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Monitoring Recovery of Cognitive Function Following Severe Traumatic Brain Injury

Published online by Cambridge University Press:  21 February 2012

Barbara A. Wilson*
Affiliation:
MRC Cognition and Brain Sciences Unit, Cambridge, UK. [email protected]
Agnes Shiel
Affiliation:
MRC Cognition and Brain Sciences Unit, Cambridge, UK.
Lindsay McLellan
Affiliation:
University of Southampton, Southampton, UK.
Sandra Horn
Affiliation:
University of Southampton, Southampton, UK.
Martin A. Watson
Affiliation:
University of East Anglia, Norwich, UK.
*
*Address for correspondence: Professor Barbara A Wilson, OBE, MRC Cognition and Brain Sciences Unit, Box 58, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
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Abstract

We report on the development of a new assessment tool to monitor recovery after severe traumatic brain injury (TBI). Although a number of scales exist to identify such recovery, most are limited if one is interested in monitoring small changes or in setting goals for rehabilitation. This is due to the fact that items are too broad, they may cross more than one dimension (e.g. cognition and motor functioning) and there is a danger that recording of responses may be too subjective. The Wessex Head Injury Matrix (WHIM) was developed to avoid these problems. We observed 88 people with severe TBI. These were consecutive admissions to two hospitals. Mean coma duration was 14 days and mean duration of post traumatic amnesia (PTA) was 56 days. Of 145 behaviours observed, we selected 62 and each behaviour was compared to every other behaviour to determine a likely order of recovery. The resulting WHIM is an observational tool to assess and monitor cognitive recovery after severe head injury. It can be used with patients who are in coma, just out of coma or who are minimally conscious. Two case examples are provided.

Type
Articles
Copyright
Copyright © Cambridge University Press 2001

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