Recovery of cognitive function during comprehensive rehabilitation after severe traumatic brain injury.

OBJECTIVE To explore the course and timing of functional recovery in patients who have emerged from coma after undergoing severe traumatic brain injury. METHODS An observational study involving 19 patients with traumatic brain injury recovered from coma who underwent holistic, intensive and multidisciplinary neurorehabilitation. Daily performance in each cognitive function (long-term memory, short-term memory, orientation, calculation, attention, mental control, automation, and planning) was clinically scored and compared at admission and discharge. RESULTS The course of cognitive recovery after post-traumatic coma is not uniform, offering a curve with many ups, downs and plateaus. To achieve a good response and outcome nearing normalcy, a patient needs over 300 h of intensive rehabilitation. CONCLUSION The consolidation of functional recovery in patients with traumatic brain injury requires time and adequate training, and discharge is not recommended until cognitive improvement is established.