Fever frequently presents during recovery from traumatic brain injury (TBI). Elevated body temperature may result from ensuing infection, thrombophlebitis, drug reaction, or a defect in the central thermoregulatory system such as seen in post-traumatic hyperthermia (PTH). Typically, the diagnosis of PTH follows only after thorough investigation. Literature supports the theory that the febrile TBI patient, lacking a documented source, has central hyperthermia. The purpose of this study was to determine the incidence of PTH in the acute rehabilitation setting. We reviewed a consecutive series of 84 TBI patients participating in a rehabilitation programme. Four per cent of the patients in this study met our criteria for PTH. We describe a fever protocol that should aid the physician in diagnosis and treatment of the febrile TBI patient. Proposed mechanisms involved in thermoregulation are discussed.

The physical health of individuals with TBI is associated with spiritual beliefs but not religious practises or congregational support. Better mental health is associated with increasing congregationally based social support for persons with TBI. Religious practises (i.e. praying, etc.) are not related to either physical or mental health, as some persons with TBI may increase prayer with declining health status.

The current study attempted to determine: 1) If frontal lobe TBI produces specific long-term cognitive deficits that are measurable on objective testing; and 2) Which tests are most appropriate for assessing frontal deficits. The study involved 41 patients: 10 sustaining TBI with frontal lesions on CT, 11 sustaining TBI without frontal lesions, and 20 controls. TBI subjects were included only if they were evaluated as outpatients to ensure that their cognitive deficits were stable, and not due to acute injury. The results suggest that: 1) Frontal lobe TBI produces a specific profile of cognitive deficits (characterized as inflexibility), with relative deficits on the Trail Making Test Part B and Rey AVLT that 6 (not trials 1-5), but generally intact performance on other cognitive measures: and 2) Tests useful in evaluating global cognitive dysfunction (i e, Rey AVLT) may need to be used differently for the specific evaluation of frontal lobe dysfunction.

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