Rehabilitation after severe head injury.
123 survivors of severely head injured patients presenting with coma grade III show a decreasing mean duration of coma with increasing age. The numbers and frequency of good recovery decrease, whereas poor recovery increases with age. Increase of the duration of coma grade III produces an increase of the mean latency and time of recovery and of the frequency of poor recovery, regardless of the age of the patients. Increasing age does not increase the mean latency and time of recovery systematically. The important conclusion of this analysis is, that the clinical feature of coma grade III, corresponding to GCS score of 4 and RLS of 6 and 7, indicates a different kind of brain damage at various age groups. It represents a lesser degree of brain damage for younger patients under 20, than for those over 20. In our opinion our observations do not demonstrate a better capacity of recovery of the young patients: but the young patients show a more severe clinical picture than the older patients do, if only the clinical syndrome of coma grade III with extensor rigidity, is considered as a yardstick for comparison.
Frowein
R A
RA
Neurosurgical Department, University of Cologne, Köln, Federal Republic of Germany.
Terhaag
D
D
auf der Haar
K
K
Richard
K E
KE
Firsching
R
R
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D002648:Child; D003128:Coma / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests