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Nearly 5 million individuals in the US disabled from the effects of stroke, brain hemorrhages, and traumatic brain injuries suffer from memory loss, damage to their mental processing skills, or severe behavioral changes. These effects from brain trauma often do not surface until months after initial medical treatment has been administered. Brain injury patients often find themselves feeling like their lives are back to normal after initial treatment, only to have their lives turned upside-down in a matter of weeks.

Complications range from complete short-term memory loss to erratic mood swings. One woman reported that she could not decide what kind of bread to get while at the grocery store and simply burst into tears in the middle of the aisle. She also reported forgetting the names and faces of her husband and daughter and not being able to find her way home after driving. Physicians are treating patients like the woman described above with cognitive rehabilitation. Cognitive rehabilitation is a medical treatment that attempts to re-teach the injured parts of the brain basic, everyday functions. The therapy was derived from methods used on children with learning disabilities and attempts to create new pathways in the brain.

Cognitive rehabilitation patients show vast improvements in memory and behavior, but the results are difficult to physically document. The lack of concrete evidence has led many insurance companies to refuse to pay for the treatment. This issue is a major problem for physicians of brain injury patients. “It’s hard to demonstrate cognitive progress to the insurance company,” says Thomas K. Watanabe, a Philadelphia professor of physical medicine and rehab. By contrast, he says, “If a patient starts out in a wheelchair and then starts walking with a cane, you can measure that progress.” Until medical providers can find a way to demonstrate evidence of improvement to the insurance companies, many brain injury sufferers simply will not get the much needed treatment.

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