Faculty Bibliography

One hundred twenty-five closed head injured postcoma patients in a rehabilitation medicine center underwent standardized aphasia tests to determine the presence and nature of verbal deficits. Mean time since injury for the group was 45 weeks. All patients evidenced linguistic impairment which was only apparent on testing, not in conversation. The population fell into three relatively equally sized groups: classic aphasia, dysarthria accompanied by linguistic deficits, and 'subclinical' aphasic deficits. No patient with a history of coma after closed head injury was spared defective performance on selected language tasks. The patient groups reflected a severity continuum ranging from aphasia, the most severely impaired group, to the least impaired, the subclinical aphasia group. Further, closed head injured patients with a history of coma who manifest motor speech impairment (dysarthria) also manifest linguistic processing deficits. The study results suggest that linguistic functions are particularly vulnerable in severe head injury

Moderate and severely impaired poststroke aphasic patients followed in a rehabilitation medicine program were systematically examined initially between 4 and 6 months poststroke and again between one and 2 1/2 years postonset. No gender differences were found on ratings of everyday communication function or certain measures of language, specifically auditory comprehension and the spontaneous generation of spoken words

This study is a replication of an earlier study published in this journal (Sarno, M. T. The nature of verbal impairment after closed head injury. J. Nerv. Ment. Dis., 1968: 685-692, 1980). Consecutive admissions of 69 closed head injured (CHI) postcoma patients at an average of 1 year post-trauma in a rehabilitation medicine center were examined with standardized aphasia tests. As in the first study, all patients evidenced linguistic impairment which was not necessarily manifest clinically but was apparent on testing. Again the population divided itself into three relatively equally sized groups: those with classical aphasia, those with dysarthria accompanied by linguistic deficits, and those with 'subclinical' aphasic deficits. As in the first study, consistency of performance was noted for all groups. For example, dysarthric patients consistently evidenced severe language impairment on at least three out of four linguistic tasks taken from an aphasia test. Also, the major types of aphasia were represented in the aphasia group. This study confirms the observation that all CHI postcoma patients suffer important, disabling verbal changes, however mild or apparent, which persist up to 1 year post-trauma. The findings are considered important for patient management, particularly with respect to social, vocational, and psychological aspects in the chronic stage of recovery