Biomedical subjects
E A Freeman
Publications and source records attributed to E A Freeman.
Coma and severe brain injury.
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Clinical course and outcome of severe head injury in Australia.
The records of 159 severely head-injured patients (all in coma for longer than 6 hours) from Sydney, Australia, were studied. The clinical course, charted over a 2-week period, indicated that 60% of deaths occur by Day 3 and that 12% of patients remain in coma (Glagow Coma Scale (GCS) score less than 7) for more than 2 weeks. Overall, at long-term follow-up review more than 2 years after injury, 51% of patients were dead, 7% were severely disabled or vegetative, and 42% had a good to moderate recovery. Outcome of the patients in prolonged coma was assessed separately, with only one-third making a good or moderate recovery; two-thirds of the severely disabled patients came from this group. The high proportion of poor outcomes associated with prolonged coma suggests that this group of patients should be specifically targeted in research. One appropriate intervention with this group would be the restructuring and intensification of early rehabilitation. However, the GCS score lacks the precision needed for this type of study, and a better measure of recovery should be developed.
Effects of 5-phenyloxazolidinedione on sodium-potassium-magnesium-activated adenosine triphosphatase activity in mouse brain.
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Severe brain injury: intensive family involvement in community-based rehabilitation.
A 15-year-old boy, severely brain injured as a result of a motor vehicle accident, was in coma for six weeks. Five months after the injury, while still severely disabled, he was taken home and treated by an intensive, organised domiciliary programme of community-based rehabilitation supplemented by additional help from the local hospital. The patient regained function, and the programme was emotionally rewarding for the relatives, friends and volunteers. Significant cost savings to the State may be obtained with this method of management.