Severe TBI Can Result in Disorder of Consciousness

TBI recovery is slow, with a step-by-step course which progresses from coma, vegetative state, minimally conscious, conscious and then to a post-traumatic confusional state.  The severity of a TBI cannot be determined in the first few days after injury it may take weeks – or even months – to determine how or if a person will recover over time.  Many persons will eventually regain consciousness, but some will not.

Often improvement continues slowly over time.  There is much variation of how people move through each stage and how long each stage lasts.  Some people move quickly or skip stages while others may get stuck in a stage.  Every injury is different and follows its own timeline.  The longer a person remains in a coma or state of impaired consciousness, generally the more likely they will be severely disabled. 

One of the first meaningful behaviors a severely brain-injured person shows is the ability to follow an object with their eyes (visual tracking), is a definite sign of moving toward consciousness.  The earlier a person moves from a coma or vegetative state to a minimally conscious state, the better the long-term outcome.  Even if the disorder of consciousness lasts for several months, improvement can still be shown.  In this case specialized TBI rehabilitation may be beneficial.

Age plays a role in recovery outcome.  Younger people are more likely to return to a more independent, productive life.  Older persons don’t usually fair as well.  However, an accurate diagnosis of level of consciousness is imperative because it helps predict the short and long term outcomes.  This helps in making decisions concerning rehabilitation or whether to stop care altogether.

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