Trauma Rehabil 1995; 10: 90-95.
  • 21. Cockrell J. Paediatric brain injury rehabilitation. In: Horn LJ, Zasler ND, editors. Medical rehabilitation of traumatic brain injury. Philadelphia: Hanley and Belfus, 1996: 171-198.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.