Introduction. Neuropsychological rehabilitation is needed in case of disorders of higher mental functions (HMF) due to various brain diseases of traumatic, hypoxic, vascular, inflammatory, atrophic or neoplastic genesis.
The severity of HMF disorders is associated with many factors, including the volume and location of brain damage, the presence and duration of a coma and post-comatose unconscious state in the acute phase of brain trauma. A coma up to seven days' results in moderate disability or so-called complete recovery, whereas a longer coma increases the risk of severe disability. Even a one-to-two-day post- comatose unconscious state triples (17 to 56%) the risk of low-reversible cognitive disorders in the late period after TBI. Only 7% of patients having a post-comatose unconscious state for more than one month end up with moderate to mild cognitive disorders.
Neuropsychological rehabilitation should start as early as possible, ideally as soon as vital functions stabilise. The recovery is fast within the first five months after TBI and then it slows down significantly. New neural ensembles formed as a result of neurogenesis, are meant to increase the adaptivity in the changing conditions of the internal and external environment. Thus, in order to integrate new neurons into functional neural networks, the environment must be restructured as to get problem areas activated. Newly formed functions can appear only in a specially designed problem environment. However, neuropsychological rehabilitation has not been developed enough so far to provide evidence-based options and standards for this type of patient care.