NormanNORMAN — specialised neurological rehabilitation for 30 years.

Rehabilitation after traumatic brain injury

Specialised rehabilitation for patients recovering from a traumatic brain injury.

Book a rehabilitation stayCentre Director+48 603 201 757Stay Coordinator+48 530 490 600

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Specialised rehabilitation for patients recovering from a traumatic brain injury

Traumatic brain injuries can lead to a wide range of motor, cognitive and speech deficits. We always tailor the rehabilitation programme to the type of injury, your current functional status and your most important needs.

Traumatic brain injuries (TBI) are a serious health problem worldwide, affecting people of all ages. They are injuries to the brain caused by external mechanical forces, which can lead to temporary or permanent neurological dysfunction. These injuries can be classified as closed, where there is no break in the continuity of the skull bones, or open, where the skin, soft tissues and skull bones are damaged, exposing the brain. The effects of traumatic brain injuries can vary widely, from mild symptoms such as headaches and dizziness, through to serious ones, including loss of consciousness, amnesia and permanent brain damage leading to deficits in motor and cognitive function.

Our specialised rehabilitation programme is designed for precisely those patients who have developed various functional and cognitive limitations as a result of a traumatic brain injury.

Rehabilitation after a traumatic brain injury is a key part of the treatment process, aimed at restoring — as far as possible — the functions lost as a result of the injury, improving patients’ quality of life and supporting their return to social life.

The deficits that arise from brain damage differ from person to person, depending on the nature and severity of the damage. At the NORMAN Neurological Rehabilitation Centre we focus mainly on the rehabilitation of:

  • motor function disorders (paresis, paralysis, ataxia, apraxia, involuntary movements, tremors)
  • sensory disorders (loss of sensation, reduced sensation, paraesthesia)
  • speech and language disorders (aphasia, dysarthria, dysphagia, dysphonia, mutism)
  • balance and gait disorders
  • disorders affecting the lower and upper limbs
  • spasticity disorders

All of the deficits described above that arise from a traumatic brain injury require specialised neurological rehabilitation in a facility that is equipped to care for such patients.

At the NORMAN Neurological Rehabilitation Centre we rehabilitate patients with dysfunctions caused by brain damage every day, including those recovering from traumatic brain injuries. A traumatic brain injury often results not only in motor deficits, but also cognitive and emotional ones. As a result, there is a need for personalised therapy dedicated to each individual patient.

Comprehensive rehabilitation — combining specialised neurological rehabilitation focused on restoring hand and upper limb function, gait and balance re-education, as well as speech and swallowing therapy in cases of aphasia, dysphagia and dysarthria — is a key element in enabling patients to improve their quality of life and reintegrate with their family and society.

Classification of traumatic brain injuries

Traumatic brain injuries (TBI) are a serious medical problem and can be classified in various ways, depending on the mechanism of injury, its severity and its effects on the patient’s health. The main categories and severity assessment scales are set out below.

Closed and open injuries

  • closed (non-penetrating) injuries: these are injuries in which the continuity of the skull is not broken. The brain is damaged by the force of the impact or a shock wave, but the skin and skull bones remain intact. Examples include concussion and brain contusion;
  • open (penetrating) injuries: in this case the continuity of the skull is broken, and often the meninges and the brain itself as well. These are injuries caused by penetrating objects such as bullets or metal fragments, but they can also result from severe accidents in which fragments of the skull penetrate the brain.

Injury severity assessment scales

  • Glasgow Coma Scale (GCS): this is the most widely used scale for assessing a patient’s level of consciousness and neurological responses after a head injury. The assessment is based on three categories: eye opening, verbal response and motor response. The total score ranges from 3 (deep unconsciousness) to 15 points (full consciousness);
  • Brain Injury Severity Scale: used in conjunction with the GCS, this scale helps to determine the severity of a brain injury on the basis of medical imaging and other clinical investigations;
  • Abbreviated Injury Scale (AIS): this is an injury severity scoring system that classifies injuries to each part of the body on a six-point scale from 0 (no injury) to 6 (fatal injury);
  • Injury Severity Score (ISS): this is an overall assessment of injury severity that sums up the severity of injuries across different regions of the body. A score above 15 is considered a serious injury.

Injury mechanisms

  • Direct injuries occur when the head is struck by an object or strikes an object with considerable force. A direct mechanism is characterised by localised damage at the point of impact. Examples include striking the head against a steering wheel during a car accident or falling onto the head. Direct injuries can lead to skull fractures, brain contusions, haematomas and soft tissue damage.
  • Indirect injuries, also known as inertial injuries, occur without a direct blow to the head. They result from rapid acceleration or deceleration, which can lead to the stretching and tearing of brain structures and blood vessels. An example is the “coup-contrecoup” injury, where the brain strikes the inner surface of the skull on the side opposite to the point of impact.
  • children – head injuries in children often result from falls, especially in the youngest, who are learning to walk. At an older age, injuries may be associated with sporting activities and cycling accidents;
  • adults – in this age group injuries are often the result of road accidents, falls from height and sports injuries. Car accidents are particularly dangerous because of the high energy of the collision;
  • older people – in this group falls predominate as the main mechanism of injury, often as a result of poorer coordination, balance problems and general frailty. Head injuries in older people can lead to more serious health consequences, including subdural haematomas.

Clinical symptoms of traumatic brain injuries

  • changes in level of consciousness – these can range from mild dazedness to deep unconsciousness;
  • headaches – often intense and difficult to relieve;
  • memory disturbances – particularly difficulty remembering new information;
  • dizziness and nausea – these may be accompanied by vomiting;
  • visual disturbances – double vision, blurred vision;
  • balance and coordination disturbances;
  • speech disturbances – difficulty forming sentences or understanding speech;
  • behavioural disturbances – personality changes, aggression, apathy;
  • neurological symptoms – such as numbness, paraesthesia, partial or complete paralysis;

Diagnostic methods

Diagnosing traumatic brain injuries requires an integrated approach, combining a thorough medical history, clinical assessment and imaging investigations. Rapid and precise diagnosis is crucial for planning appropriate treatment and minimising the long-term consequences of the injury.

Early and accurate classification and assessment of the severity of a traumatic brain injury are crucial for planning appropriate treatment and rehabilitation, and also have a significant influence on predicting the patient’s treatment outcomes.

Diagnosis of traumatic brain injuries is based on several key methods:

  • computed tomography (CT): this is the principal investigation in the diagnosis of traumatic brain injuries, particularly where haematomas, skull fractures or brain swelling are suspected. CT allows for a rapid assessment of the patient’s condition and is often carried out in emergencies;
  • magnetic resonance imaging (MRI): MRI is a more detailed investigation than CT and allows for a better assessment of brain tissue damage, including diffuse axonal injury, microscopic bleeding and damage within the brainstem;
  • electroencephalography (EEG): this is used to assess the electrical activity of the brain. It can be helpful in diagnosing disorders of consciousness, and also in detecting epileptic seizures, which may occur after a head injury;
  • additional investigations: these may include blood tests, assessment of vital signs and other imaging investigations, such as angiography, in order to assess the condition of the blood vessels of the brain.

General principles of rehabilitation after traumatic brain injuries

Rehabilitation after a traumatic brain injury is a complex and lengthy process, often requiring ongoing support throughout the patient’s life. Because of the wide-ranging impact of the injury on the functioning of the whole body, rehabilitation should begin as early as possible and be tailored to the individual needs of the patient.

Goals of rehabilitation

  • The main goal of rehabilitation after a traumatic brain injury is to restore, as fully as possible, the patient’s vital functions, which may have been limited as a result of the injury.
  • Working towards regaining the greatest possible independence in everyday activities, improving motor and psychological function, as well as reducing dysfunctions such as paresis, paralysis or speech disturbances, is key to improving the injured person’s quality of life.

Stages of rehabilitation

  • Rehabilitation in the acute phase of the condition: this begins almost immediately after the injury, focusing on preventing complications arising from prolonged immobility, such as pressure sores or contractures;
  • Regenerative and compensatory rehabilitation: continuation of passive exercises, the introduction of simple active exercises and work on restoring psychomotor ability;
  • Rehabilitation in the chronic phase of the condition: long-term rehabilitation aimed at maintaining and improving the results achieved.

Interdisciplinary rehabilitation team

  • Effective rehabilitation requires the involvement of an interdisciplinary team of specialists, comprising doctors from various specialities (neurologists, internal medicine physicians), physiotherapists, neuropsychologists, speech therapists and occupational therapists.
  • Each member of the team plays a key role in the recovery process, providing the patient with specialised care and support at every stage of rehabilitation.

Rehabilitation

  • In patients recovering from a traumatic brain injury, it is the brain that has been damaged. Consequently, in order to restore lost functions, neurological rehabilitation is required.
  • The techniques and procedures used with patients recovering from a traumatic brain injury should always be adapted after physically assessing the individual patient’s functional status, as well as their medical records.
  • The best results in terms of the appropriateness of the treatment applied are achieved when the decision is made by a team of specialists experienced in the various aspects of therapeutic management.

Patient story

The story of a patient after a severe traumatic brain injury

Traumatic brain injury — he saved others, now he needs help himself

Traumatic brain injury — he saved others, now he needs help himself

Regaining function after a severe traumatic brain injury

5:15

Support for patients and their families

Support for patients recovering from traumatic brain injuries and for their families is crucial to the rehabilitation process. In such sudden situations, immediate access to knowledge is needed to help take the right steps once a loved one returns home into the care of the family. We have gathered practical information together in our compendium of knowledge about traumatic brain injuries for families.

Uncertainty about what lies ahead and about how effective the treatment will be places an enormous emotional burden on the patient’s family. This is where other families — those further along in the treatment and rehabilitation process — can offer support. It is worth reaching out to such people through various kinds of support groups, for example on Facebook. Learning from the experience of others can be valuable and can help you avoid many poor choices in the course of care outside hospital.

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Norman ŁozińskiCentre Director+48 603 201 757Sebastian LeweStay Coordinator+48 530 490 600kontakt@normanrehabilitacja.pl

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