摘要:

Although significant advances have been made in the application of psychopharmacological treatment methodologies to the survivors of traumatic brain injury, to date little has been published regarding the Integration of these new therapeutic options within the context of traditional rehabilitation approaches. This article describes a conceptual approach to such an integration and discusses aspects of current clinical, fiscal, and legal environments that affect implementation of such an integration.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

With the increasing survival of patients with traumatic brain injury (TBI), there is a growing recognition of the severity and heterogeneity of associated cognitive problems. Cognitive impairments ranging from arousal and attentional decrements to memory problems and various disorders of speech and language provide significant obstacles to the ongoing rehabilitation effort. One approach to ameliorating cognitive deficits is to intervene pharmacologically in an effort to effect symptomatic change via neurochemical alteration. In this review we discuss the therapeutic rationale and use of various classes of drugs including stimulants, dopaminergic agents, cholinergic agents, and antidepressants for the cognitive deficits that are apparent within a wide range of patients with acquired brain injury. A thorough review of literature pertaining to TBI is emphasized while necessarily including some studies from other populations. Recommendations based on findings within the literature are suggested as well as an overview on clinical use and monitoring of individual agents.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Destructive behavior following traumatic brain injury can occur during every phase of recovery. It is a symptom of many neuropsychiatric syndromes. To date, there have been few adequately controlled studies to guide clinicians in the neuropharmacologic management of this problem. However, there are emerging strategies that have been helpful for some patients. This article develops a syndromic approach to understanding these behavioral disorders and summarizes the available data and clinical experience in their management.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Affective and psychotic disorders may occur after traumatic brain injury. These symptoms may arise from the direct effect of the trauma on the brain, from the side effects or withdrawal from drugs and medications, and from the emotional reaction to the event. Patients with TBI are especially sensitive to the side effects of drugs that act on the central nervous system. When appropriate guidelines are followed, psychopharmacological intervention alleviates these symptoms, enhances rehabilitation, and avoids impairment of arousal and attention.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Tills review discusses recent advances in pharmacological treatments of brain injury that affect the rate at which behavioral recovery occurs in animals and humans. Treatment strategies aimed at the very early post injury stage and the later recovery stage, along with proposed mechanisms underlying such treatment, will be critically assessed with respect to clinical management.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Psychopharmacological agents are in common clinical use in traumatic brain injury rehabilitation despite relatively little formal research on their efficacy. Traditional, large, group studies of drug efficacy are exceedingly difficult and expensive to conduct in a heterogeneous population that is constantly evolving due to spontaneous recovery and non pharmacological, treatment interventions. This article proposes methods for combining individual clinical outcome measures, standardized treatment protocols, and a clinical database to allow integration of research and clinical care. At a minimum, this approach should improve documentation of patient progress. In its most developed form, it offers the potential to demonstrate drug efficacy in specific patient subgroups.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The Family Needs Questionnaire (FNQ) was administered to 119 family members of patients with a primary diagnosis of brain injury. Patients had mild, moderate, or severe injuries and were in the acute and postacute stages of injury. Relatives, including wives, mothers, fathers, and children, rated 40 needs based on importance and the extent to which needs were met. A review of responses revealed that most needs were judged as important, especially those pertaining to information and reassurance. The pattern of frequently reported unmet needs suggested that many family members felt misunderstood, isolated, and unsupported. Income and gender were related to needs, but family education, age, and injury characteristics were not. Findings were consistent with previous research on family needs and provided evidence that the FNQ has content validity.

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1994

数据来源: OVID