Patterns of recovery of post-traumatic confusional state in neurorehabilitation admissions after TBI

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Journal Article
Accession No.:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2009, vol. 90, issue 10, pp 1749-1754
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Objective: To provide preliminary descliptions of patterus of resolution of symptoms of acute confusion after traumatic brain injury (TBI). Design: Prospective, descriptive, cohort study. Setting: Inpatient neurorehabilitation unit. Participants: Patients (N = 107) meeting critetis for posttraumatic confusional state at admission to inpatient rehabilitation. Interventions: Not applicable. Main Outcome Measure: Patterns of resolution of posttraumatic confusional state symptoms over the first 3 confusion assessment protocol evaluations for patients with mild, moderate, and severe confusion. Results: Posttraumatic confusional state symptoms resolving earliest were psychotic-type symptoms, decreased daytime arousal, and nighttime sleep disturbance. Fluctuation and cognitive impairment were the 2 most persistent symptoms. Seventy three percent of patients showed improvement of 1 or more symptoms from the first to third evaluation. Confusion severity groups did not significantly differ on indices of injury severity (Glasgow Coma Scale score, time to follow commands)mbut did differ on functional status at discharge from inpatient rehabilitation. Conclusions: While posttraumatic confusional state is a heterogeneous disorder, there is a predictable pattern of symptom resolution. Differences in patients' confusIon seventy and patterns of symptoms may relate to differing underlying neural injury. Key Words: Brain injuries; Confusion; Rehabilitation.
Sherer M., Yablon S.A., Nakase-Richardson R.
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