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Title: INCOG Recommendations for management of cognition following traumatic brain injury. Part 1 posttraumatic amnesia/delirium
Epworth Authors: Ponsford, Jennie
Other Authors: Janzen, Shannon
McIntyre, Amanda
Bayley, Mark
Velikonja, Diana
Tate, Robyn
Keywords: Amnesia
Traumatic Brain Injury
Monash-Epworth Rehabilitation Research Centre, Richmond, Victoria, Australia.
Issue Date: Jul-2014
Citation: J Head Trauma Rehabil. 2014 Jul-Aug;29(4):307-20.
Abstract: After traumatic brain injury (TBI) and emergence from coma, the majority of people experience posttraumatic amnesia (PTA), characterized by confusion, disorientation, retrograde and anterograde amnesia, poor attention, and sometimes agitation and delusions. An international team of researchers and clinicians developed recommendations for assessment and management of PTA. Methods: The experts met to select recommendations, then reviewed literature to ensure they were current. The team then prioritized recommendations for implementation and developed audit criteria to evaluate the adherence to the best practice recommendations. Results: Evidence in support of assessment and management strategies during PTA is weak. It is recommended that duration of PTA be assessed prospectively using a validated tool. Consideration should also be given to use of a delirium assessment tool. No cognitive or pharmacological treatments are known to reduce PTA duration. Recommendations for environmental manipulations to reduce agitation during PTA are made. Minimizing use of neuroleptic medication is supported by animal research and 1 retrospective study. Conclusions: The duration of PTA is an important predictor of late outcome after TBI and should be monitored prospectively with a standardized tool. Neuroleptic medication should be avoided. There is a significant need for controlled studies evaluating the impact of therapy during PTA.
DOI: 10.1097/HTR.0000000000000069
ISSN: 0885-9701
Journal Title: Journal of Head Trauma Rehabilitation
Type: Journal Article
Appears in Collections:Neurosciences

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