How long will it take to recover from TBI? This question is common for many survivors of traumatic brain injury as they navigate the road to recovery. To help answer this question, we created this TBI recovery timeline to review the different stages of recovery and help survivors develop their own goals for healing and regaining function.
Every brain injury is unique, and therefore the recovery process will look a little different for everyone. Some patients will require intensive rehab in an inpatient facility for months, while others will progress through the stages of recovery more quickly. This depends heavily on the severity of the injury as well as the area of the brain that was affected.
The following timeline can help you get a sense of what to expect during TBI recovery. However, it is important to understand that this is only a general outline and does not account for all factors. If you do not progress at the same rate, that is not necessarily a bad sign. Instead, use this as a guide to help you create your own goals for your recovery process.
Early Stages of the TBI Recovery Timeline (0-2 months post-injury)
In the initial days and weeks after their TBI, a survivor may remain unconscious for some time. As the swelling in the brain decreases, the survivor should begin to regain awareness and will pass through the first three stages of TBI recovery. These stages include:
- Coma. This is the deepest state of unconsciousness characterized by no eye-opening or any form of communication. When someone is in a coma after brain injury, they are unresponsive to their environment and cannot wake up, even when stimulated.
- Vegetative State. Individuals in a vegetative state may sometimes seem awake but are unable to follow instructions or perform intentional movement. Their eyes can open and close, but they are not aware of their surroundings. Rather, these reactions are caused by autonomic (involuntary) responses or reflexes.
- Minimally Conscious State. When in this state, the person now has a reduced sense of awareness and may react to stimuli (such as a noise or touch). In some cases, the person may follow very basic instructions or attempt to communicate, though this is usually very inconsistent. It’s important to note that individuals in this state may still drift in and out of consciousness.
When the survivor becomes more alert and can respond to external stimuli consistently, doctors consider them “emerged” from the minimally conscious state. This can include answering simple questions (verbally or non-verbally) and demonstrating intentional movements. After this stage their recovery may begin to speed up, but they will still need a significant amount of assistance with basic tasks.
How Long Will It Take to Regain Consciousness After Brain Injury?
Predicting how long it takes to emerge from a coma is difficult, as it mainly depends on the severity of the person’s brain injury. According to the National Institute of Neurological Disorders and Stroke, Comatose patients typically regain consciousness within 2-4 weeks or enter into one of the three diagnostic categories described in the bullet points above. However, patients sometimes remain in an altered state of consciousness for months, which is usually categorized as a chronic coma or persistent vegetative state.
The faster a person emerges from a coma, the higher their chances of making a full recovery will be. For example, patients who reach a minimally conscious state within three months have a high likelihood of regaining full consciousness.
Once the person becomes alert, a period known as post-traumatic amnesia usually follows. During this period, the person may lose memories (retrograde amnesia) as well as their ability to form new memories (anterograde amnesia). They are also typically disoriented to time, place, person, and situation while the brain continues to heal.
Individuals with post-traumatic amnesia may become uncharacteristically violent or aggressive and will overreact to stimulation. This stage is often very distressing for families to witness but, fortunately, it is usually a temporary condition. In almost every case, the amnesia and confusion wear off after a couple of days or weeks and the person progresses to the next stage of their recovery.
Rehabilitation During Later Stages of the TBI Recovery Timeline
The later stages of the TBI recovery timeline are usually when most function is recovered. This period of accelerated recovery typically occurs between 3 and 12 months post-injury. Since the brain seems to be awakening during this period, it is important to maximize participation in therapy exercises to boost recovery during this stage.
3-6 Months Post-TBI: Fastest Recovery Occurs
During the first six months after a TBI, the brain is in a heightened state of plasticity, or healing. This explains why the greatest gains in TBI recovery will usually occur within the first 3-6 months of therapy.
It is extremely important to work closely with your rehabilitation team during this period to maximize progress. This can include physical, occupational, and/or speech therapy to work towards functional goals including walking, activities of daily living, and communication.
After this period, survivors may feel that progress stalls. Therapists call these stalls “plateaus” and they are very common in the TBI recovery process. However, it’s important not to give up therapy when you first encounter a plateau as improvements can still be made.
As discouraging as it can be to not see the same amount of progress, plateaus are only temporary. If you can persevere and continue with your rehab plan, your brain is getting much-needed stimulus that will facilitate its growth so that you will begin to make improvements again.
6 Months – 2 Years After TBI: Speech and Mobility Improve
As you continue with your treatment, you will likely reach certain milestones in your recovery. Again, keep in mind that recovery looks different for everyone and these are general statistics. For example:
- At six months, about 60% of TBI patients can walk again.
- After one year, speech and cognitive abilities will have significantly improved. In fact, 64% of TBI patients make a good cognitive recovery after 12 months, according to the Journal of the International Neuropsychological Society.
- At two years, around 50% of individuals with a moderate to severe TBI are able to drive again, often with some modifications.
- After two years, you will see more improvements in your hands and legs. Recovery may be slow, but people who have suffered hemineglect usually begin to have more use of their neglected side at this point.
What happens after the two-year mark? Does recovery cease? Research tells us differently, which we will discuss in the following section.
TBI Recovery Timeline After 2 Years and Beyond: Never Give Up Hope
In the past, many doctors and health professionals believed that two years of improvements were all a person could expect to gain after a TBI. However, recent research has challenged that idea and we now know that you can still activate neuroplasticity years, and even decades, after a brain injury.
For example, one recent study followed TBI patients for over a decade after their injury. The researchers found that even at the 10-year mark some patients were still improving their function. In fact, several patients at the 2-year and 5-year mark still needed assistance with daily activities. By 10 years, however, those same patients had finally regained functional independence.
Since recovery does continue many years after TBI, it’s crucial for survivors to continue with their therapy and other treatments to maximize their outcome. There is always hope for improvement with time and perseverance.
TBI Recovery Timeline: How Long Will It Take to Recover?
The recovery process after traumatic brain injury looks different for every survivor and this article has outlined only a general TBI recovery timeline. You might make a much faster recovery, especially if you remain dedicated to therapy and exercise. On the other hand, your recovery might be slower than our timeline suggests for a variety of reasons.
If you feel like your recovery is moving too slowly and you are not making the gains you want, try to maintain hope and stay consistent with your exercises. Sometimes, neuroplasticity is occurring and time is required to see its effects. Recovery after a TBI might take longer than you had hoped. However, the only way to ensure that you do recover is to stick with your therapy program, even when it feels as if recovery has plateaued.
Regardless of the severity of your injury or how long ago the injury occurred, improvement can always be made with enough dedication and consistency With enough stimulation, our brains are always able to grow and adapt through neuroplasticity.
