In 2014, Jagnoor and Cameron identified that the mechanisms of recovery are poorly understood and there is considerable variability in patterns of recovery.21
People with very mild and mild TBIs can be expected to recover quickly. However, some will have psychological consequences of the injury that will require assessment and management. Most people experiencing mild TBI recover fully within days to months but a small percentage (1-20%) of individuals continue to experience symptoms three months after injury.
Recovery from moderate or severe TBI tends to follow a negatively accelerating curve, which is most rapid in the first three to six months but may continue for several years.
They considered that much of the early spontaneous recovery after TBI is explained by the resolution of temporary physiological changes. In addition there are regenerative neuronal changes that have been associated with behavioural improvement. However, the potential for regenerative growth is limited, particularly in the case of severe injuries. It is thought that most recovery beyond this occurs through the substitution or reorganisation of neural structures and functions. There is a growing body of evidence to suggest that environmental stimulation and specifically behavioural therapies can alter brain function and organisation after injury.
Because the recovery and rehabilitation from severe brain injury is typically most rapid in the first three to six months (but may continue for several years), the rehabilitation pathway typically goes from the point of injury to the person being back in the community.21
Part of Paul's story
Back at work
Paul and his friend get jobs in the snowfields, where they will share accommodation. Paul keeps in email contact with his case manager, provides updates and shares concerns. Other friends have started working in the area and Paul is happy.