33 - Traumatic brain injury

Summary

Introduction

It is regrettable that rehabilitation services for people with traumatic brain injury (TBI) are non-existent in many countries and sparse and fragmented in others. Some countries have developed high quality postacute rehabilitation facilities, particularly the USA, Canada, Australia, New Zealand and many parts of Western Europe. However, even in these countries there is little coordinated community-based support after discharge from the post-acute facility. There is an urgent need for the development of more comprehensive rehabilitation facilities which will support the individual, and the family, from injury to death.

This chapter will highlight the problems encountered after TBI and suggest clinical strategies and treatment methods by which many of these problems can be alleviated. It is important that this chapter is not read in isolation but is cross-referenced with other chapters in this textbook that are of relevance to the rehabilitation of people with TBI. In particular, the reader's attention is drawn to Volume I, Chapter 14 by Nudo and colleagues on Plasticity After Brain Lesions.

Many of the difficulties encountered by people after TBI are also covered in the chapters of this volume which concentrate on rehabilitation by symptoms and in particular Chapter 28, Neglect and Anosognosia; Chapter 29, Memory Dysfunction; and Chapter 30, Neurorehabilitation of Executive Function. The present chapter will not cover the rehabilitation of the comatose patient, as this is discussed in Chapter 22 of this volume.