Article

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.

Langue : ANGLAIS