摘要:

Traumatic brain injury (TBI) refers to a broad range of neurological, cognitive and emotional factors that result from the application of a mechanical force to the head. Mechanical force can be applied on a continuum from none to very severe, and the extent of brain injury is related to the severity of this force. A review of the literature reveals that, while considerable research has been done on minor head injury, there remain several major sources of confusion. First, one of the most noticeable problems relates to the fact that the mild head injury has lower limits which are vaguely defined. This leads to individuals being categorized as having sustained a mild TBI despite minimal or no neurological damage being present. A second source of confusion in the literature is related to the failure to differentiate between cognitive consequences of TBI and post-concussion symptoms (PCS). Since PCS can occur in the absence of head injury, and are often present beyond the period of cognitive recovery from mild TBI, the two clearly result from different factors. Researchers have often failed to separate these two factors when studying recovery of function, and this has led to varying findings on outcome. Finally, many pre-injury factors (age, education, emotional adjustment) and post-injury factors (pain, family support, stress) interact with cognitive functioning and significantly affect recovery from TBI. These problems are reviewed and discussed.

ISSN:0269-9052    

DOI:10.1080/026990596124494

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

In order to investigate the organic and psychogenic components of post-concussive syndrome (PCS), the subjective complaints, the cognitive findings and the Minnesota Multiphasic Personality Inventory (MMPI) profiles of 53 consecutive mild head injury patients (MHI) with persistent PCS were evaluated. The results seem to suggest the presence of two groups: in the first, minimal lesional signs were associated with more prolonged loss of consciousness (LC) and post-traumatic amnesia (PTA), as well as an MMPI profile not indicative of a neurotic state, whereas in the second the absence of any lesional sign was associated with shorter LC and PTA duration, as well as evidence of neurotic MMPI scores. A female prevalence was observed in the first group and a male prevalence in the other one.

ISSN:0269-9052    

DOI:10.1080/026990596124502

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Magnetic resonance (MR) quantitative neuroimaging analysis was undertaken with a large group of normal (n = 197) and traumatically brain injured (TBI, n = 99) adults. Of the TBI subjects 18 patients were identified with a history of substance-related abuse (TBI/Abuse group). Both the TBI/Abuse group and the remaining sample of TBI patients ( n = 81, TBI/Non-abuse group) without a history of substance-related abuse differed significantly from the control group on most quantitative MRimaging analyses. The TBI/Abuse group displayed the greatest degree of atrophic change. However, the TBI/ Abuse group had a significantly lower Glasgow Coma Scale (GCS) score, ostensibly suggesting that those with substance-related abuse suffered more severe brain injury than non-abuse TBI patients. When a subset (n = 18) of the TBI/Non-abuse group was matched by GCS, gender and age to the TBI/Abuse group, both groups differed significantly from the control group on most morphometric measures, but did not differ from one another. Results are discussed in terms of the potential adverse role that substance-related abuse, particularly alcohol, plays in the individual who sustains traumatic injury to the brain.

ISSN:0269-9052    

DOI:10.1080/026990596124511

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

About 63% of all traumatic brain injuries (TBI) occur in teenagers and adults aged 15-64 years, the primary working population. Since reports of failure to return to work (FTRTW) vary, understanding the factors that influence FTRTW is key to improving work outcomes for this primarily working-age population. Our study sample consists of 343 previously employed persons who were hospitalized following TBI and had either returned to work at 1 year or had failed to return to work because of their injury (injury-related FTRTW). Medical records were reviewed and participants were interviewed by telephone at 1 year post-discharge. Individuals with injury-related FTRTW were far more likely to report dependence or modified independence on the Functional Independence Measure (FIM) than those who were employed at 1 year. The joint distribution of motor and cognitive items suggests that, for a given level of cognitive function, the addition of a motor limitation will result in greater injury-related FTRTW. In addition as motor function declines, FTRTW is further increased. Injury-related FTRTW is also associated with being unmarried and not completing high school. While the importance of behavioural, economic, and psychosocial factors should not be minimized, services aimed at improving function can be expected to have an impact on RTW after TBI.

ISSN:0269-9052    

DOI:10.1080/026990596124520

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

A single-case study is reported of an adult female exhibiting perseverative behaviour on the ward, following anoxic brain damage subsequent to an attempted suicide by hanging. Her behaviour consisted of excessive requests to use the telephone, and was accompanied by a lack of insight, impaired memory and blunted affect, with no evidence of anxiety when prevented from using the telephone. Treatment to reduce the persistent requests was given in two stages, and consisted of feedback, and feedback plus extinction. Results indicated a marked reduction in the perseverative behaviour, though it appeared that this did not generalize to the home environment following the woman's discharge from hospital.

ISSN:0269-9052    

DOI:10.1080/026990596124539

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Confusion, agitation, and non-compliance are some of the most common behaviours exhibited by individualswith brain injury. The presence of these behaviours affects their daily functioning and social interactions with others. Management of these behaviours ranges from prevention and total ignoring to restraint, with the strategy of redirection cited most often in the literature. However, few guidelines exist on how to use redirection to manage clients who exhibit confusion and agitation beyond the acute phase of rehabilitation. This paper describes some of the intervention strategies that use guidance and redirection for individuals with brain injury in post-acute rehabilitation. Case examples are used to illustrate the various interventions.

ISSN:0269-9052    

DOI:10.1080/026990596124548

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:0269-9052    

DOI:10.1080/026990596124557

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor