Neuropsychological Recovery Pattern in Traumatic Brain Injury: A Longitudinal Study

Head injury accounts for a quarter of trauma related deaths but for a much larger proportion of lifelong disability. With the rise in high speed traffic, the number of high velocity injuries, resulting in mainly diffuse head trauma has also increased drastically. The cognitive and behavioral sequelae of closed head injury may be extensive and diverse -ranging from cognitive deficits to psychiatric symptoms. Subtle neuropsychological deficits, mainly in the realm of attention, cognitive processing capacity and learning and memory may persist for a long time in patients who otherwise show a good physical/clinical recovery from the head injury and may affect their return to a normal life. Thus, it becomes important to evaluate the long term outcome of head injury in order to make suitable efforts for the rehabilitation of disabled persons. The aim of this study was to assess if a differential pattern of recovery existed in the head injured at the second evaluation. 45 Clinically recovered patients with closed head injury were assessed at 3 months and 6 months following the trauma, utilizing a battery of neuropsychological measures sensitive to the effects of head injury. The result on the Neuropsychological measures provided evidence of gross brain dysfunction at the first assessment –indicative of diffuse involvement and marked recovery in some functions at the second assessment. Deficits were found to be persistent on measures of sustained attention, speed of complex information processing tasks, visual learning and memory and visual scanning tasks, whereas, significant improvement was evident in certain verbal tasks and simple visual memory tasks. These results indicate poor recovery of right hemispheric functions, and a probable differential recovery pattern of brain functions. The implications of these results will be discussed.