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 create their own specific 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, 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 actually 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, most coma patients regain consciousness within 2-4 weeks. However, patients sometimes remain in an altered state of consciousness for months, which can be 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 has woken up, a period known as post-traumatic amnesia usually follows. During this period, the person may lose previous 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 only a temporary condition. In almost every case, the amnesia and confusion wear off after a couple 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 the most progress is made. This period of accelerated recovery typically occurs between 3 and 12 months post-injury. Since this is the period when the brain will make more rapid progress, it is important to maximize participation in therapy exercises to boost recovery.

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.

This means therapy will have a huge, visible impact during this time frame. It is extremely important to work closely with your rehab 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 of time, survivors may feel that progress is beginning to stall or slow down. 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 major 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, you will begin to make improvements again, even if these improvements feel slower.

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.

If you feel like your recovery is moving too slow and you are not making the gains you want, try to maintain hope and stay consistent with your exercises. Recovery after a TBI might take a long time. 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 be made with enough dedication and consistency. There is always hope for improvement, even years into the TBI recovery timeline.

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