Neuropsychological experiences in neurotraumatology

Summary

My work in Neurotraumatology was initiated in 1961, when I as a neuropsychologist got a position in a neurosurgical University department. The tasks were to evaluate the mental state of patients, give advices to family members regarding the mental and social prognosis of the patients and to support nurses in the initial care of the patients. Initially the methods that were made use of were tests developed by the German neurologist Kurt Goldstein [8] and traditional psychometric tests, but it was not until the theories of A. R. Luria and his investigation method were applied that a true position as a member of the treatment team was secured. Reading Luria’s book “Higher Cortical Functions in Man” [9] made me aware of his theories. The skill to perform the investigation was acquired during visits to Luria’s laboratory at the Bourdenko Neurosurgical Institute in Moscow in the nineteen-seventies. Text and material to “Luria’s Neuropsychological Investigation” was published in 1974 [1].

The early work was further stimulated by the development in the neurosciences regarding brain plasticity and brain repair [6] and experiences from visits to rehabilitation centres in the US, Yehuda Ben-Yishay’s center at New York Medical School, George Prigatano’s centre at the time in Oklahoma, and Lance Trexler’s center at Community Hospital, Indianapolis led in 1985 to the establishment of the first post acute rehabilitation center in Europe: the Center for Rehabilitation of Brain Injury (CRBI) at the University of Copenhagen, DK [2]. The main program was a holistic day program, six hours a day for four months in accordance with the university semesters, and an eigth months follow-up. Groups of 15 persons started together, collaborating in smaller groups. The present director of the CRBI is neuropsychologist Frank Humle.

A thorough follow-up of the patients’ state and improvement through the course of treatment towards social integration, including getting back to work was performed, and studies have indicated that successful integration of the traumatized patient is possible, provided that an early intensive care is succeeded by a comprehensive, individualized post-acute rehabilitation program, of which follow-up is a part, all within the frame of multidisciplinary collaboration.