Once a brain injury has been diagnosed, it can be difficult to immediately determine the prognosis. Because brain injuries are so complex and no two behave the same way, a prognosis may not be known for months, sometimes even years.

Measuring Length and Severity of Coma

That being said, there are several areas a physician looks at to predict a patient’s recovery after brain injury. Specifically, physicians look at the length of coma, as well as the severity of coma within the first few hours after injury. That’s because the amount of time that a patient spends in a coma will have a direct link to both post-traumatic amnesia and recovery time. For example, a coma that lasts seconds to minutes usually results in a post-traumatic amnesia that lasts a few hours or days, and a recover that reaches a plateau over days or weeks. On the other hand, a coma that lasts weeks usually results in a post-traumatic amnesia that lasts months, and a recovery that plateaus over months to years.

Measuring Location and Size of Traumas

A physician will also take the location and size of traumas in the brain into consideration. Because certain areas of the brain control specific cognitive and behavior processes, the location of the injury will determine the type of impairment.

Measuring Long-Term Effects

While a precise prognosis is nearly impossible, as a general rule of thumb the more severe the injury, the longer the recovery period, the more long-term effects a survivor will experience once recovery has reached a plateau. It’s also interesting to note that patients who require surgery don’t necessarily have a worse prognosis than those who don’t require surgery. For example, a patient who must have a blood clot removed may recover just as well as a patient who doesn’t need to undergo surgery. 

Depending upon the severity of the injury, initial improvement is usually seen once the swelling of the brain tissue is reduced. This can occur over days, weeks, or months. Once swelling is reduced, damaged brain cells begin to function again to some degree or another, over a period of weeks to months. Finally, areas that suffer permanent damage are often taken over, to a certain extent, by those areas of the brain that are healthy and undamaged.