Brain injury rehabilitation and recovery

Brain injuries fall under the broad umbrella of Acquired Brain Injury (ABI), which refers to any damage to the brain occurring after birth that is not hereditary, congenital, or degenerative.

Acquired Brain Injuries are divided into two main categories: Traumatic Brain Injury (TBI) and Non-Traumatic Brain Injury (NTBI).

There are two ways in which Traumatic Brain Injuries (TBIs) can occur:

1. Closed Brain Injury: This occurs when there is a non-penetrating injury to the brain with no break in the skull. A closed brain injury is caused by a fast forward or backward movement and shaking of the brain inside the skull. This causes bruising and tearing of brain tissue and blood vessels. Closed brain injuries are often the result of car accidents, falls, or contact sports.
2. Penetrating or Open Head Injury: This happens when there is a break in the skull such as when a bullet, blunt object, or a piece of shrapnel pierces the brain.

Non-Traumatic Brain Injuries (NTBIs) occur due to internal biological mechanisms rather than an external physical impact, including: 

• Anoxic & Hypoxic Brain Injury:
  • Anoxic: Complete lack of oxygen supply to the brain, leading to cell death within minutes (i.e., cardiac arrest, near-drowning, severe respiratory failure).
  • Hypoxic: Partial disruption or reduced supply of oxygen reaching the brain tissue.
• Vascular / Cerebrovascular Injuries:
  • Hemorrhagic Stroke: Caused by a ruptured blood vessel inside or around the brain (such as an aneurysm or arteriovenous malformation), leading to localized bleeding and increased intracranial pressure.
  • Ischemic Stroke: Occurs when a blood clot blocks or restricts an artery supplying blood to a portion of the brain.
• Toxic & Metabolic Brain Injury (Encephalopathy): Damage caused by exposure to harmful external chemicals (i.e., carbon monoxide poisoning, lead toxicity) or severe internal metabolic imbalances such as hepatic encephalopathy or acute hypoglycemia.
• Infectious / Inflammatory Conditions: Infections that cause severe inflammation of brain structures or surrounding tissue, such as Meningitis (inflammation of the membranes covering the brain) or Encephalitis (direct inflammation of the brain tissue itself).
• Oncological (Brain Tumors): Primary or metastatic tumors that compress surrounding brain tissue, disrupt blood flow, or cause localized edema.

Common brain injury symptoms include: 

• Blurred vision
• Body weakness or fatigue
• Confusion or memory problems
• Difficulty with noise/light
• Headaches
• Loss of consciousness
• Heightened emotions
• Overwhelmed easily
• Trouble speaking (aphasia)
• Vomiting

It is critical that if you are currently determining whether or not you or someone close to you has experienced a traumatic or non-traumatic brain injury that you call 911 immediately.

Brain injury therapies at Sheltering Arms Institute seek to improve: 

• Physical functioning
• Mobility
• Activities of daily living
• Behavior
• Psychosocial and emotional well-being
• Speech, swallowing, and cognitive functioning

Each person’s schedule and services vary based on individual needs; however, all patients participating in inpatient rehabilitation can expect a minimum of 3 hours of intensive therapy each day. Individual schedules vary based on each patient’s care plan and level of injury.

It is helpful to ask how many patients with brain injury the center sees per year, if they have a dedicated brain injury program, and what percentage of patients discharge home. It is also beneficial to know what technology the rehab facility has available to assist in post-brain injury recovery. Sometimes eligibility depends on your insurance, so it is important to contact your insurance provider to learn what they cover.

For more information, download our guide on How to Choose a Physical Rehabilitation Provider.

Physical rehabilitation is a team effort rooted in interdisciplinary communication and coordination. At Sheltering Arms Institute, inpatient brain injury physical rehab teams are led by a physical medicine and rehabilitation (PM&R) physician and also include:

• Physical therapists focus on walking, balance, and coordination to help patients achieve maximum mobility and independence and improve major physical and sensory deficits.
• Occupational therapists help with upper-extremity recovery and daily activity skills such as bathing, toileting, and eating.
• Rehabilitation nurses coordinate medical support needs throughout physical rehab.
• Speech-language pathologists help with speech and language skills as well as swallowing disorders.
• Recreation therapists help adapt activities previously enjoyed pre-brain injury or introduce new activities to enjoy moving forward.
• Rehab psychologists can help manage and adjust to the emotional and life changes a brain injury may bring.
• Care managers help with discharge planning and arranging follow-up care.