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 (longterm 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.