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  1. Living with a neurological condition

Traumatic Brain Injury

Around one million people visit A&E each year following a head injury. While the majority of these people will experience no lasting effects, many others will be left with a TBI that can have devastating and lifelong effects.


TBI is an injury to the brain caused by a trauma to the head (head injury). There are many possible causes, including road traffic accidents, assaults, falls and accidents at home or at work.


A brief period of unconsciousness, or just feeling sick and dizzy, may result from a person banging their head getting into the car, walking into the top of a low door way, or slipping over in the street. It is estimated that 75-80% of all head injuries fall into this category.


A moderate head injury is defined as loss of consciousness for between 15 minutes and six hours, or a period of post-traumatic amnesia of up to 24 hours. The patient can be kept in hospital overnight for observation, and then discharged if there are no further obvious medical injuries. Patients with moderate head injury are likely to suffer from a number of residual symptoms.


Severe head injury is usually defined as being a condition where the patient has been in an unconscious state for six hours or more, or a post-traumatic amnesia of 24 hours or more. These patients are likely to be hospitalised and receive rehabilitation once the acute phase has passed. Depending on the length of time in coma, these patients tend to have more serious physical deficits. (Headway. 2018)


Survivors of TBI’s are often left with life-long cognitive, physical, sensory, behavioural or emotional consequences that impact on every aspect of their lives and the lives of their loved ones. Recovery and the benefits of rehabilitation are unpredictable, but therapy and the correct support will reduce the long-term consequences for individuals and their families.


Rehabilitation can be provided in the community, in rehabilitation units or as an out-patient and should be provided by a skilled and experienced multi-disciplinary team (MDT). The MDT will normally consist of therapists, doctors, nurses and support staff. In some cases, survivors may require placement in suitable residential or nursing homes and receive continuing NHS healthcare funding.

Published: 1st December, 2018

Updated: 24th January, 2019

Author: Graham Collins

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  • Latest news

    Latest news

    Find out what's been happening at INS in our latest Newsletter... INS face-to-face groups have now resumed but we continue to support our clients through video and phone contact... A hugely positive response to INS online sessions during lockdown... Over 150 people, including then Twickenham MP Sir Vince Cable, and the Mayors of Richmond and Hounslow, joined service users, staff and volunteers at York House for INS 25th Anniversary event on 17 October 2019...

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  • INS Programme

    INS has resumed more face-to-face services. We continue to support our clients and carers by offering virtual group sessions via Zoom videolink and face-to-face sessions at our base in Twickenham- please see below for details of our current programme.

  • Latest news

    Latest news

    Find out what's been happening at INS in our latest Newsletter... INS face-to-face groups have now resumed but we continue to support our clients through video and phone contact... A hugely positive response to INS online sessions during lockdown... Over 150 people, including then Twickenham MP Sir Vince Cable, and the Mayors of Richmond and Hounslow, joined service users, staff and volunteers at York House for INS 25th Anniversary event on 17 October 2019...

  • Working for INS

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  • What is a neurological condition?

    A neurological condition is a disease, illness or trauma that affects the central or peripheral nervous system. Examples of symptoms include paralysis, tremor, cognitive difficulties, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain and altered levels of consciousness.

  • Our Staff Team

    The INS Team includes 13 staff, both full-time and part-time, with generous support from our many volunteers. Sarah Vines began work at INS in August 2020 as our Chief Executive and Clinical Lead.

  • Groups and activities

    INS offers a variety of long term and short-term groups. Some of these groups are for people with a specific neurological condition, while others are open to all neurological conditions. Our groups focus on different areas; some are exercise based, others focus on managing symptoms, while others provide you with an opportunity to try out different activities.

  • Volunteer opportunities

    INS welcomes anybody who is willing to offer their skills and some of their time to assist us in all areas of our work. We already have a team of invaluable volunteers who help us in many ways but we are currently looking for more support.

  • INS Newsletter

    INS Newsletter

    Details of what's been happening at INS in recent months and plans for the coming weeks in our latest Newsletter... Find out how INS has adapted to increased face-to-face work with our clients and carers, while maintaining many of our popular online groups... We also share some of the experiences of our clients, tell you about new activities, and introduce you to the latest INS team members... Also details of how to get your copy of INS in Lockdown from our Creative Writing group and much more!

  • Where we work

    Integrated Neurological Services (INS) provides support primarily to people who live in the London boroughs of Richmond and Hounslow. However, we may still be able to offer support to people living just outside this area (eg. in Kingston, Wandsworth, Ealing) who are within reach of our base in Twickenham.

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