The idea that a brain injury is a chronic disease has only been with us for approximately 10 years, since the seminal paper by Dr. Brent Masel. Prior to that, it was felt that only recovery occurred as time went by, without any chance of further decline. Many things have changed, however.
The notion of “neuroplasticity,” that is the ability of the human brain to repair and rewire after injury or change in function, has undergone dramatic changes in the last 120 years. As early as the late 1800’s the father of modern psychology, William James, wrote extensively on the notion of neuroplasticity of the brain and quite accurately for his time.
By the time a patient gets to the emergency room, unconscious from a trauma, the primary injury to the brain – that is the structural damage to the brain tissue, neurons and blood vessels of the brain has already occurred.