Verbal impairment after closed head injury. Report of a replication study

This study is a replication of an earlier study published in this journal (Sarno, M. T. The nature of verbal impairment after closed head injury. J. Nerv. Ment. Dis., 1968: 685-692, 1980). Consecutive admissions of 69 closed head injured (CHI) postcoma patients at an average of 1 year post-trauma in a rehabilitation medicine center were examined with standardized aphasia tests. As in the first study, all patients evidenced linguistic impairment which was not necessarily manifest clinically but was apparent on testing. Again the population divided itself into three relatively equally sized groups: those with classical aphasia, those with dysarthria accompanied by linguistic deficits, and those with "subclinical" aphasic deficits. As in the first study, consistency of performance was noted for all groups. For example, dysarthric patients consistently evidenced severe language impairment on at least three out of four linguistic tasks taken from an aphasia test. Also, the major types of aphasia were represented in the aphasia group. This study confirms the observation that all CHI postcoma patients suffer important, disabling verbal changes, however mild or apparent, which persist up to 1 year post-trauma. The findings are considered important for patient management, particularly with respect to social, vocational, and psychological aspects in the chronic stage of recovery.