Time-related sequelae of TBI in patients with prolonged post-comatose unawareness (PC-U) state

Abstract

Seventy-two patients who were in a post-comatose unawareness state for periods longer than 1 month following traumatic brain injury recovered consciousness thereafter. The incidence of residual sequelae of brain trauma in relation to duration of unawareness was studied. The incidence of motor disability, communication disorders, cognitive disturbances and malbehaviour was studied in the patients recovering consciousness after 1, 2, 3 and 6 months. It was found that no significant differences were found in the incidence of the above-mentioned residual sequelae of brain-damaged patients in relation to duration of post-comatose unawareness. However, 76.1% (51/67) of the patients who recovered consciousness and survived the first year following injury were living at home. Most of these were patients who recovered consciousness within the first 3 months following trauma. None of the patients who were in post-comatose unawareness longer than 6 months did so, Five patients (6.9%) died during the first year. Motor disability, independence in activities of daily living, vocational outcome and place of living were significantly related to duration of prolonged unawareness state whereas the disturbances in high mental functions did not. Although the vocational outcome of patients with post-comatose unawareness is not good, the fact that most of them are still able to live at home, having an acceptable quality of survival, justifies, according to our experience, the comprehensive rehabilitation programme.