Rehabilitation paths in severe brain injury

Fabrizio Denaro, Maria Zanghì, Graziano Giuffrida, Placido Bramanti

Research output: Chapter in Book/Report/Conference proceedingChapter


Vegetative state is a clinic condition that occurs after a coma caused by an acute event (trauma, stroke, cerebral anoxia). People suffering from severe brain injury usually receive the primary hospital treatment in intensive care units, during this period subjects are supported by health interventions such as ventilation and dressings. The acute phase may last for a few weeks or months until the subject is stable and it is possible to start a specialist and multidisciplinary rehabilitation path, which allows the patient not only to survive but also to maintain as much as possible the necessary vital functions [1]. Once the patient is stabilized it is necessary to define what kind of treatment should be submitted, where to continue rehabilitation and who will provide the services. Decisions concerning health are jointly taken by the health care team that assists the patient and family members, the real problem is where the subject can continue the treatments. The choice for families is limited to a rehabilitation Institute or to the reintegration at home that, if ensures the closeness of relatives, but may not provide the patient with the appropriate treatment to maintain a good quality of life, while a rehabilitation Institute does not allow family members to constantly assist the patient. A family that lives in an area of difficult geographic access, if decides for domiciliation, may have difficulty to support his patient for logistical, temporal and financial reasons; having to deal with everyday life that often doesn't allow to assist him. This last reflection is to understand that people in VS or MCS are part of the category of vulnerable people, for which law must provide protection and care assistance. The approach of care and rehabilitation to people with low responsiveness due to injury in brain structures is a problem of serious medical and social relevance. The VS due to severe brain injury and resulting in coma has, in its initial phase, a real need to be taken in intensive care. The inclusion of such patients in intensive care in a first phase is essential for survival but becomes a critical factor when the patient is stable and long hospitalization in these departments becomes "inappropriate" and reduces the resources for other types of patients. What is shared in the scientific community is the need of departments dedicated to these diseases that, as shown by some studies, have a lower incidence of mortality and a better prognosis than those treated in non-specialized departments.

Original languageEnglish
Title of host publicationChronic Disorders of Consciousness: From Research to Clinical Practice
PublisherNova Science Publishers, Inc.
Number of pages12
ISBN (Print)9781626189409
Publication statusPublished - 2013

ASJC Scopus subject areas

  • Medicine(all)
  • Neuroscience(all)


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