Pathophysiology and Behavioral Recovery

  • Barbara P. Uzzell


Concerted efforts in treating cognitive deficits after insults to the brain have been met with both enthusiasm and doubt, and have produced both satisfactory results and undocumented claims. While not within the framework of diagnostic lesion localization, intervention has not been entirely ignored by neuropsychology [1, 2]. Much of the work of Luria [3, 4] focuses on rehabilitation, and a surge of activity has lately appeared in this area [5, 6, 7, 8].


Head Injury Spontaneous Recovery Regional Cerebral Blood Flow Brain Damage Glasgow Coma Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Goldstein, K. 1932. Restitution in injuries of the brain cortex. Arch. Neurol. Psychiatr. 27, 736–744.Google Scholar
  2. 2.
    Zangwill, O.L. 1947, Psychological aspects of rehabilitation in cases of brain injury. Brit. J. Psychol. 37, 60–69.Google Scholar
  3. 3.
    Luria, A.R. 1963. Restoration of function after brain injury. New York: Macmillan.Google Scholar
  4. 4.
    Christensen, A.-L. 1984. The Luria method of examination of the brain-impaired patient. In P.E. Logue & J.M. Schear (Eds.), Clinical neuropsychology: a multidisciplinary approach. Springfield, IL: C.C. Thomas, pp. 5–28.Google Scholar
  5. 5.
    Diller, L. & Weinberg, J. 1977. Hemi-inattention in rehabilitation: the evolution of a rational remediation program. In E. A. Weinstein & R.P. Friedland (Eds.), Advances in neurology, Vol. 18. New York: Raven Press, pp. 63–82.Google Scholar
  6. 6.
    Gianutsos, R. 1980. What is cognitive rehabilitation? J. Rehabil. August, 36–40.Google Scholar
  7. 7.
    Diller, L. & Gordon, W.A. 1981. Interventions for cognitive deficits in brain damaged adults. J. Consult. Clin. Psychol 49, 822–834.PubMedCrossRefGoogle Scholar
  8. 8.
    Ben-Yishay, Y. & Diller, L. 1983. Cognitive remediation. In M. Rosenthal, E.R. Griffith, M.R. Bond & J.D. Miller (Eds.), Rehabilitation of the head injured adult. Philadelphia: F.A. Davis Company, pp. 367–380.Google Scholar
  9. 9.
    Costa, L. 1983. Clinical neuropsychology: a discipline in evolution. J. Clin. Neuropsychol. 5, 1–11.PubMedCrossRefGoogle Scholar
  10. 10.
    Caplan, B. 1982. Neuropsychology in rehabilitation: its role in evaluation and intervention. Arch. Phys. Med. Rehabil. 63, 362–366.PubMedGoogle Scholar
  11. 11.
    Tupper, D.E. & Rosenblood, L.K. 1984. Methodological considerations in the use of attribute variables in neuropsychological research. J. Clin. Neuropsychol. 6, 441–453.PubMedCrossRefGoogle Scholar
  12. 12.
    Frommer, G.P. 1978. Subtotal lesions: implications for coding and recovery. In S. Finger (Ed.), Recovery from brain damage. New York: Plenum Press, pp. 217–280.Google Scholar
  13. 13.
    Kertez, A., Harlock, W. & Coates, R. 1979. Computer tomographic localization, lesion size, and prognosis in apraxia and nonverbal impairment. Brain and Lang. 8, 34–50.CrossRefGoogle Scholar
  14. 14.
    Kertez, A. & Dobrowski, S. 1981. Right hemisphere deficits, lesion size and location. J. Clin. Neuropsychol. 3, 283 - 299.CrossRefGoogle Scholar
  15. 15.
    Naeser, M.A., Hayward, R.W., Laughlin, S.A. & Zatz, L.M. 1981. Quantitative CT scan studies in aphasia. I. infarct size and CT numbers. Brain and Lang. 12, 140–164.CrossRefGoogle Scholar
  16. 16.
    Hier, D.B., Mondlock, J. & Caplan, L.R. 1983. Recovery of behavioral abnormalities after right hemisphere stroke. Neurol. 33, 345 — 350.Google Scholar
  17. 17.
    Knopman, D.S., Seines, O.A., Niccum, N. & Reubens, A.B. 1984. Recovery of naming in aphasia: relationship to fluency, comprehension and CT findings. Neurology 34, 1461–1470.PubMedGoogle Scholar
  18. 18.
    Black, F.W. 1973. Cognitive and memory performance in subjects with brain damage secondary to penetrating missile wounds and closed head injury. J. Clin. Psychol. 31, 441–442.CrossRefGoogle Scholar
  19. 19.
    Milner, B. 1971. Interhemisphere differences in the localization of psychological processes in man. Brit. Med. Bull. 21, 272–277.Google Scholar
  20. 20.
    Naeser, M.A. & Hayward, R.W. 1978. Lesion localization in aphasia with cranial computed tomography and the Boston diagnostic aphasia exam. Neurology 28, 545–551.PubMedGoogle Scholar
  21. 21.
    Dolitnskas, C.A., Zimmerman, R.A., Bilaniuk, L.T. & Uzzell, B.P. 1978. Correlation of long-term follow-up neurologic, psychologic and cranial computed tomograph evaluations of head trauma patients. Neuroradiology 16, 318–319.CrossRefGoogle Scholar
  22. 22.
    Soh., K., Larsen, B., Skinhoj, E. & Lassen, N.A. 1978. Regional cerebral blood flow in aphasia. Arch. Neurol. 35, 625–632.Google Scholar
  23. 23.
    Uzzell, B.P., Zimmerman, R.A., Dolinskas, C.A. & Obrist, W.D. 1979. Lateralized psychological impairment associated with CT lesions in head injured patients. Cortex 15, 391–401.PubMedGoogle Scholar
  24. 24.
    Mazzocchi, F. & Vignolo, L.A. 1979. Localization of lesions in aphasia: clinical-CT scan correlations in stroke patients. Cortex 15, 627–654.PubMedGoogle Scholar
  25. 25.
    Naeser, M.A., Hayward, R.W., Laughlin, S.A., Becker, J.M.T., Jernigan, T.L. & Zatz, L.M. 1981. Quantitative CT scan studies in aphasia. II. Comparison of the right and left hemispheres. Brain and Lang. 12, 165–189.CrossRefGoogle Scholar
  26. 26.
    Borod, J.C., Carper, M., Goodglass, H. & Naeser, M. 1984. Aphasie performance on a battery of constructional, visuospatial and quantitative tasks: factorial structure and CT scan localization. J. Clin. Neuropsychol. 6, 189–204.PubMedCrossRefGoogle Scholar
  27. 27.
    Horn, J. & Reitan, R.M. 1984. Neuropsychological correlates of rapidly vs. slowly growing intriinsic cerebral neoplasms. J. Clin. Neuropsychol. 6, 309–324.CrossRefGoogle Scholar
  28. 28.
    Black, F.W. & Bernard, B.A. 1984. Constructional apraxia as a function of lesion locus and size in patients with focal brain damage. Cortex 20, 111–120.PubMedGoogle Scholar
  29. 29.
    Butters, N., Butter, C., Rosen, J. & Stein, D. 1973. Behavioral effects of sequential and one-stage ablations of orbital prefrontal cortex in the monkey. Exper. Neurol. 39, 204–214.CrossRefGoogle Scholar
  30. 30.
    Finger, S. 1978. Lesion momentum and behavior. In S. Finger (Ed.), Recovery from brain damage. New York: Plenum Press, pp. 135–164.Google Scholar
  31. 31.
    Smith, A. 1981. Principles underlying human brain functions in neuropsychological sequelae of different neuropathological processes. In S.B. Filskov & T.J. Boll (Eds.), Handbook of clinical neuropsychology. New York: John Wiley, pp. 175 — 226.Google Scholar
  32. 32.
    Finger, S. & Stein, D.G. 1982. Brain damage and recovery. New York: Academic Press.Google Scholar
  33. 33.
    Reii:an, R. 1966. Problems and prospects in studying the psychological correlates of brain lesions. Cortex 2, 127–153.Google Scholar
  34. 34.
    Pazzaglia, P., Frank, G., Frank, F. & Gaist, G. 1975. Clinical course and prognosis of acute post-traumatic coma. J. Neurol. Neurosurg. Psychiat. 38, 149–154.PubMedCrossRefGoogle Scholar
  35. 35.
    Johnson, D. & Almli, C.R. 1978. Age, brain damage and performance. In S. Finger (Ed.), Recovery from brain damage. New York: Plenum Press, pp. 115–134.Google Scholar
  36. 36.
    Teuber, H.L. 1975. Recovery of function after brain injury in man. In Outcome of severe damage to the central nervous system (Ciba Foundation Symposium). Amsterdam: Elsevier, pp. 159–190.Google Scholar
  37. 37.
    Mandleberg, I. & Brooks, D.N. 1975. Cognitive recovery after severe head injury. 1. serial testing on the Wechsler Adult Intelligence Scale. J. Neurol. Neurosurg. Psychiat. 38, 1121–1126.PubMedCrossRefGoogle Scholar
  38. 38.
    Bond, M.R. & Brooks, D.N. 1976. Understanding the process of recovery as a basis for the investigation of rehabilitation for the brain injured. Scand. J. Rehabil. Med. 8, 127–133.Google Scholar
  39. 39.
    Dikman, S. & Reitan, R.M. 1976. Psychological deficits and recovery of functions after head injury. Trans. Am. Neurol. Assoc. 101, 72–77.Google Scholar
  40. 40.
    Braun, J.J. 1978. Time and recovery from brain damage. In S. Finger (Ed.), Recovery from brain damage. New York: Plenum Press, pp. 165–197.Google Scholar
  41. 41.
    Brooks, D.N., Deelman, B.G., van Zomeren, A.H., van Dongen, H., van Harskamp, F. & Aughton, M.E. 1984. Problems in measuring cognitive recovery after acute brain injury. J. Clin. Neuropsychol. 6, 71–85.PubMedCrossRefGoogle Scholar
  42. 42.
    Brooks, N. 1984. Cognitive deficits after head injury. In N. Brooks (Ed.), Closed head injury. New York: Oxford University Press, pp. 44–73.Google Scholar
  43. 43.
    Inglis, J., Ruckman, M., Lawson, J.S., MacLean, A.W. & Monga, T.N. 1982. Sex differences in the cognitive effects of unilateral brain damage. Cortex 18, 257–276.PubMedGoogle Scholar
  44. 44.
    Bornstein, R.A. & Matarazzo, J.D. 1982. Wechsler VIQ versus PIQ differences in cerebral dysfunction: a literature review with emphasis on sex differences. J. Clin. Neuropsychol. 4, 319–334.PubMedCrossRefGoogle Scholar
  45. 45.
    Laurence, S. & Stein, D.G. 1978. Recovery after brain damage and the concept of localization of function. In S. Finger (Ed.), Recovery from brain damage. New York: Plenum Press, pp. 369–407.Google Scholar
  46. 46.
    Luria, A.R. 1980. Higher cortical functions in man ( 2nd ed. ). New York: Basic Books.Google Scholar
  47. 47.
    Bach-y-Rita, P. 1981. Central nervous system lesions: sprouting and unmasking in rehabilitation. Arch. Phys. Med. Rehabil. 62, 413–417.PubMedGoogle Scholar
  48. 48.
    Wall, P.D. 1980. Mechanisms of plasticity of connection following damage in adult mammalian nervous systems. In P. Bach-y-Rita (Ed.), Recovery offunction: theoretical considerations for brain injury rehabilitation. Baltimore, MD: University Park Press, pp. 91–105.Google Scholar
  49. 49.
    Gennarelli, T.A., Thibault, L.E., Adams, J.H., Graham, D.I., Thompson, C.J. & Marcincin, R.P. 1982. Diffuse axonal injury and traumatic coma in the primate. Ann. Neurol. 12, 564–574.PubMedCrossRefGoogle Scholar
  50. 50.
    Zimmerman, R.A., Bilaniuk, L.T., Dolinskas, C., Gennarelli, T., Bruce, D. & Uzzell, B. 1977. Computed tomography of acute intracerebral hemorrhagic contusion. Comp. Axial Tomogr. 1, 271–279.CrossRefGoogle Scholar
  51. 51.
    Dolinskas, C.A., Bilaniuk, L.T., Zimmerman, R.A. & Kuhl, D.E. 1977. Computed tomography of intracerebral hematomas. I. transmission CT observations on hematoma resolution. Am. J. Roentgenol. 129, 681–688.Google Scholar
  52. 52.
    Zimmerman, R.A. & Bilaniuk, L.T. 1978. Computer tomography of traumatic intracerebral hemorrhagic lesions: the change in density and mass effect with time. Neuroradiology 16, 320–321.PubMedCrossRefGoogle Scholar
  53. 53.
    Bruce, D.A., Alavi, A., Bilaniuk, L., Dolinskas, C., Obrist, W. & Uzzell, B. 1981. Diffuse cerebral swelling following head injuries in children: the syndrome of “malignant brain edema.”J. Neurosurg. 54, 170–178.Google Scholar
  54. 54.
    Risser, A.H. 1983. Nuclear magnetic resonance: an exciting, accessible neuro-imaging modality. J. Clin. Neuropsychol. 5, 403–406.CrossRefGoogle Scholar
  55. 55.
    Obrist, W.D., Thompson, H.K. Jr., King, C.H. & Wang, H.S. 1967. Determination of regional cerebral blood flow by inhalation of 133-xenon. Circ. Res. 20, 124–135.PubMedGoogle Scholar
  56. 56.
    Obrist, W.D., Thompson, H.K. Jr., Wang, H.S. & Wilkinson, W.E. 1975. Regional cerebral blood flow estimated by 133xenon inhalation. Stroke 6, 245–256.PubMedCrossRefGoogle Scholar
  57. 57.
    Risberg, J., Halsey, J.H., Wills, E.L. & Wilson, E.M. 1975. Hemispheric specialization in normal man studied by bilateral measurements of the regional cerebral blood flow. Brain 98, 511–524.PubMedCrossRefGoogle Scholar
  58. 58.
    Risberg, J. 1980. Regional cerebral blood flow measurements by 133Xe-inhalation: methodology and applications in neuropsychology and psychiatry. Brain and Lang. 9, 9–34.CrossRefGoogle Scholar
  59. 59.
    Kuhl, D.E. 1984. Imaging local brain function with emission computed tomography. Radiology 150, 625–631.PubMedGoogle Scholar
  60. 60.
    Kuhl, D.E., Phelps, M.E., Kowell, A.P., Metter, E.J., Selin, C. & Winter, J. 1980. Effects of stroke on local cerebral metabolism and perfusion: mapping by emission computed tomography of 18FDG and 13NH3. Ann. Neurol. 8, 47–60.PubMedCrossRefGoogle Scholar
  61. 61.
    Lassen, N.A., Henriksen, L. & Paulson, O. 1981. Regional cerebral blood flow in stroke by 133xenon inhalation and emission tomography. Stroke 12, 284–288.PubMedCrossRefGoogle Scholar
  62. 62.
    Kuhl, D.E., Phelps, M.E., Markham, C.H., Metter, E.J., Riege, W.H. & Winter, J. 1982 Cerebral metabolism and atrophy in Huntington’s disease determined by 18FDG and computed tomographic scan. Ann. Neurol. 12, 425–434PubMedCrossRefGoogle Scholar
  63. 63.
    Kuhl, D.E., Metter, E.J. & Riege, W.H. 1984. Patterns of local cerebral glucose utilization determined in Parkinson’s disease by the (18F) fluorodeoxyglucose method. Ann. Neurol. 15, 419–424.PubMedCrossRefGoogle Scholar
  64. 64.
    Rothi, L.J. & Horner, J. 1983. Restitution and substitution: two theories with application to neurobehavioral treatment. J. Clin. Neuropsychol. 5, 73–81.PubMedCrossRefGoogle Scholar
  65. 65.
    Teuber, H.L. 1974. Recovery of function after lesions in the central nervous system: history and prospects. Neurosci. Res. Program Bull. 12, 197–209.PubMedGoogle Scholar
  66. 66.
    Luria, A.R., Naydin, V.L., Tsvetkova, L.S. & Vinarskaya, E.N. 1969. Restoration of higher cortical functions following local brain damage. In P.J. Vinken & G.W. Bruyn (Eds.), Handbook of clinical neurology III. Amsterdam: North Holland Publishing, pp. 368–433.Google Scholar
  67. 67.
    Lezak, M.D. 1983. Neuropsychological assessment ( 2nd ed. ). New York: Oxford University Press.Google Scholar
  68. 68.
    Benton, A.L. 1968. Differential behavioral effects in frontal lobe disease. Neuropsychologia 6, 53–60.CrossRefGoogle Scholar
  69. 69.
    Klove, H. & Cleeland, C.S. 1972. The relationship of neuropsychological impairment to other indices of severity of head injury. Scand. J. Rehabil. Med. 4, 55–60.PubMedGoogle Scholar
  70. 70.
    Smith, E. 1974. Influence of site of impact on cognitive impairment persisting long after severe closed head injury. J. Neurol. Neurosurg. Psychiat. 31, 719–726.CrossRefGoogle Scholar
  71. 71.
    Dye, O.A., Milby, J.B. & Saxon, S.A. 1979. Effects of early neurological problems following head trauma on subsequent neuropsychological performance. Acta Neurol. Scand. 59, 10–14.PubMedCrossRefGoogle Scholar
  72. 72.
    Bond, M. 1976. Assessment of the psychosocial outcome of severe head injury. Acta Neurochir. 34, 57–70.CrossRefGoogle Scholar
  73. 73.
    Grosswasser, Z., Mendelson, L. Stern, M.J., Schechter, I. & Najenson, T. 1977. Re- evaluation of prognostic factors in rehabilitation after severe head injury. Scand. J. Rehabil. Med. 9, 147–149.Google Scholar
  74. 74.
    Humphrey, M. & Oddy, M. 1980. Return to work after head injury: a review of post-war studies. Injury 12, 107–114.PubMedCrossRefGoogle Scholar
  75. 75.
    Weddell, R., Oddy, M. & Jenkins, D. 1980. Social adjustment after rehabilitation: a two yeair follow-up of patients with severe head injury. Psychol. Med. 10, 257–263.PubMedCrossRefGoogle Scholar
  76. 76.
    Newcombe, F., Brooks, N. & Baddeley, A. 1980. Rehabilitation after brain damage: an overview. Int. Rehabil. Med. 2, 133–137.PubMedGoogle Scholar
  77. 77.
    Goethe, K.E. & Levin, H.S. 1984. Behavioral manifestations during the early and long-term stages of recovery after closed head injury. Psychiat. Ann. 14, 540–546.Google Scholar
  78. 78.
    Brooks, N. 1984. Head injury and the family. In N. Brooks (Ed.), Closed head injury. New York: Oxford University Press, pp. 123–147.Google Scholar
  79. 79.
    Thomas, J.D. & Trexler, L.E. 1982. Behavioral and cognitive deficits in cerebrovascular accident and closed head injury: implications for cognitive rehabilitation. In L.E. Trexler (Ed.), Cognitive rehabilitation. New York: Plenum Press, pp. 27–61.Google Scholar
  80. 80.
    Obrist, W.D., Langfitt, T.W., Jaggi, J.L., Cruz, J. & Gennarelli, T.A. 1984. Cerebral blood flow and metabolism in comatose patients. J. Neurosurg. 61, 241–253.PubMedCrossRefGoogle Scholar
  81. 81.
    Teasdale, G. & Mendelow, A. 1984. Pathophysiology of head injuries. In N. Brooks (Ed.), Closed head injury. New York: Oxford University Press, pp. 4–36.Google Scholar
  82. 82.
    Symonds, C.P. 1928. The differential diagnosis and treatment of cerebral states consequent upon head injuries. Brit. Med. J. 4, 829–832.CrossRefGoogle Scholar
  83. 83.
    Terrace, H.S. 1963. Discrimination learning with and without errors. J. Exp. Anal. Behav. 6, 1–27.PubMedCrossRefGoogle Scholar
  84. 84.
    Terrace, H.S. 1963. Errorless transfer of a discrimination across two continua. J. Exp. Anal. Behav. 6, 223–232.PubMedCrossRefGoogle Scholar
  85. 85.
    Terrace, H.S. 1964. Wavelength generalization after discrimination learning with and without errors. Science 144, 78–80.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston 1986

Authors and Affiliations

  • Barbara P. Uzzell

There are no affiliations available

Personalised recommendations