Main Outcome Measures: The retrospective study computedDMCP used in TBI subjects (�2-year polytrauma history) fromoutpatient rehabilitation clinic records; average retail charges (In-ternet-based) were calculated for a 12-month period. Main outcomemeasures used were %NSD, PROMIS Physical Function (PF), and6-Minute Walk Test (6MWT). The subjects were stratified by%NSD, a neurologic impairment assessment system from the AMAGuides to Evaluation of Permanent Impairment, 6th Edition, basedon the following: state of consciousness/level of awareness; mentalstatus evaluation/integrative functioning; language use/understand-ing; and behavior and mood influence. Global physical health(GPH) was measured by using the PROMIS Physical Function (PF)subscale, and the physical performance status (PPS) was calculatedby using the 6MWT.Results: Yearly DMCP was $1416.48-$13,764.48 (average,$5329.86) and accounted for 8%-46% of total medications costs(TMC), which averaged 23% TMC. Clinical scores were 10%-55%NSD (average, 36%); PROMIS-PF, 23.7- 45.7 (average, 31.8 Tscore); 6MWT distance and metabolic equivalents (METS), 339-1330 ft (average, 982 ft), and 1.58-2.93 METS (average, 2.45METS). DMCP only slightly accounted for TMC. %NSD weremostly in the mild severity, but GPH and PPS level low. There wasno trend relationship of the DMCP to the %NSD, GPH, or PPS.Conclusions: The studied cost type only included a portion ofTMC in managing TBI, that is, not included opioids, rehabilitation,and cognitive-behavioral therapy. Nevertheless, it found the healthand economic burden from medical care related to TBI to besubstantial. The study recommends that TBI pharmacologic man-agement needs to be continued to be individualized. Further studyon the correlation of DMCP in TBI and %NSD, GPH, and PPSshould be done.

BRAIN INJURY

Poster 1An Evaluation of the Health, Perceived Needs, andCharacteristics of Prospective Caregivers DuringInpatient Brain Injury Rehabilitation.Jennifer A. Cohn, MD (Stanford, San Francisco, CA,United States); Steven Barncord, PhD, Thao T. Duong,MD, Stephanie A. Kolakowsky-Hayner, PhD, CBIST, LinhNguyen.

Disclosures: J. A. Cohn, none.Objective: To examine the health, perceived needs and charac-teristics of prospective caregivers during inpatient brain injuryrehabilitation.Design: A prospective observational cohort study.Setting: Inpatient rehabilitation unit.Participants: Prospective primary caregivers of patients admittedafter a brain injury.Interventions: Not applicable.Main Outcome Measures: Data collection included the BriefSymptom Inventory (BSI), the Family Needs Questionnaire, and 12general questions from the Family Assessment Device (FAD), as wellas general demographic and social characteristics.Results: This is a pilot study with only preliminary data. Analysis iscurrently ongoing, and there is no definitive trend to the psycho-logical symptoms that the caregivers report.Conclusions: The impact of becoming a caregiver for a family

member who has sustained a brain injury is well documented. Priorresearch has shown that family members who become caregivers forpatients with a brain injury are more likely to experience anxietyand depression. The research community refers to this as “caregiverburden.” It is critical that clinicians develop interventions to de-crease caregiver burden. Investigations to date have only evaluatedcaregivers and interventions on an outpatient basis. To our knowl-edge, this is the first evaluation of prospective caregivers during aninpatient rehabilitation stay. As this study progresses with moresubjects enrolled, we expect to have sufficient data to identify a clearpattern of psychological symptoms in caregivers secondary to care-giver burden. From this work, our aim is to develop a greaterunderstanding of the health status and perceived needs of prospec-tive caregivers with the goal of developing early intervention tech-niques to alleviate these issues.

Poster 2Rehabilitation of Glioneurocytoma. A Case Report.David Rosenblum, MD (Gaylord Hospital, Wallingford,CT, United States).

Disclosures: D. Rosenblum, none.Patients or Programs: A 24-year-old woman complained ofdizziness, headaches, and tinnitus, and developed a sixth nervepalsy. Workup included a computed tomography, which revealed afourth ventricle mass with hydrocephalus, and magnetic resonanceimaging revealed a cystic-like mass causing obstruction. The tumorwas removed and was found to be a glioneurocytoma. Her postop-erative magnetic resonance imaging did not reveal any residualtumor. In rehabilitation, she was noted to have a marked dysarthriawith high voice, dizziness, poor balance, fatigue, and motor apraxia.Program Description: Inpatient rehabilitation.Setting: Inpatient rehabilitation unit.Results: Her rehabilitation was challenging, and she did makegains. In outpatient rehabilitation, she continued to progress. In themost recent follow-up, her voice quality improved to near normal,her dysarthria is nearly resolved, her strength is excellent, herapraxia lessened, and she is functionally independent.Discussion: Glioneurocytoma is a rare tumor, and, in this patient,presented significant rehabilitation challenges. The tumor was at-tached to the floor of the brainstem, situated in the fourth ventricle,which is unusual, and dissection was successful in it removal. Aftersurgery, she continued to have severe speech and communicationchallenges, marked ataxia and poor balance, an inability to doself-care, and marked decreased mobility. With a goal-directedrehabilitation approach, she was able to make significant improve-ments. Specific interventions, such as binasal visual occluders, willbe highlighted, and a literature review of this type of very rare tumorwill be presented.Conclusions: Inpatient rehabilitation was successful in improv-ing her speech, communication, mobility, and self- care, and suc-cessfully prepared her for transition back into the community.Glioneurocytoma’s epidemiology, natural history, and treatmentoptions will be reviewed, and the specific rehabilitation challenges,and specific approaches, will be emphasized.

Poster 3Weight Gain and Obesity After Traumatic BrainInjury, Looking at Body Mass Index. A Case Report.Jasmine Martinez-Barrizonte, DO (University of Miami/Jackson Memorial Hospital, Miami, FL, United States).

S175PM&R Vol. 3, Iss. 10S1, 2011