Neuropsychological rehabilitation of mild traumatic brain injury

Abstract

A significant minority of patients who have sustained a mild traumatic brain injury (MTBI) may exhibit persistent disability. There have been few attempts to describe and evaluate the effectiveness of neurorehabilitation for these patients. We conducted a retrospective analysis of the results of a neuropsychological rehabilitation programme for 20 patients with MTBI. Based upon the ability to resume productive functioning after treatment, 10 patients were determined to exhibit a good outcome and 10 patients were considered to exhibit a poor outcome. Patients with good outcome exhibited significant pre-post-treatment improvements on both neuropsychological measures of cognitive functioning and self-reported post-concussive symptoms. Patients with poor outcome demonstrated little improvement in either area, and in some cases showed a decline in functioning. The results are consistent with the view that there may be significant variability in recovery and response to treatment after MTBI. There is a continued need to identify which patients may benefit from neurorehabilitation, develop specially tailored interventions, and conduct controlled, prospective studies in this area.

Efficacy of Traumatic Brain Injury Rehabilitation: Interventions of QEEG-guided Biofeedback, Computers, Strategies, and Medications

“…The raw initial scores (immediate and delayed recall) on the Wechsler Memory scale were provided in three studies using interventions of computers (Gray and Robertson 1992) and strategies (Cicerone et al 1996;Ryan and Ruff 1988). The mean recall score for the three studies was 13.9 (average SD of 3.38; Ms range from 11.1 to 16.8).…”

A systematic review of treatments for mild traumatic brain injury

“…In general, participants were treated soon after injury (range: hospital discharge 4.5 years). In some instances, studies failed to provide any information regarding participant gender [40,47,52]. In studies evaluating injuries of all severities, information on age and gender were not provided specifically for persons with MTBI [56,57].…”

“…One study [41] failed to provide an operational definition of MTBI, while others [49,50,[55][56][57] employed loose, idiosyncratic definitions that lacked reference to common brain injury markers such as GCS, PTA or LOC. Of the studies reviewed, four referred to a GCS score of 13-15 [39,46,51,52], four referred to PTA less than 24 hours [39,40,51,52], six used LOC less than 60 minutes [40,42,45,[52][53][54] and one used LOC equal to 24 hours [48] to define MTBI in study participants. Only four studies adhered to the consensus definition put forth by the ACRM [37,38,43,44,47].…”

Mentally disordered offenders with a history of previous head injury: are they more difficult to discharge?

“…It may be assumed that for most of these patients the head injury was relatively minor. However, even mild head injury can lead to disturbed functioning and persistent deficits [21,22], and a minor head injury may be a significant stressor in someone who is already vulnerable by reason of the various social and medical factors outlined above. Furthermore, because of the poor medical notes available for some patients and the absence of any consistent recording of a head injury, it is possible that some of the patients in the non-HI group may have had a mild head injury themselves.…”