Neuropsychological aspects of the rehabilitation of patients with paralysis from a spinal injury who also have a brain injury.

In order to examine the rehabilitation process of patients suffering from a severe spinal cord injury and who also have a cerebral injury, 322 patients with paralysis from a spinal injury were subjected to neuro-psychiatric and neuro-psychological examinations. On average 20.2% of these patients showed an associated cerebral lesion. The psychological results of such cerebral lesions are summarized under the concept of the co-called organic psychic syndrome (OPS). In 27.7% of these patients no organic psychic syndrome resulted, and in these patients a conventional paralysis rehabilitation could be carried out. 41.6% showed very minor to moderate injuries, with 30.7% being severely disabled from the cerebral injury. Rehabilitation for these patients was modified, using new therapeutic approaches, and also traditional therapeutic methods adapted to the abilities and needs of this patient group. In 25.5% of the patients there was no substantial improvement during the treatment period of initial rehabilitation (x = 12.5 weeks for the treatment of cerebral injury); but in 36.2% of the patients there was substantial improvement and in 38.3% full remission of organic psychic disorders occurred. Improvements in this sphere have a direct bearing on the rehabilitation capacity of this patient group.