Article

OBJECTIVE: To report clinical conditions and neuropsychological functioning of
patients with late recovery of responsiveness at least 5 years after injury.
DESIGN: Patient series. SETTING: Patients discharged from an inpatient
rehabilitation unit. PARTICIPANTS: Patients (N=13) who recovered from a
vegetative state 1 year after severe traumatic brain injury or 6 months after
nontraumatic brain injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Coma Recovery Scale-Revised, Disability Rating Scale, and FIM. For patients who
recovered full consciousness, neuropsychological tests specifically adapted for
patients with very severe disabilities were used. RESULTS: After regaining
responsiveness, 2 patients died because of severe clinical complications. Among
the remaining 11 patients, 5 were still in a minimally conscious state at their
last assessment, but 4 of them had recovered some complex behavioral responses to
the environment (eg, they could follow simple commands, albeit inconsistently).
Six patients had emerged from a minimally conscious state at the last evaluation.
Severe functional disability was present in both patients who were conscious and
patients who were minimally conscious. No patient was autonomous in common daily
life activities or in transfers. All patients who were conscious showed variable
cognitive impairments, and some of them also developed behavioral and
psychological symptoms. However, such disturbances did not impede the patients'
interaction with relatives and caregivers. CONCLUSIONS: This study provides
systematic data about the course of the disease in a cohort of patients that was
previously considered as exceptional. Patients with late recovery show a variable
degree of functional recovery, although they experience marked residual motor and
cognitive disabilities. The present findings contribute to enhance the
understanding of the course of the disease in patients with late recovery and
might help clinicians optimize the levels of care and provide the patients'
families with correct information.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS