Traumatic Brain Injury Rehabilitation

Traumatic Brain Injury (TBI) Diagnosis

TBI is diagnosed when a person experiences a traumatic blow, impact, whiplash, or puncture to the head. Depending on your particular injury, your doctor will diagnose you with mild, moderate, or severe TBI.

High impact sports are notorious for TBI injuries. Over the last decade, football players, in particular, have received a lot of attention after a string of domestic violence incidents, personality changes, memory issues, and suicides.

Postmortem forensic autopsies of these players over the years revealed that 110 out of 111 had suffered brain damage patterns consistent with Chronic Traumatic Encephalopathy (CTE). This condition develops after years of repeated TBI injuries.

Time Magazine reported in 2017 that a large study found that 87% of all former football players showed signs of CTE.

Mild TBI

The majority of our patients are diagnosed with mild TBI. This condition results from a light impact or blow to the head, and can resolve on its own. One example of a mild TBI would be a blow to the head where the patient may lose consciousness or have mild brain swelling in response to the injury.

Your doctor will ask you lots of questions about your symptoms to arrive at a diagnosis of "mild TBI." Symptoms may include headache, feeling confused, hearing a ringing sound in the ears, blurry vision, an unpleasant taste in the mouth, or a number of other warning signs.

If you play sports, you may have experienced multiple TBI injuries. Each time that a new TBI occurs, your doctor will ask you about your history with prior TBI injuries and look for changes in the brain that may point to permanent brain damage. Over time, repeated TBI events can lead to impairment in one of more areas.

Moderate TBI

A moderate TBI is usually diagnosed after a head injury that results in a period of unconsciousness along with moderate brain swelling. This diagnosis is given when a person suffers more serious symptoms than with mild TBI. These complications can be quite serious and may result in moderate brain damage after the injury.

Many people with moderate TBI experience more serious symptoms in the early phases after the injury occurs. After brain swelling is reduced, some side effects can subside to a certain extent.

Your doctor will keep a close eye on your symptoms, take brain scan images, and measure your cranial pressure (if you have serious brain swelling) to monitor your injury. These tests help to detect fluctuations in cranial pressure and to observe any physical changes in your brain tissue.

With moderate TBI, you may experience some or all of the symptoms that come with mild TBI. However, with a moderate injury, those symptoms will be more intense. You can experience serious symptoms such as uncontrollable vomiting, seizures, pupil changes in the eye(s), an inability to speak clearly, neurological symptoms, and cognitive changes to the way you think and behave.

Moderate TBI can result in impairment to cognitive function, neurologic function, and coordination. Traumatic brain injury rehabilitation can be done to lessen these effects and help a person regain some or all of their functionality. A number of specialized therapies, technologies, medications, and cutting-edge solutions can be used as a multi-faceted approach to recovery.

Rehab focuses on improving your specific symptoms to reduce impairment. The goal of traumatic brain injury rehabilitation is to give you the best chance at achieving a satisfactory level of physical, cognitive, and neurologic function.

Severe TBI

A severe TBI can include symptoms of both mild and moderate TBI, but with extreme impairment. Severe TBI injuries can result in an extended coma (unconsciousness) and permanent disability. Oftentimes, people with severe TBI need to learn how to walk again, speak, and perform coordinated motor movements.

This type of intense rehabilitation can help you regain some functions. The rehab process usually takes many months, if not years, of continual and ongoing efforts to help the brain regain some of its functionality.

Testing for an Accurate TBI Diagnosis

TBI is a serious injury, whether it is mild, moderate, or severe. As soon as you suffer a head injury, it is important to seek immediate medical attention at an emergency room or from your primary care doctor. There are a number of diagnostic tests that can be done to see if you have the mild, moderate, or severe type.

One of the most critical aspects of diagnosis is a clinical interview that your doctor will conduct to assess your symptoms and their severity. Your doctor will ask you how your injury occurred, what you experienced directly afterward, and what symptoms you still have.

It is very important to have someone else with you to help your doctor obtain this information. Oftentimes, someone with TBI experiences confusion and memory loss in the minutes and hours after injury.

Neurological Tests

• Your doctor will check for neurological symptoms such as slurred speech, weakness in your limbs, or diminished sensation. Other neurologic symptoms may include a loss of reflexes or motor coordination.
• Your doctor can assess for weakness by having you resist against his or her arm.
• You may also be asked to perform fine motor skill tasks such as pointing to a specific target point, grasping an object, or moving an object from one place to the other.
• Diagnostic testing will include assessing you for memory loss, ability to think clearly, and general cognitive (thinking) function.

Images of Your Brain

• Brain scan images will help your doctor visually see what is going on in your head. This can be done using magnetic resonance imaging (MRI) or computerized tomography (CT scan).
• These images allow for a detailed view of your brain including the location and extent of damage, structural changes to the brain, and how much swelling you have.

Causes of Traumatic Brain Injury (TBI)

As mentioned earlier, one of the most common ways that a TBI can happen is from an impact to the head resulting from a sports injury. However, TBI can also happen for a number of other reasons. A closed TBI injury is one that occurs without the skull being penetrated by an object or piece of bone.

Closed TBI injuries can include:

• Falls resulting in head trauma. This type of TBI happens most often in older adults who may have trouble keeping their balance. Within the home, the most common area where this type of fall occurs is in the shower or bathroom.
• In teenagers and people in their 20’s, car accidents are the most common reason for a TBI injury. During a crash, the head can suffer a blow from the steering wheel, windshield, car frame, or back of the seat. The sheer velocity of an accident and the sudden stop can cause the brain to hit the front or back of the skull, resulting in brain damage, bleeding, and swelling.
• Violent attacks and domestic violence incidents are another cause of TBI. Any assault with an object (including a body part) can result in a head injury. The degree of damage depends on how hard the skull is hit.
• In young children, the most common cause for traumatic brain injury is physical child abuse by a caregiver.
• Military veterans of war can also experience TBI from a bomb explosion or blast. Before medicine had solid knowledge about TBI, this condition was commonly referred to as “shell shock.”

Open or penetrating TBI injuries:

• An open TBI injury is one that occurs after penetration of the skull into the brain cavity. This can occur from a violent attack such as being hit with a metal tool, stabbed with a knife, or hit with a heavy object.
• People can also experience a penetrating TBI after being shot or having shrapnel enter the skull. In large cities, these types of injuries are more common than in rural areas.
• Veterans also experience penetrating TBI injuries at a much higher rate than the average population. This is due to war-related gun violence, improvised explosive devices, and exposure to other weaponry.

Traumatic Brain Injury Rehabilitation

TBI rehabilitation refers to treatments that focus on recovering from a brain injury. At Pacific Pain & Wellness Group we offer rehabilitation services that can help you regain some of your lost functionality.

A serious TBI injury can result in problems with thinking and memory, mood and behavioral and emotional changes, and loss of neurological or physical function. Our team of medical providers offers a full spectrum of rehab services view your recovery from a holistic point of view.

Physical Therapy

Physical therapy is one of the most helpful treatments to help you recover from TBI. In physical therapy, you will work on improving muscle strength and regaining fine and gross motor skills so that you can be as independent as possible.

Speech Therapy

If you have suffered a traumatic brain injury that has affected your speech, a speech therapist can help you relearn how to speak clearly. They will also help the language center in your brain to more effectively send signals to your lips and tongue.

If you have impaired swallowing function as a result of your injury, a speech therapist can also help you relearn how to eat, drink, and swallow. With time, this can eliminate the need for a feeding tube.

Occupational & Cognitive Therapy

Occupational therapy can restore your independence and ability to take care of yourself by teaching you how to get dressed, get around your home safely, prepare meals, bathe, and do other tasks related to independent living. Even if you require some level of assistance in your home, occupational therapy can help you do more tasks for yourself.

Cognitive therapy can help you regain cognitive function in areas such as decision-making, insight, short-term and long-term memory, focus and concentration, staying organized, and regaining knowledge that was lost.

Mental Health Counseling

Seeing a therapist with experience in treating TBI can help you feel understood and give you a place to learn how to cope with stressors and changes to your life. TBI can result in personality changes that can increase conflict in personal relationships and/or posttraumatic stress disorder (PTSD). Individual counseling can help with this, and we also offer couple and family counseling if desired.

For some people with severe psychological impairment from TBI, counseling can help manage newly acquired mental health disorders such as anxiety, depression, and posttraumatic stress disorder.

Our therapists use evidence-based treatments, such as cognitive behavioral therapy (CBT), to help you identify unhelpful thoughts, make adjustments accordingly, and to feel better, both emotionally and psychologically.

Our clinic provides group therapy options to help you connect with others who are also recovering from TBI. Having social and emotional support can go a long way toward helping you recover.

We offer a number of interventions that directly involve processing the trauma related to the specific incident that caused your injury. Our mental health providers are highly attuned to identifying trauma and providing evidence-based treatments that lessen the effects.

Advanced Treatments for PTSD, Anxiety, and Depression

At Pacific Pain & Wellness Group, we understand that the aforementioned treatment options may work better for some than for others. We offer a variety of advanced and innovative treatments that can help you overcome debilitating symptoms when standard treatments have failed.

Transcranial Magnetic Stimulation (TMS) for TBI

One such treatment is transcranial magnetic stimulation (TMS), which uses magnets to create a magnetic field to penetrate the brain. When this energy is directed toward the prefrontal cortex of the brain, it can relieve depression that has not responded to other treatments. A six-week series of five treatments a week is required to achieve optimal results.  

 TMS can be offered when the following treatments do not work:

• Antidepressants
• Psychotherapy
• Electroconvulsive Therapy (ECT)

Ketamine Infusions for TBI

Ketamine infusion is another option we can use for treatment-resistant depression, PTSD, and suicidal thoughts. Ketamine is delivered through a vein in the arm, and directly affects the neurons in the brain responsible for thought and mood regulation.

This medication is appropriate for patients who do not have psychosis and have not responded to standard medications. About six initial infusions are prescribed with booster infusions scheduled periodically to maintain symptom relief.

Traumatic Brain Injury (TBI) Rehabilitation in Torrance

At Pacific Pain & Wellness Group in Torrance, we care about you as much as you do. Our goal is to help you feel better so you can live better. Our team of expert doctors specialize in both standard and advanced treatment options for recovery.

No matter how your injury happened or is affecting you, Dr. Mohan Nair and our team are waiting for your call. We can help you with your personal injury case, treatment of chronic physical pain, and symptoms of PTSD, anxiety, or depression.

Contact us today at (310) 437-7399 to book your personalized consultation to find out how we can meet your needs.