title: Moderate-to-severe traumatic brain injury.
abstract: Managing patients with moderate-to-severe traumatic brain injury (TBI), particularly those with combat-related blast injury, is exceptionally challenging. Optimal care requires the coordinated efforts of numerous providers, contributing to an interdisciplinary team. Given the complexities of TBI and the variety of physiologic, physical, cognitive, behavioral, and emotional manifestations of the injury, a holistic approach to patient care is needed throughout the entire continuum of care. In this article, the authors provide an overview of how interdisciplinary care is provided from the acute to the chronic settings, and illustrate the important role that rehabilitation plays throughout the continuum of care in facilitating maximizing recovery, functional independence, and quality of life. Common conditions associated with TBI are illustrated through a case presentation of an individual with blast-related polytrauma and help to frame a more detailed discussion of subtopics including neurointensive care, posttraumatic seizures, venous thromboembolic disease prevention, spasticity management, vestibular disorders, endocrine dysfunction, and psychological trauma.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Paul
authors.initials: P
authors.lastname: Pasquina
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kirtley
authors.affiliation: Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Ling
mesh_terms: D001753:Blast Injuries / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000639:trends*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D055815:Young Adult