[Early rehabilitation after cerebral lesions: indications, methods, results]

Early neurological and neurosurgical rehabilitation after severe brain injury of traumatic, hemorrhagic, ischemic, neoplastic, inflammatory, or hypoxic origin fills the gap between acute treatment and traditional rehabilitation services. During the last years, specific treatment modalities began to develop, directed at the key problems of severely brain injured patients: for example, stabilization of vegetative regulation, treatment of spasticity, swallowing disorders, disturbances of perception and communication, coping, and conditioning of the relatives. Procedures are gradually emerging to facilitate assessment, documentation of progress, and results. Prognosis is still very uncertain, especially in patients in a vegetative state. As a rule of thumb, about three out of four patients will improve substantially during the treatment.