Answers to Your Questions About Brain Injury

The brain cannot be "rehabilitated" per se. Over time, areas of the brain that were rendered dysfunctional can improve, and these areas can make up for permanently destroyed areas of the brain. Rehabilitation, in general, improves the overall coordination of brain-body function but permanently injured areas of brain are forever lost. One can re-create functions that are lost by having another noninjured or less-injured area of the brain subserve the area that is permanently injured.

- Dr. W. Welch, chief of neurosurgery, University of Pittsburgh

Do brain cells ever grow back?

Dead brain cells do not "grow back," and there is no consistent evidence that surviving neurons can replicate. There is abundant evidence for "sprouting" in which surviving neurons send out axonal "sprouts" (extensions) into areas of damage to communicate with other neurons that have lost their input.

- Dr. Martin Weiss, chairman, department of neurosurgery, USC

What are the critical things to look for in the days after brain damage? What is the recovery time in terms of stages? How long does it take to know what damage is going to last?

The speed in which the person returns to consciousness and the early rate of recovery will predict the rate of further change, usually. It can take days or even weeks to have a good idea. Serious swelling and intracranial pressure can cause additional damage, as can infections.

- Susan Bookheimer, Brain Mapping and Research Institute, UCLA

It may take weeks or even months to fully ascertain function that is permanently lost because of the potential for overlap of brain function. In general, overlap/improvement can occur for two to three years. Obviously, and again in the most general of terms, the longer it takes to identify meaningful recovery, the worse the prognosis for overall recovery.

- Dr. W. Welch, chief of neurosurgery, University of Pittsburgh

With battlefield damage especially, what do you look for in terms of trauma, shrapnel, special considerations? Why?

Penetrating injury such as shrapnel can complicate traumatic brain injury by causing bleeding inside the skull, creating high pressure that can choke off blood supply. In addition, penetrating injury may damage important regions of the brain that control specific functions. Overall, blast injury also commonly affects the chest, breaking ribs and causing lung tissue damage. This can result in impaired breathing or create air emboli entering the blood, both of which can worsen the extent of a brain injury.

- Dr. Douglas H. Smith, director, University of Pennsylvania Center for Brain Injury

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