The nature of verbal impairment after closed head injury.

Fifty-six closed head injured patients referred to a rehabilitation medicine center were examined to determine the presence and nature of verbal deficits. Eighteen (32 per cent) presented classical symptoms of aphasia, 21 (38 per cent) had motor dysarthria, and 17 (30 per cent) had no discernible aphasic deficit in spontaneous speech, but showed clear evidence of verbal deficit on testing. No patient admitted with sequelae of closed head injuries was spared some degree of verbal impairment, however mild or apparent. Dysarthric patients, without exception, showed subclinical linguistic deficits. Although the patients studied were thought to be more severe than most of those reported in the literature, our findings suggest the desirability of a careful linguistic evaluation of all closed head injured patients because of the potential impact of verbal deficits on rehabilitation out come.