OUR SERVICES

The treatment of traumatic brain injury (TBI) requires a multispecialty team approach because each injury is as unique as the individual affected. Effective treatment begins with a thorough examination, followed by assembling the right combination of specialists and tailored interventions to improve the patient’s quality of life and functional independence. As the constellation of symptoms can change over time with treatment, repeated evaluations are essential to adjust and optimize the care plan. This dynamic approach ensures that all aspects of the patient’s recovery are addressed, maximizing the potential for rehabilitation and long-term success.

Specialties

Physical Medicine and Rehabilitation (Psychiatry): Specializes in the rehabilitation of TBI patients, helping to restore physical function, mobility, and overall quality of life through customized therapy plans.

Neurology: Focuses on diagnosing and managing the neurological complications of traumatic brain injury, such as cognitive impairment, headaches, and seizures.

Neurosurgery: Provides surgical intervention for patients with severe traumatic brain injuries, including decompressive craniectomy or the removal of hematomas to relieve pressure on the brain.

Neuropsychology: Assesses and treats cognitive, emotional, and behavioral changes resulting from traumatic brain injury, developing strategies to enhance mental functioning and adaptation.

Speech-Language Pathology: Addresses communication, cognitive-communication, and swallowing disorders in TBI patients to improve their ability to communicate and manage daily activities.

Psychiatry: Manages mood disorders, anxiety, depression, and other psychiatric conditions that may arise after a traumatic brain injury, offering both medication and therapy-based interventions.

Neuro-optometry: Specializes in diagnosing and treating visual problems related to traumatic brain injuries, such as visual field loss, double vision, or visual processing difficulties.

Neurosurgery: In a TBI clinic, neurosurgeons perform comprehensive evaluations to assess brain and spinal injuries using advanced imaging techniques and neurological exams, determining the severity and appropriate course of treatment, including nonsurgical management options.

Therapies

Trauma Therapy: Specializes in treating PTSD and other trauma-related conditions in TBI patients using Eye Movement Desensitization and Reprocessing (EMDR), a therapeutic approach that helps process and reduce distress from traumatic memories, promoting emotional healing and resilience.

Social Work: Supports TBI patients and their families by connecting them to community resources, providing counseling, and helping navigate the challenges of long-term care and rehabilitation.

Vision Therapy: Provides specialized therapeutic exercises and techniques to improve eye coordination and visual processing in patients with convergence insufficiency or binocular vision disorders following a traumatic brain injury, enhancing their ability to focus and process visual information accurately.

Occupational Therapy: Focuses on helping TBI patients regain independence in daily living activities through exercises, adaptive strategies, and environmental modifications.

Neuropsychology: Offers targeted treatment for patients with traumatic brain injuries by developing individualized rehabilitation plans to address cognitive deficits, emotional regulation, and behavioral challenges, aiming to enhance overall brain function and daily living skills.

Sleep Medicine: Evaluates and treats sleep disorders in TBI patients, addressing issues such as insomnia, hypersomnia, or sleep apnea that may be exacerbated by brain injury or chronic pain, to improve sleep quality, overall health, and recovery outcomes.

Vestibular Physical Therapy: Focuses on diagnosing and treating dizziness, balance problems, and vertigo in TBI patients by using exercises and techniques designed to retrain the brain’s ability to coordinate movement and maintain balance.

Testing

EEG with Evoked Potentials: Measures the brain’s electrical activity and its response to sensory stimuli, helping to identify abnormalities in neural pathways affected by traumatic brain injury.

Oculometrics: Analyzes eye movements to assess neurological function, providing insights into brain injury impact on visual and cognitive processing.

Video Nystagmography (VNG): Evaluates eye movements and balance by recording involuntary eye movements (nystagmus) to diagnose vestibular disorders associated with brain injury.

Customized Balance Testing and Retraining: Assesses and improves a patient’s balance and coordination through tailored exercises, addressing deficits caused by traumatic brain injury.

Sleep Studies: Monitors sleep patterns and disorders, such as insomnia or sleep apnea, often associated with traumatic brain injuries to optimize sleep quality and recovery.

Vestibular Ocular Motor Screening (VOMS): Screens for vestibular and ocular motor dysfunctions, including dizziness and visual disturbances, common in traumatic brain injury patients.

Laboratory Testing for Pituitary Injury and Advanced Biomarkers: Involves measuring hormone levels and conducting specialized blood tests to detect dysfunctions in the pituitary gland, which can be disrupted by traumatic brain injury, and utilizing advanced biomarkers to assess brain inflammation, neuronal damage, and recovery potential.

3 Tesla MRI with Diffusion Tensor Imaging (DTI) and Post-Imaging Processing: Utilizes high-resolution 3 Tesla MRI combined with DTI to visualize and measure the integrity of white matter tracts in the brain, providing detailed insights into microstructural damage following traumatic brain injury. Post-imaging processing includes volumetric analysis to quantify brain atrophy or changes in specific regions, aiding in the diagnosis, prognosis, and personalized treatment planning.

Interventions

Botox for Migraines: Involves injecting botulinum toxin into specific areas of the head and neck to reduce the frequency and severity of migraines commonly experienced by traumatic brain injury patients.

Trigger Point Injections: Administers medication directly into painful muscle knots to relieve localized pain and muscle tension resulting from trauma or injury.

Occipital Nerve Blocks: Involves injecting anesthetic and anti-inflammatory medication around the occipital nerves at the base of the skull to alleviate headache and neck pain associated with nerve irritation.

Cryoneurolysis of the Occipital Nerves: Uses extreme cold to temporarily disable the occipital nerves, reducing chronic pain and headaches stemming from nerve irritation or injury.

IV Ketamine for Refractory Traumatic Brain Injury-Associated Depression, Anxiety, Acute Suicidality, and PTSD: Provides intravenous ketamine infusions to rapidly alleviate symptoms of severe depression, anxiety, suicidal ideation, and post-traumatic stress disorder when other treatments have been ineffective.

Medication Management: Involves a comprehensive evaluation and adjustment of medications by a team of specialists to effectively manage symptoms related to traumatic brain injury, such as pain, mood disorders, cognitive dysfunction, and sleep disturbances, ensuring optimal therapeutic outcomes while minimizing side effects and interactions.

Patient Education: Offers comprehensive education through videos, handouts, and personalized counseling to help patients and their families understand the nature, symptoms, and management of traumatic brain injury. Advanced 3D modeling of brain scans is also used to visually demonstrate the specific areas affected by the injury, enhancing patient comprehension and engagement in their treatment plan.

Rincon Physical Medicine & Rehabilitation

Topher Stephenson, M.D.

875 University Avenue
Sacramento, CA 95825
(916) 538 – 3545

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