Approccio logopedico al recupero funzionale e neuropsicologico del traumatizzato cranico post-comatoso.

Speech-therapy approach to thè functional and neuropsychological recovery of post-comatose head injuryed patients. The rehabilitation of thè brain injuryed patient involves professionals from a number of different specialities during thè generally long period of time between thè acute phase and the return of the patient to a state that is as much as possible similar to the pre-traumatic state. The prognosis is based on evaluation factors such as: - thè Glasgow coma scale; - thè duration of thè coma; - thè duration of post-traumatic amnesia; - the patient's age; The fìrst two factors are based on data collected during thè acute phase and during the 72 hours after thè trauma and are intended to deter¬mine whether the coma is irreversible. The other three factors allow a prognosis of the potential for functional and cognitive recovery. The age of the patient is important because the prognosis is usually more optimistic for patients between 15 and 50 years of age. The rehabilitation through speech therapy begins during the post-comatose acute phase and is used to recover thè ability to swallow (so the patient can begin feeding through the mouth) and to breathe (so that the patient can be weaned from the breathing tube). In the post-acute phase, speech therapy is aimed at the recovery of the cognitive functions and at overcoming post-traumatic amnesia. During the chronic phase, speech therapy is aimed at refining the functions the patient has recovered and at further reducing any residuai behavioral problems. During the entire rehabilitation process it is important to instruct the family with respect to how to care for the patient, how to assist with therapy, and how to behave with the patient.