Recovery of communicative functions after prolonged traumatic coma

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Prolonged coma following craniocerebral injury presents significant challenges in patient recovery and functional assessment.
• Understanding communicative function recovery is crucial for long-term patient outcomes and rehabilitation strategies.

Purpose of the Study:

• To evaluate the communicative functions in patients with prolonged coma after craniocerebral injury.
• To identify factors influencing communicative recovery and long-term prognosis.

Main Methods:

• Longitudinal observation of 15 patients with prolonged coma for over a year.
• Assessment of communicative functions, including semantic abilities and speech production (dysarthria).
• Correlation of communicative recovery with motor function, activities of daily living (A.D.L.), and specific neurological signs.

Main Results:

• Nine out of 15 patients showed considerable recovery; 6 remained in a vegetative state.
• Of the recovered patients, 6 had complete semantic function recovery, 3 had aphasic deficits, and 8 remained dysarthric.
• Communicative recovery commenced around 5.7 months post-injury, paralleling improvements in locomotion and A.D.L.
• Restlessness and sweating were favorable prognostic indicators, while excessive salivation and certain reflexes were unfavorable.
• Dysarthric patients exhibited reduced expiratory and inspiratory reserves and forced vital capacity.

Conclusions:

• Significant communicative recovery is possible in some patients with prolonged coma after craniocerebral injury, though deficits like dysarthria may persist.
• Early prognostic indicators can help predict recovery trajectories.
• Pulmonary function is notably impaired in patients with persistent dysarthria post-coma.