Neuropsychological problems in everyday life: A 5-year follow-up study of young severely closed-head-injured patients

Abstract

The aim of this follow-up study was to examine the long-term disabilities and handicaps caused by severe head injuries and their effects on the everyday life of patients and their relatives. The group studied consisted of 19 subjects who had suffered a severe closed-head injury during 1984 and had been rehabilitated in the Käpylä Rehabilitation Center. In 1989 a thorough functional assessment of these patients was carried out. In addition, information concerning the quality of life, activities of daily living (ADL) and social situation was gathered by means of questionnaires filled in by the patient and, if possible, by a close relative. The results indicated the importance of changes in cognitive functions, personality and emotional reactions. Changes in personality and emotional reactions were especially emphasized by the relatives. We also correlated the patients' and their relatives' estimates of the occurrence of memory problems, whereas tests of visual memory, though able to discriminate the brain-injured from normal subjects, did not correlate on a statistically significant level with the estimates of patients and relatives. The implications of the results for methods of assessment and the planning of rehabilitation programmes are discussed.

Secondary attention deficit/hyperactivity disorder due to right basal ganglia injury: A case report

“…Frontal lobe syndrome includes disinhibition, lack of judgment or foresight, and mood changes which can range from apathy to euphoria (Gerring et al, 1998). Social disinhibition, poor impulse control, hyperactivity, attention deficits, disinhibited talk and forgetfulness are also among the chronic sequelae of the closed head injury (Kaitaro et al, 1995).…”

Outcomes after head injury: level of agreement between subjects and their informants

“…However, opposing trends have been found in this area. Kaitaro et al (1995) noted that relatives identified more negative traits in the person with the TBI whereas Brown and Nell (1992) reported that caregivers were more optimistic than subjects in rating psychosocial items. Dodwell (1988a) found a positive correlation between subjects' and informants' ratings on two assessment tools measuring personality changes.…”

“…Many assessment tools have been used, not all of which are standardized, sample recruitment is variable, and sample sizes in some cases are very small. For example, Hendryx (1989) and Kaitaro et al (1995) had samples of less than 30 subjects, which limits the external validity of their results (Hart, Poston & Perry, 1980). Moreover, several studies have utilized survivors from a wide range of follow-up times (Dodwell, 1988a;Dodwell, 1988b;Hendryx, 1989;Tennant et al, 1995).…”

“…As a first step towards addressing the question of who will provide the best information, a number of researchers have investigated outcomes from TBI by comparing responses between persons with TBI and a family member (or close friend) on questions about their life situation (McKinlay & Brooks, 1984;Brooks, Campsie, Symington, Beattie & McKinlay, 1987;Dodwell, 1988a;Dodwell, 1988b;Hendryx, 1989;Brown & Nell, 1992;Cavallo, Kay, & Ezrachi, 1992;Burton & Volpe, 1993;Kaitaro, Koshkinen & Kaipio, 1995;Tennant, Macdermott & Neary, 1996;Tepper, Beatty & DeJong, 1996). Despite the considerable work done in this area a number of important issues remain.…”

“…Percentage agreement, the measure used in two studies (McKinlay & Brooks, 1984;Tennant et al, 1995), does not account for errors due to chance (Feinstein, 1987). Correlation coefficients, which were employed by other studies (Dodwell, 1988a;Dodwell, 1988b;Hendryx, 1989;Burton & Volpe, 1993;Kaitaro et al, 1995), measure only trend. Finally, there are no studies that have measured agreement in outcomes among the adolescent population.…”