Chapter 12.Neurocognitive Disorders
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Excerpt
Across the spectrum of traumatic brain injury (TBI) severity, cognitive impairments are nearly universal in the immediate and early postinjury periods and, particularly after moderate or severe TBI, common problems in the late postinjury period. In the immediate and early postinjury periods, problems with arousal and awareness (i.e., disorders of consciousness), attention, processing speed, working memory (i.e., posttraumatic confusional state), episodic memory (i.e., posttraumatic amnesia, or PTA), and executive function (i.e., posttraumatic dysexecutive syndrome) are common and lead to functional impairment (Arciniegas 2011; Arciniegas and McAllister 2008; see Chapter 10, “Disorders of Consciousness,” and Chapter 11, “Acute Traumatic Encephalopathy”). These impairments typically improve with time since injury, albeit less completely after TBI of greater initial severities (Dikmen et al. 2009). When cognitive recovery is incomplete or cognitive impairments limit engagement in rehabilitative interventions, interfere with activities of daily living, or adversely affect community participation, evaluation and domain-targeted treatment of posttraumatic cognitive impairments is warranted.
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