Long-Term Outcome and the Role of Neurorehabilitation After Severe Traumatic Brain Injury

Successful cognitive and functional outcomes following the stabilization of patients with severe traumatic brain injury (TBI) require longitudinal follow-up and rehabilitative care. Nearly half of hospitalizations for moderate and severe TBI result in substantial long-term disability, greatly reducing quality of life for those affected and inducing significant short- and long-term cost burdens on the afflicted individuals and the healthcare system. This is further exacerbated by higher rates of hospital readmission, unemployment, dependence on others, use of illicit substances, and decreased lifespan. Early and intensive neurorehabilitation is associated with improved short- and long-term outcomes for severe TBI, a phenomenon that has been supported with a multitude of clinical studies and animal models of TBI. Based on existing evidence and guidelines in long-term management of severe TBI, this chapter summarizes the features that highlight the role of neurorehabilitation in post-acute and longer-term care for severe TBI. However, not all patients affected by severe TBI have equal access to neurorehabilitative care as the current system of TBI care is not optimally designed to meet the needs of a diverse TBI patient population. Identifying and addressing demographic and socioeconomic disparities in longitudinal TBI management is equally important to understanding the physiological mechanisms for improving long-term functional and cognitive outcomes.