Understanding Traumatic Brain Injury
Traumatic brain injury (TBI) results from an external force — a blow, jolt, or penetrating injury to the head — that disrupts normal brain function. TBIs range from mild concussions (brief loss of consciousness or altered awareness) to severe injuries associated with prolonged unconsciousness and lasting neurological impairment. The leading causes include falls, motor vehicle accidents, sports injuries, and assaults.
Brain injury severity is classified by the duration of loss of consciousness, post-traumatic amnesia, and Glasgow Coma Scale score. However, severity classification does not fully predict outcomes — even mild TBIs can produce prolonged, disabling symptoms, while intensive rehabilitation can significantly improve outcomes at all severity levels.
Common Functional Consequences
- Physical — hemiparesis, spasticity, ataxia, balance deficits, fatigue, headache, and post-traumatic pain
- Cognitive — memory impairment, slowed processing speed, difficulty with attention, concentration, and executive function
- Communication — aphasia, dysarthria, word-finding difficulties
- Behavioral and emotional — irritability, depression, anxiety, emotional lability, and impulse control problems
- Sensory — visual disturbances, vestibular dysfunction, tinnitus, and anosmia
- Sleep disruption — insomnia, hypersomnia, and disrupted sleep architecture
Rehabilitation Approach at CHLMD
TBI rehabilitation at CHLMD is goal-directed and intensity-matched to the patient's current functional level. Physical rehabilitation addresses motor deficits, balance and vestibular impairment, spasticity management, and restoration of mobility. Therapeutic exercise is introduced progressively, with careful attention to post-concussion exercise tolerance and symptom provocation.
Dr. Lichtblau coordinates care across the full rehabilitation spectrum — acute recovery, subacute rehabilitation, and long-term community integration — and collaborates with neurologists, neuropsychologists, speech-language pathologists, and occupational therapists as needed. Spasticity is managed with pharmacological and, when appropriate, injection-based interventions to maintain comfort and prevent contracture.
Long-Term Management and Community Reintegration
Recovery from TBI is not linear, and improvement can continue for months to years after injury. CHLMD provides ongoing physiatric management to adapt the rehabilitation program as the patient progresses, manage late-emerging complications, and support return to work, school, or recreational activities. Family education is an integral component of the long-term management plan.
