[Return to work after brain lesions: cognitive and behavioral factors]

Complete or partial return to work (RTW) succeeds in around 40% of TBI and 25% of stroke patients. Positive factors include: (1) post-traumatic amnesia, hospitalization length, age, race, pretraumatic work and socio-educational status, quality of life, (2) premorbid intellectual level, learning, language and attentional, (3) social cognition and deficit's awareness and (4) absence of behavioural impairment. In stroke, RTW is associated with normal neurological and cognitive/communication abilities. Vocational rehabilitation necessitates: (1) cognitive retraining (speed, visuospatial skills and memory), (2) behavioural approach (compensation, organization, abstraction) and (3) adaptation of work profile. Case management models, with early intervention, continuity of care and coordination, increase twofold partial or complete adapted RTW.