Monitoring emergence from coma following severe brain injury in an octogenarian using behavioural indicators, electrophysiological measures and metabolic studies: a demonstration of the potential for good recovery in older adults.
This case study describes a multi-disciplinary investigation of the emergence from coma of an 80-year old female (KE) following severe traumatic brain injury. The relationship between cognitive/behavioural ability and the integrity of cerebral function was assessed using neuropsychological measures, positron emission tomography, electroencephalography, somatosensory evoked potentials and trans-cranial magnetic stimulation. These investigations were performed as KE was beginning to emerge from coma (4 weeks) and, again, approximately 1 year following brain injury, when she was judged to have achieved her maximum level of recovery. Neuropsychological measures revealed improvement during the first year post-injury in KE's speed of information processing, memory and executive abilities. Electrophysiological and metabolic studies indicated a restoration of functional integrity that was consistent with the gradual recovery in higher brain function documented using behavioural procedures. This case study demonstrates the rehabilitation potential of pre-morbidly healthy older adults following severe traumatic brain injury.
Crossley
M
M
Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. crossley@sask.usask.ca
Shiel
A
A
Wilson
B
B
Coleman
M R
MR
Gelling
L
L
Fryer
T
T
Boniface
S
S
Pickard
J
J
D000063:Accidents, Traffic; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D003128:Coma / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D004569:Electroencephalography / Q000379:methods; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D009483:Neuropsychological Tests; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods