Brain Injury Can Initiate Biological, Behavioral and Social Changes that Persist for Years or Decades and Recommend Integrated Long-term Care
The Lancet is widely considered one of the most prestigious and influential medical journals in the world.
In a new paper just published in The Lancet Neurology, Research Spotlight: Working towards an integrated, long-term approach for traumatic brain and spinal cord injury, a team of international experts across institutions and disciplines propose a fundamental shift in how traumatic brain injury is understood and managed. (Two of the authors work at the Mass General Brigham Neuroscience Institute.)
The authors began with a multiple database search of available published studies. This evidence, they found,
“Consistently indicates that neurotrauma can initiate biological, behavioral, and social changes that persist for years of decades. These include chronic inflammation, accelerated biological aging, and increased cardiometabolic risk, to name a few… survivors of traumatic brain injury and spinal cord injury face higher rates of new cardiovascular, endocrine, neurological, and psychiatric conditions.”
Unfortunately, most heath systems “provide episodic support rather than coordinated follow-up…surveillance is often fragmented or absent once patients leave acute care and rehabilitation.” As a result, “complications may not be recognized until they cause hospitalization, functional decline, or other preventable harm.”
The authors propose reframing the way the field of medicine characterizes brain injury, from an isolated event with time-limited consequences, to a chronic multi-system disorder with the potential for multi-system, long term consequences. They propose a more integrated system of care including “structured follow-up, clear information about long-term risks, and a reliable point of contact, such as a care navigator.” These changes, they conclude, “would help survivors recognize early warning signs, understand the purpose of recommended screening and take a more active role in their own preventive health.”