Rehabilitation after severe head injury

T. Najenson, L. Mendelson, I. Schechter, C. David, N. Mintz, Z. Groswasser

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

The results of rehabilitation in 169 patients who suffered major cerebral injury during the period 1965-1971 are presented. Treatment sought to achieve maximal functional improvement during the patients' hospital stay and thereafter to guide them in their altered role within their families and in the community. The outcome of rehabilitation was evaluated in terms of functional capacity which included locomotor, intellectual and communicative abilities. Patients were classified in 5 functional categories: vegetative state, independent in daily living, independent and capable of sheltered employment, capable of simple work under normal conditions, capable of professional work. Improvement occurred in the majority during their stay in the rehabilitation unit and many continued to show improvement three and more years after injury. Negative prognostic factors in rehabilitation were prolonged unconsciousness, age over 45 yr, severe neurological motor deficits, epilepsy, aphasia and hemianopsia. A large group of patients failed to make full use of their potential after rehabilitation, in particular those capable of sheltered employment and those able to do simple work under normal conditions. The avoidance of contractures and the proper treatment of limb fractures is stressed. The diagnosis and treatment of normal pressure hydrocephalus may result in a marked improvement. Patients in the psychometric categories of Dull Normal and Borderline showed an improvement in intellectual function on follow up. A corresponding degree of improvement was not seen in the Mental Defective group. The need to provide continuing aftercare, both medical and social, after completion of the hospital rehabilitation programme is stressed.

Original languageEnglish
Pages (from-to)5-14
Number of pages10
JournalScandinavian Journal of Rehabilitation Medicine
Volume6
Issue number1
StatePublished - 1974

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