ISSN:0269-9052    

DOI:10.3109/02699059209008134

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Forty-three patients with closed head injuries were followed up 5 to 12 months post-injury. Patients had magnetic resonance imaging (MRI) and performed a variety of neuropsychological tests. There were systematic relationships between lesions in different sites: depth of lesions in orbito-frontal regions, frontal regions, and temporal poles were particularly strongly intercorrelated. Depth of lesions in specific sites also correlated with an overall measure of brain damage: the number of areas with lesions present. After correcting for premorbid differences there were significant correlations between lesions in specific sites and scores on three out of five WAIS subtests. Scores on these three subtests also correlated significantly with overall brain damage. In general, hemispheric sites which were significandy related to neuropsychological measures also showed significant intercorrelations among themselves. The findings stress the importance of patterns of lesions in head injury, and emphasize the difficulty of showing differential localization of cerebral function in this population.

ISSN:0269-9052    

DOI:10.3109/02699059209008135

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Compensation neurosis (CN), also known as accident neurosis, has generally not been considered to be a 'real' disorder. In 1961 it was seemingly laid to rest by Henry Miller, a distinguished neurologist, in a sharp article which appeared in theBritish Medical Journal.Miller's view of patients who presented psychological symptoms following accidents or traumas was suspicious. Compensated or not, his view seemed to be that they should have their legal process finished as quickly as possible and then they will miraculously convalesce. Miller's work, it appeared, was thecoup de gracefor this ill-defined diagnosis. Today, however, compensation neurosis seems to ride again. After a prolonged silence in the psychiatric literature, new papers are emerging, strongly suggesting that this vanishing diagnosis be reconsidered. This new trend will be presented.

ISSN:0269-9052    

DOI:10.3109/02699059209008136

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The status of sensory stimulation as a clinical procedure is still in some doubt. Recent papers have shown no significant clinical changes as a result of sensory intervention but this may be due to an inappropriate model on which these procedures were based. This paper outlines the results of a controlled pilot study, based on a sensory regulation model currendy being tested at the Casa Colina Peninsula Rehabilitation Center, Los Angeles. The study contrasts the outcome of four patients treated in a sensory regulated environment with four who were exposed to sensory stimulation of an unregulated kind. The results are quite encouraging in favour of a sensory regulation approach.

ISSN:0269-9052    

DOI:10.3109/02699059209008137

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The combined effects of intensity of treatment and length of stay during inpatient rehabilitation hospitalization on the outcomes of 95 traumatic brain injury patients were examined. Outcome was assessed using the Rancho Scale and three measures of functional status-physical performance, higher-level cognitive skills, and cognitively mediated physical skills. The effects of intensity of treatment and length of stay were assessed using 2×2 analyses of variance with repeated measures. The results showed clearly that both length of stay and intensity of treatment affect outcomes. Patients in the long length of stay group consistently made more progress across all outcome variables than patients in the short length of stay group. However, the greater progress of the long length of stay patients was from a point significantly more disabled than that of the short length of stay patients, with improvement at discharge to the point at which the groups were now equal. The effect of intensity of treatment was significant or closely approached significance for higher-level cognitive skills and Rancho Level. In the long length of stay group, the two intensity groups were initially equivalent, but at discharge the high-intensity group surpassed the low-intensity group. The practical implications of the results are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059209008138

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

In view of the difficulties in finding control groups in sensory stimulation research, a single case methodology was explored. A pilot study was conducted on six comatose CHI patients in a neurosurgical intensive care unit. Each patient was given alternating weeks of directed multisensory stimulation (SDS) and non-directed stimulation (NDS) for half an hour a day in an ABAB single subject design. Eye movement, motor and vocal responses to stimulation were recorded using the Sensory Stimulation Assessment Measure (Rader Scale). Comparisons of eye movement and motor responses on the Rader Scale appeared to indicate a greater degree of responsiveness to the SDS as compared with the NDS treatment. Overall improvement levels on the GCS, Rancho Scale and Western Neurosensory Stimulation Profile are discussed. The results are interpreted as indicative of the potential value of using single case methodology in this population, and future research directions are also discussed.

ISSN:0269-9052    

DOI:10.3109/02699059209008139

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

A retrospective analysis of functional status at discharge, disposition, Glasgow Outcome Scale (GOS) score at 6 months and 1 year was undertaken for 23 consecutive 'low-level' traumatic brain injury victims admitted in a state of complete dependency to an acute rehabilitation programme. All patients met criteria for extremely severe traumatic brain injury, with an average Glasgow Coma Scale score of 8-7 at admission to the rehabilitation facility (an average of 44 days post-injury). All but three patients made significant functional gains during the acute rehabilitation stay. Almost half of the study patients (48%) were discharged at home while the rest went to sub-acute rehabilitation programmes. At 6 months post-injury eight (35%) met GOS criteria for 'good' outcome or 'moderate disability'. A review of clinical features, categories of functional progress, and relationships of outcome and disposition to variables known to have predictive value in such a patient population is described. Analysis of variables related to admission selection criteria that have been used in this rehabilitation programme is presented and the basis and implications of selection criteria discussed.

ISSN:0269-9052    

DOI:10.3109/02699059209008140

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Central nervous system (CNS) trauma can produce a multitude of physical and psychological sequelae, depending on the neurological level of injury. Clinicians have long recognized the adjustment difficulties posed in marriages of CNS trauma victims, yet there is little research documentation for this observation. The marital relationships of moderate (n=31) and severe (n=17) head injury (HI) groups and a spinal cord injury (SCI) group (n=24) were assessed through spouses' self-reports in interview and through standardized questionnaires. Analyses indicated that the three groups were not statistically different in age, number of months post-injury, pre- and post-injury occupational status, and level of income. In the post-injury marital relationship, the severe HI group was significantly lower than the moderate HI and SCI groups on standardized and validated scales assessing affectional expression (p<0.002), dyadic satisfaction (p<0.001), dyadic cohesion (p<0.01), and total dyadic adjustment (p<0.001). On a scale of social role functioning, the severe HI group's performance was significantly lower than the moderate HI and SCI groups (p<0.005). These results empirically substantiate the clinical observation that adjustment difficulties may be more intense for wives of the severely head injured than the moderately injured or the SCI, as they must deal with neuropsychological as well as physical fall-out from the injury.

ISSN:0269-9052    

DOI:10.3109/02699059209008141

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Somatic delusions following brain injury are not uncommon, and have been well documented in the literature. This study documents a case of somatic delusion which was seen in a patient following a head injury secondary to a motorcycle accident. Although perhaps not typical it serves to illustrate an interesting example of a somatic delusion following head trauma. On recovery from coma this patient reported the existence of a 'third arm' adjacent to the limb that had received the greatest impact in the accident. The patient was unreceptive to any counter-persuasions and in fact remained largely unconcerned about this addition to his anatomy. A thorough neuropsychological evaluation was carried out in an attempt to seek an explanation for this phenomenon. The results suggest that the phenomenon has at least a partly psychiatric aetiology rather than a purely neurological foundation.

ISSN:0269-9052    

DOI:10.3109/02699059209008142

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

ISSN:0269-9052    

DOI:10.3109/02699059209008143

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor