摘要:

Attention deficits are a prominent aspect of cognitive dysfunction after mild traumatic brain injury MTBI. Patients frequently complain of distractibility and difficulty attending to more than one thing at a time, and several neuropsychological studies have found evidence for a specific attention deficit without general neuropsychological impairment. The present study examined the nature of attentional disturbance after MTBI using an extended version of the 2 and 7 Test, which introduced two conditions reflecting patients' subjective complaints: the ability to perform with background 'noise', and while simultaneously attending to a secondary task. The dual task demands produced a significant slowing in processing speed for both the MTBI patients and control subjects. However, the relative decline in processing speed appeared much greater for the patients with MTBI, and they differed from control subjects only in this condition. The results are consistent with findings that patients with MTBI exhibit relatively subtle cognitive deficits which are apparent primarily under conditions which require effortful or controlled cognitive processing and exceed their available cognitive resources. Thus, the attentional deficits apparent during dual task demands may represent decreased cognitive, and perhaps neural, efficiency which reflects MTBI patients' subjective complaints and functional impairments.

ISSN:0269-9052    

DOI:10.1080/026990596124566

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

The language functioning of a group of children who had sustained a severe closed head injury CHI was evaluated. The subjects were administered a battery of language assessments including measures of syntax, semantics and pragmatics. Performance of the experimental group was compared with that of a control group matched for age and sex. Results indicated that all areas of language competence assessed syntax, semantics, pragmatics appeared to be compromised by the childhood CHI. The findings of this study are considered in light of the implications for the existence of different language components syntax, semantics, pragmatics as opposed to a unified concept of language. Also considered is the evidence of a specific linguistic impairment in the childhood CHI population as opposed to a more generalized cognitive decline expressed as an overall decrease in performance across all domains of language skill.

ISSN:0269-9052    

DOI:10.1080/026990596124575

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

The term 'concussion' has been applied to head injuries of varying severity. Most studies have examined subjects suffering concussion of a severity requiring hospital observation, usually as a consequence of motor vehicle accidents. Milder concussive injuries such as those resulting from contact sport are often not reported in hospital-based studies. In this study, subjects with mild concussive injuries were studied with the aim of determining if neuropsychological sequelae are detectable. The subjects received their injuries while playing Australian Rules Football. Baseline pre-injury measures on the Paced Auditory Serial Addition Test PASAT, Digit Symbol Substitution Test DSST and Four-Choice Reaction time, involving measures of decision time DT and movement time MT, were obtained in a sample of 130 players. Ten players subsequently concussed were re-tested at 5 days post-injury. A control group of age-matched umpires were asssessed on two corresponding occasions. Analyses of covariance showed poorer performances following concussion on the DSST and DT measures. The results suggested that neuropsychological deficits are detectable after resolution of neurological symptoms in the early stages following mild concussive injury.

ISSN:0269-9052    

DOI:10.1080/026990596124584

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Arousal profiles are a method that we have developed for using data derived from time sampling to examine how behaviours such as the frequency with which the eyes are observed open, and the frequency of spontaneous movements, vary in the periods immediately before and immediately after sensory stimulation treatment. We believe changes in such behaviours reflect changes in arousal. The use of this new technique is illustrated with examples from a pilot study using data from 15-day treatment blocks, gathered for 10-minute periods immediately before and after sensory stimulation treatment from three patients using single-case research methods. The patients were diagnosed as being in vegetative state following traumatic brain injury. The possible significance of the differing characteristics of the profiles is discussed.

ISSN:0269-9052    

DOI:10.1080/026990596124593

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Subsequent to the setting up of an outpatient psychological service for head-injured patients, 50 patients were interviewed a year from the time of their discharge from our neurorehabilitation unit. The problems which persisted at this stage are presented and discussed. Some of the difficulties encountered in the evaluation of rehabilitation effects are identified. We conclude that: 1 there is a desperate need in the UK for more long-term support and rehabilitation services for this group of patients and 2 it is essential that such services are carefully monitored and evaluated despite the difficulties involved.

ISSN:0269-9052    

DOI:10.1080/026990596124601

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Postacute neuropsychological rehabilitation cannot be done successfully without the personal engagement of the brain-injured client. However, systematically collected data referring to clients' satisfaction with rehabilitation programmes are rare. In this study a structured interview was developed to assess various aspects of treatment evaluation by clients. In addition, handicap was judged by primary therapists. An aetiologically mixed sample of 130 mildly to moderately brain-injured clients undergoing a comprehensive neuropsychological rehabilitation programme was investigated. About twothirds of the sample seemed content with the training programmes whereas a minority (13%) of mostly highly handicapped persons reported being largely discontented. In this respect no differences between cognitive, speech language, and physical therapies were found. Even though many subjects were satisfied with the programme, a majority of clients desired a substantial amelioration in the future (80%), judged their life quality as reduced in comparison to the time preceding brain injury (77%), reported difficulties in accepting 'deficits' (52%), and were frightened of becoming dependent on others (52%).

ISSN:0269-9052    

DOI:10.1080/026990596124610

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Recent research has suggested that staff working with head-injured HI patients experience higher levels of psychopathology than those working with non-HI patients, mirroring findings obtained with relatives of HI subjects. The present study examined this issue further while controlling for the influence of a range of occupational and extraneous, non-occupational factors which moderate the experience of staff stress. The results indicated that nurses involved in the rehabilitation of HI patients did not differ significantly from those working with non-HI patients on measures of overall stress, job satisfaction or psychopathology. The implications of these findings are discussed, with particular relevance to the potentially important protective effect of staff-patient ratios.

ISSN:0269-9052    

DOI:10.1080/026990596124629

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

To aid in determining health care service needs, Wisconsin Department of Health and Social Services DHSS data on Wisconsin hospital discharges for traumatic brain injury TBI, using ICD-9-CM codes for intracranial injury with and without skull fracture, and Wisconsin Department of Transportation data on incapacitating non-fatal head injuries INHI from traffic accidents from 1989 through 1992 were reviewed. Yearly TBI hospital discharges in Wisconsin declined 15.0%, and by 23.9% for Milwaukee County residents, over 1989 through 1992, correlating closely with changes in yearly INHI in Wisconsin (r= 0.999;p<0.01) and in Milwaukee County (r= 0.989;p<0.05). Using 1990 census data the yearly TBI risk ratio for Milwaukee County residents compared to the rest of Wisconsin increased from 1989 (1.76) to 1990 (1.92) and then decreased in 1991 (1.83) and 1992 (1.51). The results of this pilot study suggest there was a decrease in the incidence of hospitalization of patients with TBI in Wisconsin from 1989 through 1992, paralleling a decline in INHI from motor vehicle accidents. There appeared to be a relatively greater decline in these patients in Milwaukee County from 1991 to 1992 as compared to the rest of the state. The techniques employed in this study may be used to help assess rehabilitation service needs in other areas.

ISSN:0269-9052    

DOI:10.1080/026990596124638

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

A chart review of dextroamphetamine treatment in 27 traumatic brain injury patients during rehabilitation therapy suggests that amphetamine treatment enhanced the recovery and functional status of 15 patients.

ISSN:0269-9052    

DOI:10.1080/026990596124647

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

Interactions of physical, emotional, cognitive and behavioural impairments after severe closed head injury (CHI) remain poorly understood. A 47-year-old man was referred to our department 13 months after a severe CHI. He demonstrated severe left hemiplegia and disabling orthopaedic complications (left hip infectious arthritis, after surgical treatment for heterotopic ossification). His hip was blocked and extremely painful. He was totally dependent for daily-life activities (Functional Independence Measure (FIM) score = 18). Moreover he exhibited severe cognitive and behavioural troubles, which had been stable for many months beforehand, e.g. complete disorientation for time and place, major memory disorders, agitation, anxiety, depression, irritability, disinhibition, aggressiveness and lack of initiative. Pain disappeared within a few weeks after treatment. Progressively, functional improvement occurred (sitting position, transfers, walking between parallel bars). The FIM score increased to 63. Aggressiveness, irritability and agitation disappeared. Surprisingly, neuropsychological assessment demonstrated parallel improvement of cognitive functions, especially in regard to orientation, and to a lesser degree attention and memory. Such an observation should encourage use of active treatment of physical disabilities, even in patients presenting with an apparently poor cognitive prognosis at a late stage of severe CHI.

ISSN:0269-9052    

DOI:10.1080/026990596124656

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor