What exactly is the reticular activating system and is it something that can be damaged from a closed head injury? And if so, can it be fixed or treated?
The reticular activating system (RAS) is the area of the brain responsible for regulating arousal and sleep-wake transitions. Damage to the reticular activating system, which has its origins in the brainstem, can occur after a TBI.
Damage to the RAS is generally not “fixable,” but certainly can be treated with rehabilitation strategies that focus on the awake/sleep cycle, pain management, balance issues, and learning to filter incoming stimuli to discriminate irrelevant background stimuli from what you want to retain.
Nathan Zasler, MD is CEO and medical director for Concussion Care Centre of Virginia, Ltd. as well as CEO and medical director for Tree of Life Services, Inc. He is board certified in physical medicine and rehabilitation and fellowship trained in brain injury.