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Key factors that weigh in on traumatic brain injury care, rehab

Here is a startling disconnect, as noted by Geoff Manley, a neurological surgery expert at the University of California, San Francisco, and Lisa McGuire of the federal Centers for Disease Control and Prevention: Although the estimated costs to the nation associated with traumatic brain injury (TBI) last year were in excess of $76 billion, the total funding that is available to the National Institutes of Health for TBI research in 2012 is a scant $85 million.

That both perplexes and frustrates researchers and medical practitioners who work with brain-injury victims. Manley calls the dearth of available services and lack of funding "a travesty."

What medical professionals also find disconcerting are the relative hit-or-miss aspects related to treatment. One patient might be lucky enough to receive exemplary intensive trauma care with long-term rehabilitative treatment thereafter, for example, while another patient receives mediocre care initially and little follow-up over time to address issues concerning cognitive abilities, the emotional aspects of severe head trauma, and related issues.

The severe head injury sustained by Arizona Rep. Gabrielle Giffords last year, and information concerning her rehabilitative therapy, has served to focus a great deal of attention on brain-injury symptoms and care. Giffords has both lauded the care she has received and advocated that it should be standard for every person suffering from a brain injury.

Experts say that Gifford's high level of care owes less to her congressional status than it does to her insurance carrier and coverage through federal workers' compensation.

Many factors are involved that influence the type of care ultimately received, say experts. The state a person lives in can have an affect (Texas law, for example, requires that rehabilitation be provided for brain-injury victims). Insurance plans vary widely, as does personal advocacy in any given case.

And hospitals matter. Some -- if not most -- render merely adequate care for head injuries, says Manley, who adds that there are very few facilities that truly stand out for offering exceptional care.

Source: Pro Publica, "Giffords may get better brain-injury care than most of her constituents" Lena Groeger, Jan. 17, 2012

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*Certified Specialist in Injury and Wrongful Death Litigation by the State Bar of Arizona, Board of Legal Specialization