摘要:

The use of pharmacological agents as rehabilitative tools following brain injury remains to some degree both a science and an art. Recent work in the area of the neural sciences has shed new light on the workings of basic CNS neurochemical systems and the use of pharmacologic agents in altering central neurophysiologic processes. The major central neurochemical systems are reviewed both anatomically and physiologically. An overview is provided of basic neuropharmacologic agents by class. Lastly, some of the newer neuropharmacological options for treatment of post-acute brain injury deficits are examined.

ISSN:0269-9052    

DOI:10.3109/02699059209008117

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Ten adults, who had sustained a closed head injury, were interviewed regarding their self-understanding, concepts of persons, and interpersonal negotiation strategies. Responses were evaluated in terms of developmental levels of social cognition. Levels of interpersonal negotiation strategies were significantly lower than levels of self-understanding, descriptions of psychological characteristics of self were at a significantly higher level than descriptions of active and physical characteristics of self. Within interpersonal conflict situations, proposed solutions were at a significantly lower level than the justifications offered for the solutions. In general, developmental levels of social cognition were comparable to levels exhibited by non-clinical samples of adolescents. The two areas in which the head-injury patients appeared to perform at a significantly higher level than adolescents were their justifications for their proposed solutions to the interpersonal conflict situations and their ability to express the emotional consequences of interpersonal conflict.

ISSN:0269-9052    

DOI:10.3109/02699059209008118

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

This study investigated the hypothesis that children sustaining a mild closed head injury have a higher prevalence of premorbid behavioural problems than children in the general community. The prevalence of emotional and behavioural problems among children with a mild closed head injury was compared with the prevalence of problems in children with a severe closed head injury, children in the general community, and children referred to a psychiatric outpatient clinic. The results showed that the children with a mild head injury did not have significantly more premorbid emotional and behavioural problems than other children in the community. The children with a mild head injury also had significantly fewer emotional and behavioural problems than children referred to a psychiatric outpatient clinic. The results suggest that the common assumption that children with a mild closed head injury have a higher prevalence of premorbid emotional and behavioural problems than other children in the general community may not be correct.

ISSN:0269-9052    

DOI:10.3109/02699059209008119

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The language functioning of a group of 14 children who had sustained a mild closed head injury (CHI) at least 10 years previously was assessed. The subjects were administered a battery of language assessments including an overall language test, and specific language skills assessments. Performance of the head-injured group was compared with that of a group of non-neurologically impaired accident victims matched for age, sex and educational level. Overall language performance of the experimental group did not differ significantly from the controls.

ISSN:0269-9052    

DOI:10.3109/02699059209008120

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The quality of outcome after severe closed head injury has become of increasing concern to neurosurgeons. The assessment of residual deficits in patients who have recovered from closed head injury can be very difficult. Many patients are classified as having a good recovery according to the Glasgow Outcome Scale (GOS), but this may be insufficiently focused or sensitive to demonstrate mental deficits objectively. We investigated 33 patients with severe closed head injury who subsequently were diagnosed as having made a good recovery according to the GOS. The severity of the injury was determined by the Glasgow Coma Scale (GCS) and by the presence of a midline shift in the preoperative CT scans. There was a minimal interval of 15 months (x= 1080-5 days, SD = 491 days) between injury and time of neuropsychological testing. Their performance was compared with that of 15 orthopacdic cases. Residual neuropsychological deficits can be demonstrated on the majority of measures in a group of patients who have achieved good recovery on the GOS. Midline shift in preoperative CT scans is not of prognostic value for long-lasting neuropsychological deficits.

ISSN:0269-9052    

DOI:10.3109/02699059209008121

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The relationship between traumatic brain injuries and associated peripheral nerve injuries has not been previously studied in children in the rehabilitation setting. One hundred and fifty-seven consecutive admissions of brain-injured children were included in this prospective study to determine the frequency and pattern of recovery of peripheral nerve injuries in such patients. Twelve patients met the clinical diagnostic criteria for peripheral nerve injury. Electrodiagnostic studies confirmed the clinical diagnosis in 11 (7%) patients. Grading of spontaneous activity and electrodiagnostic study of the contralateral limb were used to differentiate electromyographic abnormalities due to upper motor neuron lesion and nerve injury. Electrodiagnostic study was useful to confirm clinical diagnosis and predict prognosis of nerve injuries. Two patients developed preventable pressure neuropathy. Eight patients showed moderate or full recovery in 9-10 months post-injury. All children with severe brain injuries should be evaluated for concomitant peripheral nerve injuries.

ISSN:0269-9052    

DOI:10.3109/02699059209008122

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Significant concern exists regarding occupational stress among nurses; the present study explored the ways in which nurses' clinical symptoms and coping styles may relate to their working on a brain injury unit or a general rehabilitation unit within an acute physical rehabilitation hospital. A comparison of rehabilitation nurses' responses with those of physical therapists within the same setting was also completed. Staff members completed questionnaires related to job stress and satisfaction, coping (Ways of Coping Checklist) and adjustment (Symptom Checklist-90). Staff groups differed with regard to symptomatology. Brain injury nurses reported higher psychological distress than physical therapists on subscales including depression, interpersonal sensitivity and the global severity index. While brain injury nurses' distress in several areas was higher than other staff groups and than a normal non-patient sample, it did not approach the levels reported by a psychiatric outpatient normative group. Although the three staff groups did not differ notably with regard to most styles of coping, data suggest that work with brain injury patients may foster use of a problem-solving style. Lower physical and cognitive functioning of brain injury patients as compared with general rehabilitation patients may influence the greater psychological distress reported by brain injury nurses. Job stress appears to relate specifically to the perceived stressfulness of cognitive behavioural aspects of care for all staff groups. Implications of these findings, particularly with regard to support interventions, are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059209008123

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

A controlled treatment outcome study was conducted comparing the efficacy of memory remediation treatment with no treatment on traumatic brain-injury patients. The memory remediation treatment consisted of both compensatory and executive training skills and was delivered 6 hours weekly over a 2 1/2-week period. Six subjects in the treatment group and 6 subjects in the control group were matched on WAIS-R FSIQ scores, pre-test memory scores and age. Pre-and post-test measures were obtained for both groups on a paragraph memory task. A significant difference was demonstrated between the treatment and control post-test memory scores. The experimental group significantly improved memory scores beyond that of the control group, suggesting that memory remediation is effective for head-injury patients with memory deficits. Discussion of findings and suggestions for further investigation are presented.

ISSN:0269-9052    

DOI:10.3109/02699059209008124

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

This study reports the case of an elderly female patient who made a late and unexpected recovery from a closed head injury after a medium-pressure shunt valve was replaced with a low-pressure valve.

ISSN:0269-9052    

DOI:10.3109/02699059209008125

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

A number of difficulties have been encountered in carrying out MRI scans with severely brain-injured subjects. One of the problems is maintenance of head position for the 30 minutes' duration of the scan. The use of a vacuum cushion has proved a low-cost solution to this problem.

ISSN:0269-9052    

DOI:10.3109/02699059209008126

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor