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Brain injury remains a major cause of disability and death, especially in young people. In survivors, the extent of recovery depends largely on the severity of the injury. Residual disabilities include both cognitive and physical impairments with the most rapid recovery often occurring within the first 6 months after injury, but improvement may continue for years.
Outcome after TBI also depends on many other factors including patient and injury characteristics such as premorbid state (e.g. older age, comorbidities, personality, cognitive functioning), mechanism of trauma, presence and severity of extracranial injuries, patient response, quality of care and the social environment.
The role of the family in recovery from brain injury is of central importance. Family members provide emotional and practical support, advocate for the patient and assist in rehabilitation. The experience of observing a family member following a traumatic injury is extremely challenging and families can experience high levels of distress, anger, guilt and denial in the early post-traumatic phase. These features are followed, in the longer term, by increasing social isolation, depression and anxiety about the future1–3 and can persist for many years after discharge from hospital. Cognitive and personality changes in the individual with the brain injury are reported as the main causes of family distress than other consequences.