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Traumatic Brain Injury: Evaluating The Effects Of Computer Based Cognitive Rehabilitation On Memory And Functional Communication

3039 words - 12 pages


Treatment for TBI after the acute stage is largely dependent on the client’s overall health and type of secondary symptoms present, if any. The varying degrees of severity, causes of trauma, and any combination of secondary injuries require that each case be carefully assessed. There is no standard course of treatment, due to the complex nature of TBI (Vanderploeg et al., 2001). Pharmacological management has been used to treat the residual symptoms of TBI, although there is no specific medication to completely absolve the long-term effects of TBI. The medications include steroids to aid in decreasing inflammation, but researchers found that this was effective only in the acute and immediate sub-acute stage (Alderson & Roberts, 1997). There are many clinical trials being conducted to test the possible outcomes of medication use to treat TBI. Anti-convulsant medications, such as Dilantin (phenytoin), Valproate, and magnesium sulfate, have been administered to assess their effectiveness in minimizing post-traumatic seizures (Narayan et al., 2002). Studies conducted in the 1980s and 1990s looked at effects of each medication immediately post-trauma and again on follow up assessments months or years later. A different medication was administered to patients with TBI in each trial. They began initiating treatment within the first 24 hours after the injury. Dilantin was found to prevent seizures within the first week after the medication was administered. The patients were reassessed at 6 month and 1 year post-trauma; however, the medication showed no effect on follow-up assessments. Dilantin was shown to have significant behavioral and medical side effects in severe cases of brain injury. The second study was conducted using a design similar to the first study, but Valproate was administered. The medication was administered early in the acute stage and follow-up assessments were conducted at 1 month and 6 months and continued for up to 2 years. Researchers noted that Valproate had no adverse effects on neuropsychological status, but was shown to be no more effective in preventing early or late seizures than Dilantin. The second study showed a higher mortality rate, but the cause of death has not been confirmed. The latest study is examining the use of magnesium sulfate as a preventative measure against seizures, neuropsychological effects, and survival rates. Criteria for the third study were less stringent than those used for the Dilantin and Valproate studies, so the medication will be tested on a much wider scale (Narayan et al., 2002).
Other studies have examined the effect of purposely altering the CPP and thus manipulating the ICP. The exclusion criteria mainly included cases involving conditions that prevented the placement of a jugular catheter, brain death, and other severe associated conditions. The concept of the study was to carefully monitor the ICP and jugular oxygen saturation in order to prevent the...

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