Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Pat #5

DEAR PAT: I am wondering if some of the problems I have (due to a traumatic brain injury) will ever disappear. What are the chances of improvement over time? For example, I have heard of patients regaining speech a year or two after an injury. Is there a "typical" course of recovery for people with traumatic brain injuries?

PAT'S RESPONSE: There is no typical course of recovery from traumatic brain injury since TBI affects each person in a unique way. After all, we start out as individuals, and even after the injury, we still are individuals. In general, a person achieves the most dramatic recovery during the first year after the brain injury. Intensive rehabilitation services can greatly enhance one's improvement. However, improvement can continue to occur over the next several years. The physical healing of brain tissue eventually will taper off, but the door remains wide open for personal growth. The key is for the individual with brain injury to STRIVE for continuous improvement. Participation in appropriate therapeutic activities and embracing a healthy, active lifestyle are good for your brain, body, and soul. So, see good therapists, participate in a dance class, take a course in Chinese cooking, and meditate, instead of, say, munching Cheeto's in front of "McHale's Navy."

DEAR PAT:My wife had a postpartum hemorrhage and is in a rehabilitation hospital now. She suffers from lack of oxygen to the brain. Can we classify her as a TBI patient? How can I get more information about her illness and the treatment needed?

PAT'S RESPONSE: Brain injury can include any event which causes bruising, swelling, bleeding, tearing to brain tissue/cells, nerves .... This includes a blow to the head, gunshot, stroke, aneurysm, tumor, and hemorrhage. Lack of oxygen to the brain is called hypoxia (diminished oxygen) or anoxia (complete lack of oxygen). In brain injury, the tissue which is damaged may repair itself (just as a bruised knee eventually gets better). There is debate as to whether nerves can repair themselves. Even if nerve regeneration occurs, the nerves are not the same as pre-injury, so functioning is impaired. In anoxia, brain cells die and do not recover. It sounds like you need to get very clear information on your wife's diagnosis and then consider pursuing information through the Internet and the nearest university library.


I am searching for resources for people with brain injury who live in Canada. Any ideas?

PAT'S RESPONSE: Pat recommends you contact the Ontario Brain Injury Association by telephone 905-641-8877 or e-mail ( They have a lot to offer!

DEAR PAT: I teach pre-school children with disabilities. I have a student who is developmentally delayed and has serious emotional/behavioral issues. He has a history of banging his head on hard surfaces. I am curious if all those years of banging his head could have caused some sort of brain trauma which has affected his behavior and his ability to process information.

PAT'S RESPONSE:Emphatically, YES. Children's brains are very vulnerable. The effects of a brain injury in a child may not show up until months or years after the actual injury. This is because pediatric brain trauma injures a developing brain. There is a wealth of information on pediatric brain injury and positive, effective behavior shaping techniques. You may want to start by contacting:

May Institute Center for Education and Neurorehabilitation
Ron Savage, Ed.D. (Specialist in pediatric neurorehabilitation)
35 Pacella Park Drive, Randolph, MA 02368
617) 963-3600

Research and Training Center on Rehabilitation and Childhood Trauma
New England Medical Center
750 Washington Street, #75K-R, Boston, MA 02111
(617) 636-5031

DEAR PAT: I was recently told that the minor head injury I sustained 24 years ago in a bicycle accident may be the cause of several of my current problems. At the time of the accident, I was in the hospital for about 2 weeks. I was in a coma for 3 days. There are no physical effects, but I am slow at everything. For example, I experience comprehension/reading problems. In the past 4 years I have struggled with mood swings and severe depression. I just started college and I am having a difficult time. Could my problems be related to this childhood brain injury, and how can I get help?


Your situation is common among people with minor brain injuries. Often these injuries are overlooked or minimized because the period of unconsciousness is minimal, the CT scan is negative, and/or the person "looks fine." Twenty-four years ago, no one even heard of brain injury anyway. (They were still using exorcists to cure epilepsy.) A person in need of accurate diagnosis and specific recommendations should see a neuropsychologist, which is a psychologist specially trained in evaluating brain-behavior relationships. In Pat's educated opinion, a neuropsychologist is the best person for you to consult at this point. Then you will have specific suggestions for yourself and your school to help you be academically successful.


I was a teacher for many, many years when I was beaten unconscious by one of my students. I am now learning to accept my brain injury. My husband walked out and has a new girlfriend. My school is trying to make me retire early, but I cannot afford that. I have lost my creativity as well as my spelling ability. Everything seems so pointless. I do not know who I am; will I ever?

PAT'S RESPONSE:Who You Are: a human being with innate value who is deserving of compassion and kindness. There are others who have experienced what you have. They want to help you. Consider contacting the Florida Brain Injury Association and attending a support group for people who have sustained brain injuries. Telephone the Florida Brain Injury Association in Pompano Beach at 954-786-2400 or 800-992-3442 . And send your ex-husband a box of chocolate-covered grasshopper heads from Pat.

PAT'S FINAL WORD: The despair expressed in the previous "Dear Pat" question is a desolation that so many have experienced and conveyed to Pat through this column. Please read some words of encouragement submitted to Pat from our site's visitors.

"You must never give up hope for any type of recovery in your child. Even the smallest steps gained during recovery should be viewed as positive because they can lead to more steps. Kids need their families' support more than anything else."

"I know how you are feeling. I was in a wreck 3 years ago and I have a head injury. I tried going back to work and fell into a depression too deep to express. The injury was work-related and I was on workman's compensation. It took a year of court hearings and doctors to get back onto compensation benefits because no one thought of my depression and other cognitive problems as injury-related. I am, now, sitting in a rehab hospital 3 years after my accident finally getting the treatment I need. Good luck and don't let anyone tell you that you are making anything up!!"

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