• Fermín Alberdi Odriozola, Marta Iriarte Ibarrarán, Angel Mendía Gorostidi, Arantza Murgialdai, and Pilar Marco Garde.
• Servicio de Medicina Intensiva, Hospital Donostia, San Sebastián-Donostia, Guipúzcoa, Spain. falberdi1952@telefonica.net
• Med Intensiva. 2009 May 1; 33 (4): 171-81.

AbstractAcquired 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 specialties. 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 adaptation 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.

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