William James

BRAIN INJURY, VOL.

17,

NO.

8 August 2003, 701–713

Case study The cognitive impairments due to the occipito-parietal brain injury after gunshot. A successful neurorehabiliation case study

JOANNA SENIOW{, KATARZYNA POLANOWSKA{, TOMASZ MANDAT{ and KRZYSZTOF LAUDANSKI}

{ 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland { Department of Neurosurgery, Central Clinical Hospital of Military Medical Academy, Warsaw, Poland } Department of Surgery, University of Rochester Medical School, Rochester, NY, USA (Received 14 May 2002; accepted 13 January 2003 ) Objective: The presented case study describes the beneficial results of the neuropsychological rehabilitation of a gunshot victim, even with late initialisation of the therapy—over 1 year after head trauma. Design: A case study of DE, a victim with bilateral damage of the parietal-occipital regions of the brain due to a gunshot. Methods: Neuropsychological rehabilitation, first preceded by an initial neuropsychological examination (standard psychological tests: WAIS-R, RAVLT, Rey’s CFT, BVRT and clinical experiments tailored to DE’s condition), was initiated 1 year after trauma. The rehabilitation programme consisted of computer-based tasks, paper-and-pencil exercises, and occupational therapy. The patient’s progress was assessed as improvement in performance in standardized tests and computer-based tasks. Results: DE was diagnosed with complex cognitive deficits syndrome, including visual associative agnosia, apraxia, visuospatial and constructive disorders and linguistic defects. After 1 year of rehabilitation the patient’s functioning significantly improved as measured by psychological tests and computer-based tasks (p < 0:05) as well as the evaluation of the patient’s quality of life. Conclusions: The case study demonstrates beneficial effects of neurorehabilitation even initialized at the so-called ‘late stage’ after a brain injury.

Introduction Gunshot wound to the...