[Severely injured patients after the initial phase--vegetative state or remaining cognitive functions?]. / Store hjerneskader etter akuttfasen--vegetativ fungering eller bevarte kognitive funksjoner?

BACKGROUND: We wanted to quantify improvements in the subacute rehabilitation phase in patients with severe brain injuries classified as vegetative or minimal brain consciousness. MATERIAL AND METHODS: Five patients were studied during a 12 months period using a method called Coma Recovery Scale (CRS) as described by Giacino et al. (1991). The parameters measured included visual and hearing functions, motor functioning, oromotor/verbal function, communication, and arousal. The observations of the patients and commandos given were standardised in a manual, and the responses achieved from the patients were recorded according to a scale for each parameter. RESULTS: This procedure for measuring closely the progress over time in these severely brain injured patients, was used for planning a realistic rehabilitation program. It was found to be very practical in communication with relatives of the patients and with the other therapists involved. INTERPRETATION: By decomposing the cognitive functions by this method using all the available possibilities for inputs, even minimal improvement in the cognitive functions mentioned could be uncovered and recorded.