Language-Cognitive Disorganization Following Closed Head Injury: A Conceptualization

  • Chris Hagen


Closed head injury (CHI), defined here as a blow to the head which may or may not produce a skull fracture, does not cause tearing of the dura but does alter the individual’s level of consciousness, frequently causes profound language and cognitive impairments that present the Speech-Language Pathologist with a diagnostic, prognostic and treatment challenge that is at once unique and complex. If the traditional language assessment instruments are applied one will obtain a diagnosis, prognosis and embark on a course of treatment only to find that all three aspects of patient management are inapropriate later that day, the following day or week. However, if one waits until the patient “stabilizes” they will find that not only have two to three months of valuable treatment time been lost but also that they are now confronted with a patient who has developed coping strategies that interfere with the effectiveness of treatment. Clearly, such patients cannot be successfully understood, diagnosed and treated within the framework of our traditional approach to language disorders.


Head Injury Specific Language Impairment Close Head Injury Psychological Corporation Treatment Task 
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  1. Adams, R. and Sidmann, R.L. Introduction to neurophathology. New York: The Blakeston Division, McGraw-Hill Book Co., 1968.Google Scholar
  2. Arseni, C., Constantinovici, A. and Iliesca, D. Considerations on post traumatic aphasia in peace time. Psychitria, Neurologia, Neurochirurgica, 1970, 73, 105–112.Google Scholar
  3. Ayres, A.J. Southern California Figure-Ground Visual Perception Test, Los Angeles: Western Psychological Services, 1966.Google Scholar
  4. Baker, H.J. and Leland, B. Detroit Test of Learning Aptitude, Indianapolis: Bobbs-Merrill, 1959.Google Scholar
  5. Benton, A.L. The Revised Visual Retention Test, New York: The Psychological Corporation, 1963.Google Scholar
  6. Brain, L. and Walton, J.N. Brain’s diseases of the nervous system, 7th edition. New York: Oxford University Press, 1969.Google Scholar
  7. Brock, S. Injuries of brain and spinal cord, 4th edition. New York: Springer Publishing Company, 1960.Google Scholar
  8. Brooks, D.N. Memory and head injury. Journal of Nervous and Mental Disease, 1972, 155, 350–355.PubMedGoogle Scholar
  9. Caveness, W.F. Introduction to head injuries. In Walker, E., Caveness, W., and Cutchley, M. (Eds.), The late effects of head injury. Springfield: Charles C. Thomas, 1969.Google Scholar
  10. Christensen, A.L. Luria’s neuropsychological investigation. New York: Spectrum, 1975.Google Scholar
  11. Courville, C.B. Coup, contre-coup mechanisms of craniocerebral injuries: Some observations. Archives of Surgery, 1942, 45, 19–43.Google Scholar
  12. Courville, C.B. and Amyes, E.W. Late residual lesions of the brain consequent to durai hemmorrhage. Bulletin Los Angeles Neurology Society, 1952, 17, 163.Google Scholar
  13. Cronholm, B. Evaluation of mental disturbances after acute head injury. Scandinavian Journal of Rehabilitation Medicine. 1972, 4, 35–38.PubMedGoogle Scholar
  14. Dye, O.A., Milby, J.B., and Saxon, S.A. Effects of early neurological problems following head trauma on subsequent neuropsychological performance. Acta Neurologic Scandinavia, 1979, 59, 10–14.CrossRefGoogle Scholar
  15. Fahy, T.J., Irving, M.H., and Millac, P. Severe head injuries. Lancet, 1967, 7514.Google Scholar
  16. Field, J.R. Head injuries pathophysiology. Journal of the Arkansas Medical Association. 1970, 66, 340–347.Google Scholar
  17. Frostig, M. Developmental Test of Visual Perception. Chicago: Follett, 1963.Google Scholar
  18. Glasser, M.A. and Shafer, F.P. Skull and brain traumas: Their sequalae: Clinical review of 255 cases. Journal of American Medical Association, 1932, 98, 271–276.CrossRefGoogle Scholar
  19. Goldman, R., Fristoe, M. and Woodcock, R.W. G-F-W Sound Symbol Tests. Circle Pines: American Guidance Service, 1974.Google Scholar
  20. Goldman, R., Fristoe, M. and Woodcock, R.W. G-F-W Auditory Memory Tests. Circle Pines: American Guidance Service, 1974.Google Scholar
  21. Goldman, R., Fristoe, M. and Woodcock, R.W. G-F-W Tast of Auditory Discrimination. Circle Pines: American Guidance Service, 1970.Google Scholar
  22. Goldstein, K. and Scheerer, M. Goldstein-Scheerer Object Sorting Test. New York: The Psychological Corporation, 1951.Google Scholar
  23. Goldstein, K. and Scheerer, M. Goldstein-Scheerer Stick Test. New York: The Psychological Corporation, 1945.Google Scholar
  24. Greenfield, J.G. Some observations on cerebral injuries. Procedings Royal Society of Medicine, 1938–1939, 32, 45.Google Scholar
  25. Greenfield, J.G. and Russell, D.S. Traumatic lesions of the central and peripheral nervous systems. In Blackwood, W. (Ed.), Green-field’s neuropathology. Chicago: Year Book, 1963.Google Scholar
  26. Groher, M. Language and memory disorders following closed head trauma. Journal of Speech and Hearing Research, 1977, 20, 212–223.PubMedGoogle Scholar
  27. Hagen, C. and Malkmus, D. Intervention strategies for language disorders secondary to head trauma. American Speech-Language-Hearing Association Convention Short Course, Atlanta: 1979.Google Scholar
  28. Halpern, H., Darley, F.L. and Brown, J.R. Differential language and neurologic characteristics in cerebral involvement. Journal Speech and Hearing Disorders, 1973, 38, 162–173.Google Scholar
  29. Heilman, K.M., Safron, A. and Geschwind, N. Closed head trauma and aphasia. Journal of Neurology, Neurosurgery and Psychiatry, 1971, 34, 265–269.CrossRefGoogle Scholar
  30. Hooper, R. Patterns of acute head injury. Baltimore: Williams and Wilkins, 1969.Google Scholar
  31. Horowitz, N. and Rizzoli, H.V. Complications following the surgical treatment of head injuries, Clinical Neurosurgery. Proceedings of the Congress of Neurological Surgeons, 1966, 277–287.Google Scholar
  32. Jacobsen, S.A. The post traumatic syndrome following head injuries - Mechanisms and techniques. Springfield: Charles C. Thomas, 1963.Google Scholar
  33. Kirk, S.A., McCarthy, and Kirk, W.D. Illinois Test Psycholinguistic Abilities. University of Illinois, 1968.Google Scholar
  34. Levin, H.S., Grossman, R.G., Rose, J.E. and Teasdale, J. Long term neuropsychological outcome of closed head injury. Journal of Neurosurgery, 1979, 50, 412–422.PubMedCrossRefGoogle Scholar
  35. Lewin, W. The management of head injuries. Baltimore: Williams and Wilkins, 1966.Google Scholar
  36. Mandleberg, I.A. and Brooks, D.N. Cognitive recovery after severe head injury. Journal of Neurology, Neurosurgery and Psychiatry, 1975, 38, 1121–1126.CrossRefGoogle Scholar
  37. Meyer, J.S., and Denny-Brown, D. Studies of cerebral circulation in brain injury. II. Cerebral concussion. Neurophysiology, 1955, 7, 529–544.Google Scholar
  38. Miller, E. Simple and choice reaction time following severe head injury. Cortex, 1970, 6, 121–127.PubMedGoogle Scholar
  39. Miller, H. and Stern, G. The long term prognosis of severe head injury. Lancet, 1965, 225–229.Google Scholar
  40. Russell, R.W. Cerebral involvement in head injury. Brain, 1932, 55, 549–603.CrossRefGoogle Scholar
  41. Russell, W.R. and Smith, A. Post-traumatic amnesia in closed head injury. Archives of Neurology, 1961, 5, 4–17.PubMedCrossRefGoogle Scholar
  42. Schilder, P. Psychic disturbance after head injuries. American Journal of Psychiatry, 1934, 91, 155–188.Google Scholar
  43. Smith, E. Influence of site of impact on cognitive impairment persisting long after severe closed head injury. Journal of Neurology, Neurosurgery and Psychiatry, 1974, 37, 719–726.CrossRefGoogle Scholar
  44. Strick, S.J. Diffuse degeneration of the cerebral white matter in severe dementia following head injury. Journal of Neurology and Psychiatry. 1956, 19, 163.CrossRefGoogle Scholar
  45. Thomsen, I.V. Evaluation and outcome of aphasia in patients with severe closed head trauma. Journal of Neurology, Neurosurgery and Psychiatry. 1975, 38, 713–718.CrossRefGoogle Scholar
  46. Tomlinson, B.E. Pathology. In Rawbothm, G.F. (Ed.), Acute injuries of the head, 4th Edition. Edinburgh, 1964.Google Scholar
  47. Walker, A.E., Kabros, J.J. and Case, T.J. The physiological basis of concussion. Journal of Neurosurgery, 1944, 1, 103–116CrossRefGoogle Scholar
  48. Walker, E., Caveness, W. and Critchley, M. (Eds.) The late effects of head injury. Illinois: Charles C. Thomas, 1969.Google Scholar
  49. Wechsler, D. Wechsler Adult Intelligence Scale. New York: The Psychological Corporation, 1955.Google Scholar
  50. Wechsler, D. and Stone, C.P. Wechsler Memory Scale. New York: The Psychological Corporation, 1945.Google Scholar
  51. Weigl, E., Goldstein, K. and Scheerer, M. Color Form Sorting Test. New York: The Psychological Corporation, 1945.Google Scholar

Copyright information

© Plenum Press, New York 1982

Authors and Affiliations

  • Chris Hagen
    • 1
  1. 1.Speech, Hearing and Neurosensory CenterSan DiegoUSA

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