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Service members with moderate to severe TBI, often have rehabilitation at a "polytrauma center." These centers were set up by the VA along with the Defense and Veterans Brain Injury Center to research and treat traumatic brain injury.


These centers provide the highest level of state-of-the-art care for the rehabilitation of patients with TBI. The care is delivered by a specialized medical team that may include case managers, speech therapists, physical therapists, occupational therapists, and a variety of others.

The goal is to help the patient return to normal everyday life in as many ways as possible, making up for lost abilities using new tools. This is sometimes called “cognitive retraining.” For those who can, getting back to work or school is often a major goal in their rehabilitation plan. For some TBI survivors, this is not a realistic goal.

Patients with moderate to severe TBI often have long-term medical problems that require specialized attention. Some common problems and their treatments are:

  • Abnormal and spastic muscle tone can sometimes be treated with physical therapy, medication, or minor surgery 
  • Chronic pain can sometimes be treated with medication, physical therapy, and psychological techniques
  • Depression, anxiety, and behavioral problems can be treated with medication and psychotherapy, and
  •  Seizures and headaches require medication

As the patient recovers, many rehabilitation centers use the Ranchos Los Amigos Scale of Cognitive Functioning to monitor the patient’s progress in a rehabilitation program.

In most cases, patients are discharged from the rehabilitation center once they recover from PTA and can show, along with family and caregivers, that they will be safe at home. Patients are usually discharged with detailed written instructions about when it is safe to return to their regular activities.



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