NeuroRehabilitation - Volume 1, issue 3

Authors: Kreutzer, Jeffrey S. | Zasler, Nathan D.

Article Type: Introduction

DOI: 10.3233/NRE-1991-1301

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 7-7, 1991

Authors: Collison, Ann Marie

Article Type: Research Article

Abstract: This first person account is meant to enhance professional awareness regarding the potential profound physical, cognitive, and affective sequelae of mild traumatic brain injury, specifically when complicated by a preexisting diagnosis of epilepsy. For professionals who treat patients after significant brain insult due to trauma, it is hoped that awareness of the potential benefits and risks of anticonvulsant therapy manipulation relative to the multifactorial neuromedical issues will increase sensitivity to some of the many medication-related issues that confront these patients.

DOI: 10.3233/NRE-1991-1302

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 9-11, 1991

Authors: Stringer, Warren | Balseiro, Jesse | Fidler, Robert

Article Type: Research Article

Abstract: X-ray computed tomography, by virtue of its widespread availability and ability to identify virtually all acute surgical lesions, remains the primary imaging modality for the evaluation of acute traumatic brain injury. It has been less successful in predicting the long-term neuropsychiatric sequelae in brain injury survivors. Compared to x-ray computed tomography, newer imaging modalities such as magnetic resonance imaging, single photon emission computed tomography, and positron emission tomography give a more detailed anatomical and physiological evaluation of the brain. These newer techniques are now the imaging methods of choice for evaluating patients with subacute and chronic brain injury.

DOI: 10.3233/NRE-1991-1303

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 13-32, 1991

Authors: Zasler, Nathan D. | Kreutzer, Jeffrey S. | Taylor, Donald

Article Type: Research Article

Abstract: Appropriate care and management strategies for low level patients after traumatic brain injury are at best controversial. Management issues tend to be confounded by inconsistencies in the neurorehabilitation nomenclature; misunderstandings regarding “normal” neurological recovery patterns after severe brain injury; inconsistencies or lack of appropriate functional measures; and inadequate knowledge pertaining to scientifically sound practices for neuromedical assessment and management of this special patient population. This article attempts to clarify issues pertaining to the state-of-the-art aspects of “coma stimulation” and the neuromedical recovery and management of low level patients with brain injury.

DOI: 10.3233/NRE-1991-1304

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 33-40, 1991

Authors: Wenzinger, Karen S. | Nemec, Shelley A. | DePompei, Roberta | Flexer, Carol

Article Type: Research Article

Abstract: When professionals treat a patient who has sustained traumatic brain injury (TBI), they should always be concerned about the patient’s hearing competency. Without adequate hearing, communication is compromised. The audiologist can provide expertise in assessing the hearing of persons who have sustained TBI and suggesting methods for enhancing listening skills. This article presents an overview of the audiological tests that can be administered, outlines modifications in the test procedures that might be necessary for the attention level of the patient, and provides suggestions for enhancing listening skills for the patient with even a mild hearing impairment. It presents justification for …including the audiologist on the rehabilitation team for patients with TBI. Show more

DOI: 10.3233/NRE-1991-1305

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 41-51, 1991

Authors: Blackerby, W.F. | Gualtieri, Thomas

Article Type: Research Article

Abstract: Improved understanding of the neuropsychology, pharmacology, and behavioral effects of brain injury has enabled improvements in the technology and techniques of brain injury rehabilitation. This article describes improvements in the behavioral and pharmacological intervention arenas that have enabled more effective rehabilitation. Included are discussions of neurobehavioral syndromes, with behavioral intervention techniques for each, the combination of behavioral and pharmacological interventions, and milieu-based behavioral teaching methods.

DOI: 10.3233/NRE-1991-1306

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 53-61, 1991

Authors: Deaton, Ann V. | Holland, Alison | Stonnington, Henry | Veach, Sharon | Wilkins, Sheri-Lee

Article Type: Research Article

Abstract: Day rehabilitation is a relatively new addition to the continuum o/care for persons with traumatic brain injury. This article describes the day rehabilitation model and the roles of team members within day rehabilitation programs, and identifies specific problems that may ideally be dealt with in day rehabilitation. Some of the potential problems with the day rehabilitation process are addressed as well. Although limited research is available on the efficacy of this model, it is suggested that it is already a needed part of the continuum of care; what is now essential for its widespread availability are increased funding sources and …the empirical validation of its effectiveness and cost efficacy. Show more

DOI: 10.3233/NRE-1991-1307

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 62-69, 1991

Authors: Boake, Corwin | Bobetic, Karen M. | Bontke, Catherine F.

Article Type: Research Article

Abstract: Patients with mild traumatic brain injury (TBI) present unfamiliar assessment and management problems. This article provides an orientation to the rehabilitation of patients with mild TBI, including clinical. symptoms, epidemiology, and terminology. Neurological and psychological factors as causes of postconcussional symptoms are explained. An assessment plan is outlined and diagnostic studies such as neuroimaging and neuropsychological testing are discussed and compared. A management plan is recommended that is based on patient and family education, the temporary reduction of cognitive demands, specific interventions for persisting postconcussional symptoms, and coordination of the clinical services provided to each patient.

DOI: 10.3233/NRE-1991-1308

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 70-78, 1991

Authors: Stutts, Michael | Kreutzer, Jeffrey S. | Barth, Jeffrey T. | Ryan, Thomas | Hickman II, Julian | Devany, Catherine W. | Marwitz, Jennifer H.

Article Type: Research Article

Abstract: Evidence is accumulating that many persons with spinal cord injury also have acquired brain injury. The investigation reported here included a comprehensive neuropsychological assessment of 89 persons admitted to university hospitals for treatment of acute spinal cord injury. Between one-fourth and one-half of the subjects demonstrated impairment in most areas of cognitive functioning. Findings are consistent with those of prior investigations. These results have important implications for clinical practice; however, uncertainties exist about the exact etiology of cognitive impairments, and further research is needed to elucidate their origin.

DOI: 10.3233/NRE-1991-1309

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 79-85, 1991

Authors: Mazmanian, Paul E.

Article Type: Research Article

Abstract: Considerable evidence indicates that services intended to support cognitive rehabilitation are provided on a widespread basis by facilities serving brain injury survivors. The scope of services for cognitive rehabilitation therapy has not been circumscribed, nor has a parsimonious theory of cognitive rehabilitation been advanced to inform study and practice. Qualitative research identifying the techniques used; how they are used; and the outcomes of the applied techniques might enable generation of a theory to help define a discrete body of knowledge and skills associated with cognitive rehabilitation therapy. Having acquired that information, those who practice and study cognitive rehabilitation should be …better able to guide the development of these services for those who survive brain injury. Show more

DOI: 10.3233/NRE-1991-1310

Citation: NeuroRehabilitation, vol. 1, no. 3, pp. 86-89, 1991