Recovery of function following severe traumatic brain injury: A retrospective 10-year follow-up

Abstract

It has been widely assumed that most of the recovery following severe traumatic brain injury (TBI) occurs within the first 6 months, and that virtually all of the recovery occurs within the first 1-2 years post-injury. In an effort to evaluate the long-term recovery of patients who had sustained severe TBI, we interviewed the relatives and significant others of 20 patients who had sustained TBI at least 5 years earlier, using a modified version of the Portland Adaptability Inventory. Retrospective ratings were collected to evaluate the patients' psychosocial, cognitive, physical, and emotional status prior to their injury, and at 1, 2, 5, and an average of 10.3 years post-injury. The results indicated that TBI patients exhibit significant improvements in their social, cognitive, physical, and emotional functioning after 2 years post-injury regardless of the severity of their initial brain trauma. These data suggest that patients who sustain severe TBI continue to make gradual improvements in their functioning for at least 10 years post-injury. Our findings contradict the widely held assumption that the recovery process ends after 1 or 2 years post-injury.

Spontaneous corticospinal axonal plasticity and functional recovery after adult central nervous system injury

“…Parallel with these changes, rodents recover on a skilled motor task that is sensitive to corticospinal function. Such sprouting may explain protracted improvement in function in many humans after lesions to the CNS (1)(2)(3)(4)(5).…”

“…Yet, spontaneous improvement in motor, sensory, or other neurological function occurs in 41% of patients who sustain spinal cord injuries (1,2) and in a large proportion of patients with strokes (3,4) and head trauma (5). Although some of this improvement seems to result from rapid resolution of diaschisis (transient disruption of electrical transmission) or from functional compensation (use of uninjured systems to compensate for injured pathways) (6,7), a significant proportion of functional recovery occurs over a more protracted time period of several weeks to months.…”

Time course of recovery following poor-grade SAH: the incidence of delayed improvement and implications for SAH outcome study design

“…36 Likewise, the greatest capacity for improvement after traumatic brain injury appears to occur in an early time window, typically 3-6 months following injury. 32 However, some studies have demonstrated the potential for cerebral plasticity to allow for delayed recovery in select patients. 1,32 The demographic, clinical, and genetic features underlying this capacity are not clear and have been the subject of several investigations.…”

“…32 However, some studies have demonstrated the potential for cerebral plasticity to allow for delayed recovery in select patients. 1,32 The demographic, clinical, and genetic features underlying this capacity are not clear and have been the subject of several investigations.…”

Mechanisms and Treatment of Progressive Damage After Traumatic Brain Injury

“…Himian head trauma frequently results in chronic disability [18,30,31,45,54,55] associated with long-lasting cognitive [18,30,31,46,54,55] and motor [31,54] problems. Persistence of functional deficits results in a poor prognosis for the head-injured patient population.…”