The severity of an illness or injury is usually graded according to the amount of tissue that has been damaged and the extent to which normal function of the affected parts of the body has been impaired. This is easy to do when an injury is fully visible – like a broken leg – and when technical tests are available that can be measured precisely by a machine – such as a blood test in someone with kidney failure.

After brain injury, assessment is much more complicated. The brain is a communications system in which a small area of damage in one part of the brain may cause much more serious problems than a larger area of damage in a different part of the brain. Measurement of the consequences is less precise and relies on a careful assessment by other people of the injured person’s overall physical and mental functions and behaviour, backed up by interviewing the patient, family members and, sometimes, others who know the person well – as well as looking at the scans and Xrays of the head.

In most cases of significant brain injury, assessment by more than one type of professional is needed to identify the problems accurately enough for a rehabilitation plan to be made. The rehabilitation professionals should then pool their observations and share them with the injured person and family members before proceeding with therapy.

A key component in all testing is finding out from others who know the patient what their personal history is, what their interests are, their likes and dislikes are and how they normally behave.

The methods that are most helpful in assessing severity are different at different stages of recovery. Predictions made early on are often not very accurate but they get more... Read in full...

There tends to be a period after regaining consciousness in which memory is unreliable, especially for day to day events after the injury. This is called ‘post-traumatic amnesia’. After... Read in full...

For those whose recovery is not yet complete, the rate and trajectory of recovery  provides further help in predicting how long it is likely to take and what the... Read in full...

After more severe injures it can be difficult to decide exactly when to take stock of the ‘final’ outcome, since subtle improvements can continue for so long. Eventual outcome... Read in full...

Although the outcome of rehabilitation itself is usually assessed with reference to the recorded objectives of the therapy that has been given, this is only one indicator because of... Read in full...