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• W2004964918 abstract "El daño cerebral adquirido (DCA) es un grave problema de salud pública por su gran incidencia y prevalencia, prolongados efectos, repercusión individual y familiar y enormes costes socioeconómicos. En nuestro país lo atienden con desigual equidad distintas instituciones y especialidades. La etiología es, por orden de incidencia, el accidente cerebrovascular, el traumatismo craneoencefálico y, a gran distancia, un grupo misceláneo, en el que destaca la encefalopatía hipóxica. El DCA se sitúa entre dos polos extremos: el coma profundo y, en su opuesto, la reintegración completa en la comunidad en un grado similar al que precedía a la lesión. Entre medio quedan los estados vegetativos, los estados de mínima consciencia y, cuando se produce una recuperación cognitiva, toda una gama de deficiencias, desde los estados de gran dependencia a diferentes déficit cognitivos, conductuales, emocionales, motores, con las subsiguientes discapacidades y minusvalías de muy difícil clasificación por su heterogeneidad. Su pronóstico evolutivo se establece midiendo la situación funcional a partir de escalas descriptivas y funcionales, que tienen importantes problemas de validez y fiabilidad. Unas escalas (GOS, GOSE, etc.) clasifican el deterioro funcional en la fase aguda y subaguda lesional. Otras analizan la planificación y la monitorización de la neurorrehabilitación (ERLA, Barthel Index, SRS). La clasificación ICIDH-2 describe las discapacidades y minusvalías. La eficacia de los tratamientos rehabilitadores depende de su individualización, precocidad, intensidad y que los realicen centros acreditados. Sus resultados son difíciles de cuantificar y, por lo tanto, de comparar, a causa de problemas metodológicos graves. Acquired brain injury (ABI) is a major public health problem due to its high incidence and prevalence, long-term effects on patients and their families and enormous socioeconomical costs. In our country, this is treated unequally by the different institutions and specialities. Its etiology, by order of incidence, is due to stroke, traumatic brain injury and anoxic-ischemic encephalopathy and then, at a great distance, a miscellaneous group in which hypoxic encephalopathy stands out. ABI has two extreme poles: deep coma and full reintegration into the community with a similar level as prior to the lesion. Between these poles are the vegetative states, minimally conscious states and, when there is minimal cognitive recovery, a varying range of difficult-to classify impairments, disabilities and handicaps, due to their extreme heterogeneity. The long-term outcome is assessed by descriptive and functional scales, which usually have important feasibility and validity problems. Some scales (GOS, GOSE) classify functional deterioration during the acute and subacute lesional phase. Others analyze neurorehabilitation planning and monitoring (ERLA, Barthel Index). The International Classification of Impairments, Disabilities and Handicaps (ICIDH-2) describes disabilities and impairments. The efficacy of rehabilitation treatment depends on the how early they are done, their adaption to each patient's needs, intensity and performance by qualified rehabilitation centers. It is difficult to quantify their results in order to compare them because of the serious methodological difficulties." @default.
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• W2004964918 date "2009-05-01" @default.
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• W2004964918 title "Pronóstico de las secuelas tras la lesión cerebral" @default.
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• W2004964918 doi "https://doi.org/10.1016/s0210-5691(09)71213-6" @default.
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