Brain injury recovery: plasticity up to a certain point

When you read the latest books on brain injury recovery and brain plasticity, you would almost think that brain damage is not so bad at all. You can recover! Different success stories are found in books and other media. So, what's the big deal? Well, in my 15+ years of clinical experience, brain damage is not something to play with. Please, hear this: it is seldom with a full recovery and it is seldom without any side-effects! It is certainly not similar with a flu of which you can heal without any rest-effects.

In this short introduction I would like you to read the true stories about brain injury recovery, how recovery really takes place and what is really true of all those success stories about a full recovery. I certainly do not have all knowledge and wisdom but I do know that what I have seen in clinical practice, I do know what I have heard of family members of patients with so-called mild brain damage. I do not want to scare you off, I just want you to hear the whole story.
For more inside information about brain injury, its recovery and how to deal with it, please see Larry and Beth Jameson's website. As brain injury survivors they provide more information about brain injury, rehab facilities in the USA and more:

Brain Injury Online - Larry and Beth Jameson 

Another thrilling and fantastic website is the one of Mark Palmer. As a traumatic brain injury victim he empowers other brain injury patients in telling them that there still is hope in living with brain injury. His site can be found here:
Realistic Hope 

General factors that influence brain injury recovery

There is no one rule of how the healing process will take place after brain damage. That is the reason that no medical professional, at the intensive care unit where your partner lies after a serious brain injury, dares to tell you any prognosis. All they can tell you is that it is serious and the 'next 24 hours' are crucial. However, there are several factors that certainly can tell something about the prognosis, about how well the brain injury recovery will take place. After having seen more than 3500 patients with any form of brain damage, I can tell. Science can not give you the exact answers to this one because the way science works nowadays, demands inhuman experiments (they unfortunately perform on animals). So, most data come from experience, however uncontrolled that may be.

One factor that plays a very important role in how one recovers from any form of brain damage is the condition of your brain, both before and after. Does your brain have a condition? It certainly has. Although brain imaging studies cannot see everything (mostly tissue but to a much lesser degree how the brain cells communicate), one can tell whether your brain resembles an older or younger brain. Is there more room between gyri or sulci, is there more brain fluid than normal, are there any signs of small infarctions (=brain damage due to blood or oxygen shortage)? All such questions can be answered nowadays, so something can be said about the brain's condition. And in turn, it does say something about your brain injury recovery.

Another thing we neuropsychologist know are different medical conditions that can have a negative impact on your brain. Like, diabetes, high blood pressure, chronic lung problems, chronic sleep disorders, chronic depression, (especially alcohol and smoking), bad eating habits (i.e. just fast food). In fact, all diseases and conditions that are bad as well for your general health and organs, are bad for you brain. Also having had earlier brain damage like a concussion, or having had a lot of general anesthesias in the past, all this can have caused a cumulative negative effect on your brain. It is also the other way around: when you do have an outstanding physical condition because of being an athlete, baseball or soccer player, your brain's condition is very likely in a top form. All people I have met with brain injury who were very active in sports, showed a remarkably faster brain injury recovery compared to those who did not do any sports at all.

A second general factor that plays a role in any medical disease and its recovery, is your age. Normally, the younger you are, the better your prognosis is. It goes for your skin, your heart, your liver, so also for your brain.

A third general factor is your will power. By this I mean your coping style: the way you handle stress. When you are a 'winner', never quitting when faced when life's problems, you stand a better chance of an optimal brain injury recovery than someone who gives up easily and has no discipline at all. This has a lot to do with the painful way to recovery after a brain injury. You have to have a lot of patience and endurance, you must be able to stand tall against hardship and drawbacks. In this way, you will practice more and regularly which is needed for your optimal recovery.

A fourth important factor is the extent of the damage to your brain: when it is big, your chances are smaller than normal. But...this is not the whole truth. Also thelocation of the brain damage matters. For example, when you have had a deep brain stem lesion with serious consequences for you motor coordination and overall attentional level, this can mean a very long recovery process. It depends on what kind of brain function is damaged. Very highly specialized functions which reside in only a few parts of the brain, are far more difficult to replace and so the prognosis is less than with functions that use more brain parts. Examples of such highly specialized functions are the language functions, some visual perception functions like recognizing movements or faces and smell.

A fifth factor is the kind of damage as I already suggested above: some functions do seem to recover much better than other functions. Generally, highly specialized functions and functions which took years to develop, do have a less positive prognosis than more simple functions. In practice, I always use the metaphor of a highly trained specialist: it takes years to educate and train them and they can not be replaced overnight. 

Overview of this section

This page will be divided in the main cognitive functions we have: attention, memory, (visual) perception, problem solving, language, personality. On every page I will say something about the healing process of the brain, as far I have seen and read about. Of course, again, my knowledge is limited and the reader is invited to share his or her thoughts or evidence about this process. This will be via a special form to add content to these pages.The mission here is to gather all real truth about the recovery process after a brain injury, not just the (limited) truth we have from science only.

Please be patient. There are more pages to come. Writing takes place every week. Just visit me now and then to see the follow-up. In the meantime, I will collect several books about the process of brain injury recovery and how you can help. These books will be presented in the right column. 

Return from Brain injury recovery to How-psychology-tests-brain-injury 

Very good article about brain injury recovery 

About special treatment for children with brain injury 

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If you would like to tell your story about recovering from brain injury please do so below. Although readers are very pleased to read the information on this page, they do think that there is more positive news about recovering from brain injury. Glad to hear that! When you think this as well, please write down your story and your suggestions on how to recover best from brain damage. Hopefully this will help (yourself) and more people suffering from brain injury!

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If you want you can follow me on Twitter. I usually tweet in a serious way: whenever there is any news to share, being either about brain injury, emotional problems, abnormal behavior or other morality issues. Click on the link below:

Als u wilt kunt u me ook op Twitter volgen. Ik tweet eigenlijk alleen serieuze zaken, of dat nu nieuws is over hersenletsel, emotionele problemen, abnormaal gedrag of andere ethische zaken. Klik op onderstaande link:

books to read!

Very practical and moving guide about dealing with someone with brain injury and how to help such a person:

A lot of very practical tips and tricks to deal with brain injury and to survive (Kindle edition):

The same book in paper version:

From brain injured survivors themselves comes a very dedicated and useful practical guide as well:

A very practical workbook about the milder forms of brain injury: