title: 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.
abstract: 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.
authors.affiliation: Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. crossley@sask.usask.ca
authors.forename: M
authors.initials: M
authors.lastname: Crossley
authors.forename: A
authors.initials: A
authors.lastname: Shiel
authors.forename: B
authors.initials: B
authors.lastname: Wilson
authors.forename: M R
authors.initials: MR
authors.lastname: Coleman
authors.forename: L
authors.initials: L
authors.lastname: Gelling
authors.forename: T
authors.initials: T
authors.lastname: Fryer
authors.forename: S
authors.initials: S
authors.lastname: Boniface
authors.forename: J
authors.initials: J
authors.lastname: Pickard
mesh_terms: 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