Background: Findings from prognostic studies of functional and psychosocial recovery after traumatic brain injury (TBI) reported to date have been limited by the restricted timeframe for prediction, generally within the first 5 years post-trauma. This investigation examined prediction of functional and psychosocial recovery in the medium-term (6 years post-trauma; Time 1) and long-term (23 years post-trauma; Time 2). Methods: The participants comprised a consecutive series of the first 100 patients with severe TBI receiving their primary rehabilitation at a regionally based unit. At the 23-year follow-up, 91% of the sample was traced: 17 had died, 5 declined participation, and 69 were interviewed, with 68 participating at both Time 1 and Time 2. Five outcome domains were examined: mobility, self-care, employability, relationships and living skills. Results: Very few of seven pre-injury variables were significantly correlated with any of the outcome variables. A series of logistic regression analyses successfully predicted levels of recovery in all domains using four predictor variables: pre-injury occupational status, duration of post-traumatic amnesia, and physical and neuropsychological disability at rehabilitation discharge. At Time 1, 60% or more of the variance was accounted for in four of the five domains, and at Time 2, more than 40% of the variance was accounted for in all domains. Sensitivity ranged from 62% (self-care) to 90% (mobility). With a single exception (employability at Time 2), specificity was also high, ranging from 80% (relationships) to 98% (mobility). Comparable accuracy rates were also found for positive and negative predictive power. Conclusions: These results demonstrate impressive predictive capacity of early post-trauma variables for the very long-term levels of recovery. They provide guidance for the tailoring of individual rehabilitation programs and the identification of people who may require special supports after rehabilitation discharge.

People with severe traumatic brain injury (TBI) often have poor psychosocial outcomes. Poor memory may contribute to this because it impedes the ability to share experiences and reminisce about past experiences. This study was designed to determine whether photographic partial reminders would improve recall of incidentally learned complex events in people with severe TBI. Two groups of 10 people with severe TBI viewed videotapes of everyday events. One group was shown photographic reminders of half the events shown two days later on 3 occasions separated by 10 minutes. Twenty minutes after the last review (or control activity) both groups were tested for free recall and recognition of the videotape events. The reminder group recalled a greater percentage of reviewed events and objects per events recalled, but a similar number of actions per event recalled, compared to the control group. Photographic review did not decrease recall of nonreviewed events or affect recognition of reviewed or nonreviewed events.

This study assesses whether the Starship Post-Traumatic Amnesia scale, developed for children aged 3 to 7 years, can predict neuropsychological impairment and behavioural outcome following mild to moderate traumatic brain injury. Participants are 19 children aged from 3 to 7 years with a GCS score of >13, and a PTA of 0–3 days. Neuropsychological outcome is measured by the NEPSY, and behavioural outcome by the Child Behaviour Checklist (CBCL) two months after the TBI. The duration of PTA contributed to the prediction of scores on the NEPSY memory and learning domain. In all cases the longer the duration of PTA, the poorer the memory scores were. The duration of PTA did not contribute to the prediction of NEPSY visuospatial processing or attention and executive functions domain scores, or to any of the CBCL scores. This preliminary study suggests that the Starship PTA scale has good sensitivity for this very young age group, even when the TBI is mild.

The aims were to investigate the general and specific effects of mild traumatic brain injury (mTBI), and if people with orthopaedic injuries who had sustained their injuries through exposure to acceleration/deceleration force could have sustained a brain injury. The Rapid Screen of Concussion and Digit Symbol Substitution Test were given to patients with mTBI (89 male, 23 female), and patients with orthopaedic injuries that did (27 male, 5 female) or did not (27 male, 15 female) involve deceleration forces within 24 hours of injury. A group of uninjured people (31 male, 12 female) were also tested. Compared to all other groups, patients with mTBI recalled fewer words and correctly answered fewer orientation questions. Patients with either mTBI or deceleration orthopaedic injuries showed slower speed of information processing than patients with nondeceleration orthopaedic injuries or participants without injury. Nondeceleration patients and uninjured participants did not differ. These results suggest that there are both general injury effects and specific mTBI effects on efficiency of cognitive functioning. The results also highlight the probability that patients with a diagnosis of orthopaedic injury who were exposed to acceleration/deceleration forces may have suffered a mild brain injury as well.