ISSN:0269-9052    

DOI:10.3109/02699059108998504

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Seventy-two patients who were in a post-comatose unawareness state for periods longer than 1 month following traumatic brain injury recovered consciousness thereafter. The incidence of residual sequelae of brain trauma in relation to duration of unawareness was studied. The incidence of motor disability, communication disorders, cognitive disturbances and malbehaviour was studied in the patients recovering consciousness after 1,2,3 and 6 months. It was found that no significant differences were found in the incidence of the above-mentioned residual sequelae of brain-damaged patients in relation to duration of post-comatose unawareness. However, 76.1% (51/67) of the patients who recovered consciousness and survived the first year following injury were living at home. Most of these were patients who recovered consciousness within the first 3 months following trauma. None of the patients who were in post-comatose unawareness longer than 6 months did so, Five patients (6.9%) died during the first year. Motor disability, independence in activites of daily living, vocational outcome and place of living were significantly related to duration of prolonged unawareness state whereas the disturbances in high mental functions did not. Although the vocational outcome of patients with post-comatose unawareness is not good, the fact that most of them are still able to live at home, having an acceptable quality of survival, justifies, according to our experience, the comprehensive rehabilitation programme.

ISSN:0269-9052    

DOI:10.3109/02699059108998505

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

This study was an attempt to understand the relationship between provision of rehabilitation services and the perceived persistence of adjustment problems following services. Types of services provided by treatment facilities and patient ratings of presence of problems were identified. The results of the study strongly suggest that services provided by a single facility or a combination of facilities does little to reduce client-perceived persistence of adjustment problems. Severity of disability only accounts for small differences in identified problems. The relative constancy of post-treatment problems reflects the chronicity of disability. Results further suggest that post-acute care treatment by other facilities increases the number of perceived problems, especially following referral for vocational rehabilitation services.

ISSN:0269-9052    

DOI:10.3109/02699059108998506

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Between the years 1984 to 1989, 624 urgent brain CT examinations were performed for head-trauma patients in the Tel-Aviv Medical Center. In 19 patients, epidural haematomas were diagnosed. Different radiological parameters were discussed such as homogeneity of the haematoma, midline shift, ventricular collapse, obliteration of the perimesencephalic cistern and the presence of additional brain damage.

ISSN:0269-9052    

DOI:10.3109/02699059108998507

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

We report a case study of (partial) recovery from left visuo-spatial neglect, followed by progressive deterioration. The patient, A. L., suffered a right-hemisphere stroke with left hemiplegia; over the 6 months post-stroke, the overall course of his neglect was monitored with the Behavioural Inattention Test at approximately monthly intervals. An experimental investigation of multitrial line bisection was also repeated six times and analysed both between and within sessions. The results confirm previous reports of a linear relationship between transection displacements and line length, and also of anomalous crossover with‘right neglect’at‘shorter’lengths. Both effects are reliable over time in this patient. The most striking finding, however, was‘recovery’withina session of the extended line bisection task. We discuss the theoretical and practical significance of this phenomenon in the context of attentional theories of neglect.

ISSN:0269-9052    

DOI:10.3109/02699059108998508

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Imagery psychotherapy is not mentioned anywhere in the head trauma rehabilitation literature. Our experience at the Center for Living, Baltimore, indicates that imagery is useful for‘working through’the losses that result from head trauma and to create new cognitive and behavioural patterns both because it bypasses usual defence mechanisms and because it can be used to generate adaptive behaviour. This article discusses rehabilitation needs, why and how we think imagery psychotherapy is useful in head trauma rehabilitation and includes both a brief description of our programme at the Center for Living and case material to demonstrate how imagery is used in the recovery process.

ISSN:0269-9052    

DOI:10.3109/02699059108998509

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

In the context of a broader survey of adjustment after head injury, both victims and their families rated satisfaction with professional health care services. Included were ratings of quality care, and of perceived helpfulness (to the victim and to the family) of select professional groups. Quality of service inquiries concentrated on patient/familial education about the consequences of head injury, aftercare, referral sources and prognosis. Many respondents indicated inadequate information was provided in these areas. Areas of greatest informational deficit included post-hospitalisation resources and expectations for outcome. Highest ratings of helpfulness were attributed, by both victims and their families, to professional groups that provided tangible,‘hands-on’services, e.g. nursing. Significantly lower ratings were observed for social service professions, e.g. psychology. Limited contact with psychologists/neuropsychologists was targeted as an area of concern. Ratings of all professional groups were discussed with reference to staff/family dynamics. The importance of a multifaceted patient/family education programme was stressed.

ISSN:0269-9052    

DOI:10.3109/02699059108998510

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Pure word deafness, usually involving left hemisphere focal lesions that destroy Heschl's gyrus and/or isolate auditory association cortex, may be rare, but cases with additional perceptual or cognitive symptoms may not be. Word deafness can be transient or evolving, and has been seen in various conditions without identifiable focal lesions. Only two closed head injury cases with focal contusions have been reported; we report two more, with diffuse damage and no focal signs. One patient's symptoms evolved soon after they were recognized. The other patient's unresponsiveness to spoken verbal stimuli persisted despite relatively preserved reading and speech, in a context of poor initiation and moderately severe cognitive impairment. Unrecognized, word deafness following head injury could lead to overestimation of coma duration if transient, and impede rehabilitation if chronic.

ISSN:0269-9052    

DOI:10.3109/02699059108998511

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Carbamazepine is an anticonvulsant that is being used more frequently in the treatment of various psychiatric disorders. The drug has been associated with serious adverse reactions that appear to have an immunological pathogenesis. A case report describing a patient suffering an adverse reaction to carbamazepine is presented, to illustrate the various body systems typically affected in the apparent hypersensitivity reaction. The importance of laboratory and patient monitoring during the initial 3 months of carbamazepine therapy is reinforced.

ISSN:0269-9052    

DOI:10.3109/02699059108998512

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

True precocious puberty frequently occurs secondary to central nervous system pathology and is a rare sequelae of severe head injury in early childhood. It is a clinical entity consisting of accelerated somatic development, the larche and pubarche. We describe two female children, 3 and 5 years of age, who, following head trauma, displayed early pubertal changes including breast enlargement, pubic hair and vaginal secretions. Subsequent laboratory tests, which included hormone assays and luteinizing hormone response after injection of luteinizing hormone releasing hormone, established the diagnosis of precocious puberty of central origin. Long-term sequelae of this condition include accelerated skeletal growth and advanced bone age eventually resulting in short stature. The most effective form of treatment is long-acting luteinizing-hormone-releasing-hormone agonists, which result in temporary reversible chemical castration.

ISSN:0269-9052    

DOI:10.3109/02699059108998513

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor