A retrospective archival study of 129 moderate to severe closed head-injury patients from a university-based rehabilitation hospital was conducted to investigate the effect of blood alcohol level (BAL) at time of trauma on the length of post-traumatic amnesia (PTA), length of hospitalization and cognitive status on clearing PTA. While no statistical significance was obtained for the effect of BAL on length of PTA, a mean difference of 15.4 days between 'no alcohol' and 'intoxicated' patient groups was observed. A low, but significant correlation, r = 0.249, p less than 0.05, indicated that as blood alcohol level increased, time to rehabilitation admission increased. The sex of the patient had a significant effect on length of PTA, BAL and time of recovery variable F (6,81) = 2.468, p less than 0.05. Females experienced longer length of PTA, but had lower BALs than males. Measures of cognitive status on clearing PTA did not show a statistically significant effect of BAL. Results are discussed in terms of mediating variables in the relationship between BAL and the length of acute hospitalization, prolonged PTA in patients with a positive BAL, and potential physiological bases for the interaction among sex, BAL and PTA duration.
Does increased intracranial pressure in patients with pseudotumour cerebri (PTC) result in cognitive impairments? The results of previous investigations have not clarified this question. It may be that there is a subgroup within those diagnosed with PTC that does experience cognitive decline with increased intracranial pressure. However, elevated intracranial pressure, headache, and emotional distress also can contribute to reduced cognitive performance and increased self-monitoring. As a result of the lack of clarity regarding the impact of PTC on cognition clinicians are left with no empirically derived practice guidelines. A case study demonstrates subjective complaints of concentration and memory deficits in a depressed patient with PTC whose neuropsychological stores (except Seashore Rhythm Test) were in the normal range.
Patients with brain tumours often report distress. Interpretive problems ensue when measures normed on healthy persons are utilized to quantify distress. This study investigated potentially spurious elevations on the Hopkins Symptom Checklist 90 Revised (SCL 90-R). Responses of 17 patients were obtained prior to aggressive chemotherapy. Traditional interpretation indicated that 47% of the patients endorsed clinical levels of somatization, 53% obsessive-compulsive and 59% psychotic disorders. Elevations were attributable to common consequences of brain tumours, medication and the emotional reaction to prognosis. Conventional interpretation would lead to inappropriate classifications. The majority of SCL 90-R item endorsements were significantly different than those of the norm group. Appropriate interpretation of scores is discussed.
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