November 23, 2018


The Wessex Head Injury Matrix can be used to assess patients in various states of consciousness after suffering a severe head injury. Cognitive skills, cognitive. Clin Rehabil. Aug;14(4) The Wessex Head Injury Matrix (WHIM) main scale: a preliminary report on a scale to assess and monitor patient recovery. Wessex Head Injury Matrix (WHIM). – Shiel, Wilson, McLellan, Horn and Watson. (). – Cost for manual and scoring sheets. JFK Coma Recovery Scale –.

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Clin Rehabil ; With the WHIM patients can be assessed and goals for rehabilitation set from the outset of coma.

Coma Science Group

To stimuli may, for example, turn head or eyes away or withdraw limbs from stimulus III Localized response: Register a new account? Wilson et al 17 reported serial assessment with the WHIM as a tool to detect subtle changes in cognitive and communicative function over time. Rates of change for both parameters increased progressively towards the highest level of PDOC status ie, Emergedconfirming that the trajectory of change is an important indicator of eventual outcome with respect to ijury awareness.

For the purpose of this evaluation, subcategorisation was applied retrospectively for admissions prior to To stimulus may, for example, turn head or move upper limbs towards stimuli.

Assess injkry monitor recovery of cognitive function after severe head injury Qualification Level: Patients are injurry assessed at too early a stage in their recovery, based on an insufficient period of observation and in the absence of a structured approach to evaluation. A significant interaction would suggest that the change in values over time varied between groups.

Methods The WHIM was administered serially by the multidisciplinary team throughout an in-patient evaluation programme mean length 74 sd42 days. Taking together the frequency of observation and the compatibility of items with different PDOC states as reported elsewhere 12022 we proposed a new hierarchical order for the WHIM.


By discharge, group differences had widened.

Wessex Head Injury Matrix (WHIM)

Two district general hospitals in the UK. The WHIM will pick up minute indices demonstrating recovery, providing objective evidence for realistic prediction.

However, some items were rarely recorded suggesting that they may be redundant. Significant factors were then entered into stepwise multiple regression model to determine the best predictors both at baseline and at discharge.

Routine use hdad the CRS-R 16 and systematic recording of the Aspen criteria for emergence 3 were introduced in our centre in From unresponsive wakefulness to minimally conscious Wesssex and functional locked-in syndromes: Setting Consecutive admissions to a tertiary in-patient neurorehabilitation service for evaluation of PDOC in real-life clinical practice, over a year period — On the positive side our findings are reflective of the WHIM as it is actually used in the clinical setting, documented over a decade by many staff members, during which its usefulness has stood the test of time.

Within this analysis we have concentrated on the order of items, rather than item redundancies. Brain Inj ; Following this initial phase of empirical observation, behaviors were identified. Care is first optimised through:.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author s and has not been edited for content. The proposed new hierarchical order requires further evaluation in mwtrix multicentre analyses. Log in via OpenAthens. The WHIM is a hierarchical scale, designed to provide a sequential framework against which to monitor changes in a individual’s level responsiveness and interaction with their environment, as they progress from coma through to emergence from post-traumatic amnesia following traumatic brain injury.

He contributed to the drafting, reviewing and revision of the manuscript and gave his final approval. Wessex Head Injury Matrix—manual. J Neurol ; MAB was excluded from the model. Although one previous analysis has recorded change in WHIM score from first to final assessment in 12 patients with PDOC, 17 this paper provides the first longitudinal analysis to confirm the trajectory of serial WHIM assessments as an important indicator of outcome. Profound motor and sensory deficits, or indeed aphasia, 6 may mask the behaviours that demonstrate awareness; 7 Responses maatrix typically delayed and inconsistent in PDOC; 89 Patients are sometimes heda at too early a stage in their recovery, based on an insufficient weszex of observation and in wesssex absence of a structured approach to evaluation.


Disorders of consciousness after acquired brain injury: However, it occurred only 1—2 times in four individuals against a background of spontaneous movement, which is sufficiently uncommon to be considered a chance finding.

Responses are typically delayed and inconsistent in PDOC; 89. While individual patients will show some departures from the sequence identified, the scale helps to make explicit the earliest stages of natural recovery patterns after head injury. The WHIM wesdex designed to monitor all stages of recovery from coma to emerging post-traumatic amnesia, to monitor subtle changes in patients in a minimally conscious state and to reflect injiry in everyday life.

Because the emergence from coma or PDOC generally occurs through a gradual and often variable process of recovery, individual trend analysis may conceivably provide the best haed of outcome with respect to recovered awareness. Recorded behaviours are ticked off on the checklist if they meet the operational definitions. Two-level models were used with individual measurements nested within patients. A prospective observational study of a cohort of 88 consecutive hospital admissions with severe head injury.

Medical aspects of the persistent vegetative state, part 1 and 2. For permission to use where not already granted under a licence please go to http: