The Journey Back From Brain Injury

Recovery Curve Slows With Time

About six months after many traumatic brain injuries occur, patients begin to experience a slowdown in improvements.

Rehabilitation at this phase normally involves developing safety awareness and balance, cognitive rehabilitation to improve memory, and dealing with impulsivity and multitasking.

Patients may also be able to refine their motor skills, develop more sophisticated cognitive skills, articulate more effectively, and control their impulses.

However, constant care is still needed.

"When you take a look at recovery of function, you have to look at it case by case," Ashley said. "Approximately 5 [percent] to 20 percent of individuals who have sustained a mild TBI or concussion will have one or more symptoms that last a year or longer."

"These patients are entering a lifelong period of attention, concentration, memory, fatigue, cognitive and emotional disabilities."

After the first few years following injury, the improvement curve in most cases becomes completely flat; patients rarely improve past this point.

"What you see as problems at two years after injury are generally seen as permanent," O'Shanick said.

An Uncertain Return to Self

However, a few patients can recover from their injuries enough to continue their lives to a certain degree.

Abigail Baglione, a senior at NYU, was out with friends on the night of Sept. 20, 2000. It was a typical night on the town until the car they were riding in was broadsided by another vehicle.

Baglione, who was sitting in the front passenger-side seat, received the brunt of the impact.

The brain injury she sustained from the crash impaired her ability to think and learn.

"Awareness and realization takes a long time," she said. "It was really hard, and I went through periods of depression."

Yet, the damage to her brain was limited in severity. Perhaps most important, her sense of motivation, which many TBI patients lose after their injuries, was not affected.

"I really, really wanted to go back to school, so I made that happen," she said.

Her return to NYU was a challenge. Baglione was in her senior year when the accident occurred; finishing her final two semesters took two extra years.