We reviewed pre-admission diagnosis in all patients referred for inpatient brain injury neurorehabilitation over a 5-year period (n = 193). All patients more than 1 month postinjury with diagnosis of coma or persistent vegetative state were selected for review (n = 49). We found that 18 (37%) of these patients were diagnosed inaccurately. Inaccurate diagnosis was more likely if the injury was more than 3 months before admission and the etiology of injury was trauma (48%). Results were statistically significant when traumatic injuries were compared with anoxic injuries (p < 0.10). Errors in diagnosis may result from confusion in terminology, lack of extended observation of patients, and lack of skill or training in the assessment of neurologically devastated patients.

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The Wechsler Adult Intelligence Scale-Revised as a Neuropsychological Instrument (WAIS-R NI) provides methods to uniformly interpret atypical responses or response patterns. To date, little research has examined the primary population for which the supplemental measures of the WAIS-R NI were intended. The purpose of the present study was to compare the performance of individuals with brain injuries versus healthy adults on the supplemental measures of the WAIS-R NI. Forty-nine healthy adults and 45 individuals with brain injuries were tested. MANOVA indicated a significant main effect for group membership and the results suggest the WAIS-R NI supplemental measures differentiate individuals with brain injuries from healthy adults.

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