The use of the BNI screen for higher cerebral functions in assessing disorientation after traumatic brain injury.

Objective: To examine the use of the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) in assessing disorientation in patients with traumatic brain injury (TBI) during the acute phases of rehabilitation. Design: Persons with TBI (n = 65) were compared with patients with spinal cord injury (SCI; n = 18) and to controls (n = 35). Setting: Inpatient neurorehabilitation unit. Outcome measures: Orientation items from the BNIS measuring time (day, month, date of month, year) and place (city and hospital). Results: TBI patients showed a significantly greater proportion of incorrect responses to time and place compared with the SCI and normal control groups. There was a greater accuracy on orientation to place compared with orientation to time, and date of month produced the lowest rate of accuracy in all three groups. The single best predictor of disorientation to time was increasing age, and increasing age was most associated with disorientation to date of month. Conclusions: The BNIS was shown to be a sensitive measure of disorientation in TBI patients and yielded similar patterns of performance as documented by other measures.