Treatment and rehabilitation of mild and moderate head trauma.

Abstract

Intervention with patients who have sustained mild, neurologically mediated cognitive changes due to closed head trauma (CHT) depends upon several factors. Adequate assessment is required, lest deficits be missed or complaints dismissed as "emotional." The time course, recovery curve, and secondary symptoms are also important. Knowledge represents the core of the treatment approach, through direct education efforts, involvement of family members, and other sources of support. The goal is primarily prevention of further impairment. Coping is emphasized where remediation is not feasible and where natural recovery can be utilized as part of the therapeutic regimen.Rehabilitation and neuropsychology, traditionally separate disciplines, have recently come together in the care of closed head trauma (CHT) patients. The earliest applications of neuropsychological services to CHT patients in the rehabilitation setting were understandably aimed at the more severely impaired patients, whose cognitive and motor functions were clearly and permanently compromised. The more recent trend toward the application of neuropsychology in the care of mild CHT patients is partly the result of the realization that, of the nearly 8 million recorded head injuries annually in the United States, the vast majority are mild to moderate in severity, with many more mild injuries going unreported. THE NEEDS OF THE MILD CHT PATIENTIt would be an understatement to say that clinical neuropsychology has been of tremendous value to the victims of severe CHT, affording these patients the benefits of better documentation of the nature and extent of

Psychological approaches to treatment of postconcussion syndrome: a systematic review

“…There were three retrospective studies35–37 and one single case study 38. Two of the three retrospective studies considered a control group in the form of ‘little/no treatment’35 or outcomes in those treated before a change in treatment was implemented 36.…”

Communication abilities and work re-entry following traumatic brain injury

“…However, TBI may be associated with long-term physical, cognitive, and psychosocial consequences that can limit or even prohibit return to work [1,2]. Employment may be dynamic rather than stable over time, and assumptions that employment rate increases with length of recovery may be incorrect [2].…”

Clinical Test Instrument Development to Identify and Track Recovery from Concussion

“…As a result, clinical and epidemiological studies revealed specific neurocognitive deficits such as confusion, attention and concentration problems, memory impairments, slow information processing, decreased verbal expression, slow reaction time, and decreased problem solving. [5][6][7][8] The first major breakthrough came from Barth et al, 9 who introduced a more systematic approach into practice, the pre-(or baseline) and postinjury neuropsychological assessment paradigm. Their model refined our understanding of concussions and established current clinical management guideline of mild head injuries in sports and in the military.…”