A brain injury can change your life in an instant. It may affect how you think, how you feel, how you behave, how you move, and what you remember. However, remarkable progress has been made in the treatment and rehabilitation of patients who have had a brain injury.
The multidisciplinary team at the Mischer Neuroscience Institute at Memorial Hermann-Texas Medical Center and TIRR Memorial Hermann is dedicated to providing exceptional care to patients with brain injury.
In addition to the personalized care that you receive at the institute, please refer to this page to help you and your loved one navigate the journey to recovery. Along with learning about key milestones and expectations of brain injury patients, you will find important resources, clinical details and helpful suggestions for rehabilitation. We aim to be your partner as together we help you and your loved one recover from a brain injury.
Patients suffering from neurological and neurosurgical emergencies require immediate life-saving measures and treatment. As the first hospital in the Texas Medical Center, the world’s largest medical complex, we provide around-the-clock, cutting-edge neurocritical care at our 32-bed modern Neuroscience Intensive Care Unit equipped with the latest medical technologies, including a multimodal brain monitoring system.
Mischer Neuroscience Institute houses the largest and busiest Neuroscience ICU of its kind in the region. With the most experienced neurointensivists and advanced practice providers, our critical care team provides unparalleled care for the sickest, most vulnerable patients in our region.
To understand the types of brain injury, it is important to know the different functions of the brain.
A break in one or more bones that surround the brain. Many times theses fractures heal on their own.
A mild bruise to the brain. Side effects of a contusion may include headaches, nausea, vomiting, dizziness, and problems with memory and concentration. Surgery is usually not indicated.
A collection of blood that forms between the dura (outer covering of the brain) and the skull. Due to possible increases in pressure inside the brain, surgery may be needed.
A collection of blood outside of the brain. An acute subdural hematoma occurs when there is rapid bleeding in the brain. A chronic subdural hematoma may occur days or weeks after a minor injury to the brain. Due to possible increases in intracranial pressure, surgery may be needed.
Occurs when there is a lack of oxygen supplied to the brain.
Many brain injury patients may continue to experience neurological or physical symptoms following hospitalization. These may include cognitive, physical, personality and behavioral changes. Below is a list of possible changes that may occur, depending on the severity and location of the brain injury.
Confusion following brain injury can be very common. This may cause some agitation which may be treated with medications. Supervision by family may be recommended.
Cognitive deficits that may occur after a brain injury include memory loss, impaired decision-making skills, impaired communication, lack of safety awareness, and attention deficits.
Physical deficits could include inability to walk, decreased balance, impaired speech, weakness, impaired hearing or vision, and increased fatigue. Sometimes the most difficult effects of a brain injury are the changes to the personality of the individual who may experience more stress, irritability, agitation, and may feel denial, lack of motivation, depression and anxiety. There may be a loss of emotional control accompanied by mood swings. Please be aware of these changes and talk to a physician with any concerns.
Please keep in mind that recovery from a brain injury continues after hospitalization.
When arriving at the Mischer Neuroscience Institute, the healthcare team will measure a patient’s temperature, pulse and blood pressure, and generally performs urine and blood tests. A physician also will perform a physical examination of the patient, which may include testing the reflexes, eye movements, speech, muscle strength and tone, and coordination. A physician also may test attention and concentration, memory and cognitive reasoning.
While physical examination helps physicians determine the type of brain injury suffered by a patient, other tests can provide more detailed information regarding treatment. Some common tests include:
A CAT , or CT, scan uses a computer system to give a detailed picture of brain tissue to determine where the brain was injured. During the test, the patient lies on a table with his or her head in a large, donut-shaped machine that takes pictures of the brain. The scan generally takes approximately 15 minutes to complete and is painless.
An MRI is a test that uses a strong magnetic field and radio waves to give physicians a 3-D picture of the brain. During an MRI, which is painless, a patient must lie still within the MRI scanner for approximately 30 minutes. An MRI can be used for a more in-depth look of the brain than other imaging methods.
An EEG measures and records the electrical activity in the brain. An EEG is painless and can be helpful in diagnosing seizures.
Upon admission to the hospital, a patient may be admitted to the Neuroscience Intensive Care Unit (NSICU), Neuroscience Intermediate Care Unit (NIMU), or the Neuroscience Acute Care Unit depending on their current condition. All units are located in the Jones Pavilion.
Brain injury not only impacts the individual with the brain injury but also the family and friends who surround them. Below is a list of helpful tips for caregivers, family and friends of patients on how to cope and adjust to changes following a brain injury.
A brain injury may bring about emotional, physical and financial stress for the caregiver. Other emotions that may arise are denial, anger, depression, guilt or responsibility. These feelings are normal and are expected.
It can be physically and emotionally exhausting caring for a loved one. It is important for caregivers to take moments out of the day to focus on other things and do things that are part of their daily routine (e.g., read a book, call a friend, exercise, take a bath, etc.).
Prior to leaving the hospital, caregivers should think about family and friends who may be able to assist the patient with the brain injury. Rely on the support system to help with the patient’s care, and also to assist with everyday tasks such as grocery shopping, running errands, cooking meals, doing laundry or cleaning the house. Some brain injury patients may require some type of supervision after discharge, so it is important to work with family, friends or community resources to work out a supervision plan for the patient.
It is important to speak with the medical team, nursing staff and therapists about the needs of the patient following brain injury. Take time to read articles and attend support groups if possible.
The road to recovery following a brain injury will vary depending on the extent of the brain injury. During the hospital stay, patients may be evaluated by physical, occupational and speech therapists to determine their rehabilitation needs.
A physiatrist (physical medicine and rehabilitation physician) may also be consulted by the attending team to determine a patient’s rehabilitation needs. Some patients may be able to return home with home health or outpatient therapy while others may require a long-term, acute-care hospital stay (LTAC H), inpatient rehabilitation or a skilled nursing facility (SNF). A case manager or social worker will be available to review the discharge plan prior to discharge from the hospital.
Upon a patient’s discharge from the hospital, a physician will provide a list of specific discharge instructions that will include medications, follow-up instructions and follow-up appointments needed. Below is a list of helpful tips upon discharge for brain injury patients. Please always refer to the discharge instructions for specific instructions as the needs of each brain injury patient can be different.
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