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Very prolonged unresponsive state following brain injury
Scandinavian Journal of Rehabilitation Medicine
|January 1, 1978
Summary
Some patients with prolonged unconsciousness after brain injury showed late neurologic recovery, even after a year. This study highlights the potential for improvement and discusses management strategies for long-term care.
Area of Science:
- Neurology
- Neuroscience
- Rehabilitation Medicine
Background:
- Prolonged unconsciousness following brain injury presents significant management challenges.
- Patients experiencing unresponsiveness after road accidents, cardiac arrest, falls, or surgery require specialized care.
- Understanding long-term recovery potential is crucial for patient management and family support.
Purpose of the Study:
- To investigate the potential for late neurologic recovery in patients with prolonged unconsciousness.
- To evaluate the outcomes of patients admitted for rehabilitation despite unresponsiveness.
- To discuss implications for treatment and management of long-term unconscious patients.
Main Methods:
- Retrospective study of 23 patients with prolonged unconsciousness (3 months to 4 years).
- Patients divided into two groups: Group A (unresponsive) and Group B (rehabilitation potential/behavioral difficulties).
- Observation and follow-up of neurologic recovery, functional improvements, and survival rates.
Main Results:
- Late neurologic recovery (ability to swallow, improved posture, limb movement, increased awareness) observed in 6 subjects after 1 year or more.
- Five of six Group B subjects were discharged, four markedly improved.
- Eleven of 17 Group A subjects died; 6 remain alive, with 2 significantly improved.
Conclusions:
- Significant late neurologic recovery is possible in patients with prolonged unconsciousness.
- Early identification of rehabilitation potential can lead to positive outcomes.
- Long-term management requires a comprehensive approach, considering patient prognosis and family support.