Recovery Stages From a Traumatic Brain Injury

Brain Injury | July 8, 2022

Every year, tens of thousands of new brain injury cases are diagnosed. Traumatic brain injuries, or TBIs, can arise from many common accidents, such as motor vehicle collisions, falls and sports incidents. Some TBIs cause temporary symptoms that clear up in just a few weeks, while others impact a victim for an indeterminable amount of time. Every TBI is unique. There are general stages to traumatic brain injury recovery, however, that can help you know what to expect.

Coma or Unconsciousness

The first stage after a severe brain injury is often the loss of consciousness, or coma. A coma means that the individual is unresponsive to his or her environment and unable to wake up. This may occur naturally as the body’s response to a brain injury, or the victim may be placed in a medically induced coma so that the brain can focus on healing without interruption. Doctors often induce comas in brain injury patients to minimize swelling and pressure against the brain after a TBI. Most comas related to brain injuries last a couple of weeks.

Vegetative State

A vegetative state is a step up from a complete coma – they are two different states of consciousness. In a vegetative state, a patient has some neurological response and may have regained some reflexes. You may notice eye movement and some reaction to stimulation. This typically means that parts of the brain have healed and are intact, but others need more recovery time.

Minimally Conscious 

The next stage of recovery is when the patient is in a minimally conscious state. In this state, a patient may be conscious some of the time and unconscious at other times. These patients often only have a limited understanding of where they are and what happened. At this stage, doctors may use medications to help stimulate the brain so that the patient regains full consciousness.

Post-Traumatic Amnesia

Some brain injury survivors experience a recovery stage of post-traumatic amnesia. In this stage, the patient may be unable to remember his or her life or past events (retrograde amnesia). The patient may also be unable to retain new information (anterograde amnesia). Amnesia is typically temporary but can be long-lasting in some cases. Behavioral changes are frequent in this stage of recovery and often include agitation, outbursts, aggression, and erratic or inappropriate behaviors.

Later Stages of Brain Injury Recovery

At this point, the brain injury patient has been through the first four stages of recovery, which tend to take a few months. From here, most survivors go through an additional six stages over what may be several weeks, months or even years. These stages can be characterized by the following summaries: 

  • Stage 5. Patients are confused by their surroundings, have trouble focusing and answers to questions may not make sense.
  • Stage 6. Confusion, focus and memory problems may persist, but patients can follow directions and maintain short conversations. They may lack awareness of their impairments.
  • Stage 7. Able to follow a schedule and complete daily tasks unsupervised and independently. Participation in rehabilitation and physical therapy is more frequent.
  • Stage 8. Improvements in awareness and memory, with possible issues with social interactions and handling unexpected situations.
  • Stage 9. Patients can respond to the needs of others and can typically complete both familiar and new daily activities.
  • Stage 10. Patients have regained most function at this stage and can live independently, but will likely require continued rehabilitation.

Brain injury recovery looks different for everyone. As the brain moves through these recovery stages, it is attempting to repair neural connections and reassign some functions from damaged portions of the brain to undamaged parts. This is known as neuroplasticity, and it is what enables brain injury recovery. How successfully the brain recovers depends on the severity of the injury, the patient and many other factors.