[Return to work after acquired brain injury. Invisible consequences may interfere with vocational participation]

Acquired brain injury may lead to cognitive, emotional and behavioural problems which often go unrecognised. Combined with the patient's lack of self-awareness this may impede social participation, in particular in returning to work. To stress the importance of diagnosing and treating such consequences, we present two patients. A 40-year-old man suffering from the invisible consequences of brain injury caused by several cerebral infarctions. He tried but failed several times to hold down a job before he was sent to a specialized vocational rehabilitation centre. A 28-year-old man with severe traumatic brain injury started vocational rehabilitation at an early stage. This resulted in a full return to work within six months of the trauma. The Dutch guideline on acquired brain injury and vocational participation aims to help professionals and patients in the vocational rehabilitation process. The guideline strongly recommends setting up an interdisciplinary team consisting of a rehabilitation physician, an occupational physician, and employer and employee.