TRAUMATIC BRAIN INJURY OCCURRING WITH SPINAL-CORD INJURY - SIGNIFICANCE FOR REHABILITATION

Research indicates that traumatic brain injury (TBI) often occurs with traumatic spinal cord injury (SCI). However, the literature strongly suggests that TBI frequently remains undiagnosed in the presence of an SCI; a situation that may account for some rehabilitation failure and unusual affective stance seen in SCI individuals. Rehabilitation programming with people who incur SCI is intensive, and includes relearning daily living skills (ADLs), and communication and vocational skills; efforts requiring the injured person to adequately attend to and process information. Cognitive and emotional sequelae of TBI can adversely effect learning and skills acquisition and, therefore, must be assessed early in the rehabilitation process. We review literature concerning concomitance of TBI and SCI, and, we present specific instruments to assess the presence of TBI in motorically restricted individuals. Finally, we present factors which complicate the assessment of TBI in the SCI population, and provide implications for rehabilitation assessment and intervention procedures.