title: Emergence to the conscious state during inpatient rehabilitation after traumatic brain injury in children and young adults: a case series.
abstract: OBJECTIVE
  To describe clinical patterns related to emergence to the conscious state (CS) in children and young adults with traumatic brain injury receiving acute inpatient rehabilitation.
  
  
  METHODS
  One academically affiliated pediatric brain injury rehabilitation unit.
  
  
  METHODS
  Fourteen consecutive patients aged 1 to 20 years with traumatic brain injury and disorders of consciousness.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  The primary outcome was emergence to CS during the inpatient rehabilitation admission. Factors evaluated for relationship to emergence to CS included age at injury, admission level of consciousness, admission Rappaport Coma/Near-Coma Scale score, and admission Cognitive and Linguistic Scale responsiveness item score.
  
  
  RESULTS
  Ten of 14 patients emerged to CS during the inpatient rehabilitation admission. Those who emerged to CS had higher levels of responsiveness at admission to rehabilitation. There was a trend toward older age in those who emerged to CS.
  
  
  CONCLUSIONS
  In this limited cohort, the majority of patients with disorders of consciousness after traumatic brain injury emerged to CS during acute inpatient rehabilitation, underscoring the presence of functional goals for inpatient rehabilitation in this population. Larger cohorts are needed to further explore clinical variables associated with emergence to CS.
authors.affiliation: Departments of Physical Medicine and Rehabilitation (Drs Pham, Slomine, and Suskauer), Psychiatry and Behavioral Sciences (Dr Slomine), and Pediatrics (Dr Suskauer), Johns Hopkins University School of Medicine, Baltimore, Maryland; and Kennedy Krieger Institute, Baltimore, Maryland (Drs Kramer, Slomine, and Suskauer).
authors.forename: Kelly
authors.initials: K
authors.lastname: Pham
authors.forename: Megan E
authors.initials: ME
authors.lastname: Kramer
authors.forename: Beth S
authors.initials: BS
authors.lastname: Slomine
authors.forename: Stacy J
authors.initials: SJ
authors.lastname: Suskauer
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001930:Brain Injuries / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003243:Consciousness; D003244:Consciousness Disorders / Q000534:rehabilitation*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D055815:Young Adult