Traumatic brain injury as a chronic health condition.

Growing evidence indicates that multiple types of brain injury, including traumatic brain injury, are dynamic conditions that continue to change years after onset. For a subset of individuals who incur these injuries, decline occurs over time and is likely due to progressive neurodegenerative processes, comorbid conditions, aging, behavioral choices, and/or psychosocial factors. Deterioration, whether directly or indirectly associated with the original brain injury, necessitates a clinical approach as a chronic health condition, including identification of risk and protective factors, protocols for early identification, evidence-based preventive and ameliorative treatment, and training in self-management. We propose that the acknowledgment of chronic brain injury will facilitate the research necessary to provide a disease management approach.