Brain & Neurosurgery
Traumatic Brain Injury
From acute neurosurgical care to long-term recovery.
Traumatic brain injury (TBI) is a spectrum — from concussion (mild TBI) to severe injury with prolonged loss of consciousness. Severe TBI requires immediate neurosurgical evaluation to manage bleeding, swelling, and intracranial pressure. Recovery is long-term and multidisciplinary. Our neurosurgical team provides both acute care and ongoing post-TBI management, coordinating with rehabilitation, neuropsychology, and primary care.
Understanding the Condition
What is Traumatic Brain Injury?
TBI is classified by severity using the Glasgow Coma Scale: mild (GCS 13–15, including concussion), moderate (GCS 9–12), severe (GCS 3–8). Severity drives initial management. Beyond severity, the type of injury matters: focal injury (contusion, hematoma) vs. diffuse axonal injury (DAI), and which brain structures are affected.
Acute neurosurgical care focuses on preventing secondary injury — controlling intracranial pressure, managing bleeding, and maintaining oxygenation and blood pressure. Long-term care focuses on rehabilitation, cognitive recovery, mood management, and return to school/work.
Common Causes
- Motor vehicle accidents (most common cause of severe TBI in young adults)
- Falls (most common cause of TBI overall, especially in elderly and pediatric)
- Sports and recreational injuries
- Assaults
- Workplace injuries
- Military / blast injuries
Common Symptoms
- Mild TBI / concussion: headache, confusion, brief loss of consciousness
- Moderate TBI: prolonged loss of consciousness (minutes to hours), persistent confusion, focal neurologic deficits
- Severe TBI: prolonged unconsciousness, coma, severe neurologic deficits
- Acute warning signs: vomiting, seizures, unequal pupils, worsening headache, motor weakness — emergency
- Long-term: persistent cognitive issues, mood changes, sleep disturbance, fatigue
When to Seek Care
When Should You See a Specialist?
Severe TBI is hospitalized acutely; we manage neurosurgical needs in the trauma setting. For ongoing post-TBI care, evaluation is appropriate when symptoms persist, when imaging shows residual changes, or when coordinating rehabilitation. Family members frequently initiate the visit when noticing cognitive or personality changes after a head injury.
Treatment Options
How We Treat Traumatic Brain Injury
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- ICP monitoring and management in severe TBI
- Sedation and ventilation when needed
- Hyperosmolar therapy (mannitol, hypertonic saline)
- Multidisciplinary rehabilitation (PT, OT, speech, neuropsychology)
- Anti-seizure prophylaxis when indicated
- Mood and sleep medication management
- Cognitive rehabilitation
Surgical Options
- Decompressive craniectomy for refractory intracranial pressure
- Hematoma evacuation (subdural, epidural, intracerebral)
- ICP monitor placement
- External ventricular drain (EVD) for hydrocephalus
- Cranioplasty (replacing bone after decompression)
Recovery & Outlook
What to Expect After Treatment
Highly variable by severity. Mild TBI / concussion: most fully recover. Moderate TBI: 3–6 months for substantial recovery, with some residual cognitive or behavioral changes common. Severe TBI: 1+ years of rehabilitation, with outcomes ranging from near-full recovery to persistent severe disability. Quality multidisciplinary care meaningfully improves outcomes.
Meet Your Team
Specialists Who Treat Traumatic Brain Injury
Related Treatments
Services That Address Traumatic Brain Injury
Traumatic Brain Injury — Frequently Asked Questions
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Primary and metastatic brain tumors evaluated and managed by our neurosurgical team.
Concussions
Mild traumatic brain injury — evaluation, return-to-play / return-to-work, and recovery management.
Headache & Migraine
Cervicogenic headaches, chronic migraines, and surgical migraine treatment for medication-resistant cases.
Get Expert Help for Traumatic Brain Injury
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.