Brain Injury Treatment & Recovery

An emergency department physician or your primary care doctor refers you to our clinic because of symptoms you’re experiencing soon after a mild injury or concussion. We are the first specialty provider you’ve seen for this injury.

Our clinic provides timely access to evaluation for mild TBI or concussion. Early evaluation has multiple benefits:

• Early diagnosis and treatment of symptoms of concussion may accelerate recovery and prevent disability. These are some symptoms:
  • Dizziness
  • Headache
  • Sleep problems
• Cognitive assessment focused on the critical and common complaints after concussion can identify the best treatment and accommodation.
• Education to you and your family members about the expected timeline and course of recovery. This allows you to make appropriate — but temporary — changes at home, school or work until recovery is complete.

Our TBI team operates under these expectations about mild TBI or concussion:

• Recovery from a mild TBI or concussion is usually complete over days to a few weeks.
• You won’t need extended, clinic-based cognitive rehab to improve your brain function.
• Our role is to:  
  • Educate and reassure you and your family members.
  • Identify and treat symptoms.
  • Recommend how to adjust during recovery.

You will return for follow-up appointments. During these visits, we’ll determine which parts of your injury haven’t yet recovered. Once we have identified those, we can offer:

• Treatments for your physical symptoms, such as headaches, balance problems, neck pain and sleep problems.
• A brief program to educate you and give suggestions and recommendations about how to compensate.
• Medications for anxiety or depression, if necessary.
• Work or school accommodations
• A program of psychological care to help you manage other symptoms. Our mixed approach of symptom management education includes:  
  • Cognitive behavioral therapy (CBT)
  • Progressive relaxation
  • Sleep and exercise
• Referrals to helpful programs nearer to your home, if you prefer.

Your primary care doctor may refer you to our clinic many weeks or months after you are diagnosed with a mild brain injury due to continued disruptive symptoms. You may have likely already seen other specialty providers for this injury. This is sometimes called post-concussive syndrome (PCS). The symptoms of PCS can vary but may include these:

Our team is available for consultation to educate you and lend support. We provide care based on these principles:

• Symptoms that persist for more than a few weeks after a concussion aren’t usually directly due to brain trauma. We’ll make a careful assessment to determine the cause.
• Other factors related to the accident or trauma may cause disability as time passes. Problems could include these or others: 
  • Dizziness
  • Emotional issues
  • Lack of energy

  • Persistent headaches
  • Sleep disruptions

We can treat each of these problems. Once we have identified the issue, our TBI/concussion team will develop and implement a comprehensive treatment plan.

These types of consultations often include resources to the specialties outside of our clinic:

The TBI team is uniquely qualified to evaluate those who’ve had severe head trauma. Generally, you have already received inpatient hospital care. You may have completed a course of inpatient rehabilitation. You’re now looking for management of the next phase of your care: outpatient rehabilitation, including neurological rehabilitation.

Our team is here to provide comprehensive evaluation of your neurological cognitive status on an outpatient basis. We will develop an individualized treatment to help you continue your recovery.

We provide care according to these principles:

• We expect improvement — and perhaps even recovery — except for the most extreme injuries.
• Some residual disability often persists after a severe injury.
• Because severe injuries are often very complex, we may need to complete an intensive re-assessment. This may include a new MRI or CT scan of the brain. We use these test results to identify the exact nature of the injury.
• Education about the right accommodations during recovery is critical. These may include changes for home, school and work activities.
• If you are facing a longer and possibly incomplete recovery, we may refer you to other, highly specialized services.
• It’s important to find support from other people who’ve experienced similar injuries and their family members. These are valuable resources for those dealing with long-term issues of disability, retirement and leisure when return to work or school is not possible. Programs dedicated to helping people with severe head injury and their families are also very valuable.

Severe injuries, by definition, can cause much more complex disability. In addition to cognitive problems, they may cause problems with control of movement, balance, speech and emotions. By the time that you come to this program, you will have already seen many doctors and other health care professionals.

We have set goals for severely injured patients who are now out of the hospital:

• Assessing current status and prognosis for continued recovery
• Determining the need for basic neuromedical care, including seizures, spasticity or pain
• Determining options for integrating ongoing medical care, further rehabilitation plans, return to work or school, and all of the issues facing you after you’ve been out of your normal life for weeks or longer

We recommend community-based treatment when you are in the later stages of recovery from severe brain injury. However, programs can be difficult to find. Some people simply never return to their former level of functioning, and the treatment plan needs to recognize that constraint.

In these cases, we include referrals to these and other resources:

• Local and state government disability
• Mass Rehab
• Social Security disability benefits
• State Health Insurance Assistance Program (SHIP) services for help applying for private disability