The Indian Journal of Neurotrauma (Dec 2006)
Post-head injury syndrome in patients with “favorable” outcome: Some observations
Abstract
We aimed to identify problems faced by head injury patients with favorable Glasgow Outcome score (GOS), and evaluate various management techniques by a prospective observational study. Head injury patients with GOS 4/5 were evaluated for symptoms, counseled and advised neuropsychological evaluation. Patients with problems were managed by a team including a psychologist, alternative medicine therapist (Pranic Healing), physiotherapist and psychiatrist. The effectiveness of the different management techniques was documented. Total 218 patients with initial GCS of 13+/- 2 were evaluated. Symptoms included headache (54%), impaired memory (32%), increase in anger and frustration(30%), vertigo (31%), tinnitus(3%), seizures(9%), limb weakness(9%), impaired vision (6%), diplopia (4%), cranial nerve deficits(9%), and psychiatric symptoms (1.4%). Of these, 52 patients underwent neuropsychological evaluation using NIMHANS head injury battery and 83% had deficits. These included deficits of sustained attention (39%), motor speed (50%), verbal fluency (26%), verbal working memory (40%), planning ability(25%), set shifting (40%), response inhibition (33%), comprehension (23%), visual constructive ability(4%), verbal learning and memory (54%), visual learning and memory (37%). Ten patients completed cognitive retraining. Forty three patients with mild symptoms and those not benefited by cognitive retraining underwent Pranic healing therapy. Psychiatric symptoms were managed by the psychiatrist. All symptomatic patients should be counselled initially for 6 weeks and should undergo neuropsychological evaluation if significant symptoms persist after that. Cognitive retraining may benefit those with cognitive deficits. Alternative medical systems like Pranic healing may help patients who believe in this form of therapy. Everybody with physical deficits should simultaneously undergo physical rehabilitation.
