Our life care plans consider the unique needs of individuals who have sustained a traumatic brain injury (TBI).
TBI is a physical injury to brain tissue that temporarily or permanently impairs brain function. In the United States, adults with severe TBI who receive treatment immediately have a mortality rate of about 25 to 33%. The vast majority of patients with mild TBI retain good neurologic function. With moderate or severe TBI, the prognosis may not be as good, but is much better than is generally believed.
The occurrence and duration of a comatose state after a TBI are strong predictors of disability. Of patients whose coma exceeds 24 hours, 50 percent have severe, persistent neurologic sequelae, and 2 to 6 percent remain in a persistent vegetative state (PVS) at 6 months. In adults with severe TBI, recovery occurs most rapidly within the initial six months. Smaller improvements continue for perhaps as long as several years. Children have a better immediate recovery from TBI regardless of severity, and continue to improve for a more extended period.
PVS can result from a TBI that destroys forebrain cognitive functions but spares the brain stem. Life expectancy in PVS is severely truncated. Capacity for self-awareness and other mental activity is absent; however, autonomic and motor reflexes are preserved, and sleep-wake cycles are regular. Few patients recover normal neurologic function when a PVS lasts for three months after injury, and almost none recover after six months.