Cognitive Rehabilitation following Severe Traumatic Brain Injury
Along with physical, sensory, and behavior difficulties, traumatic brain injury (TBI) can impair cognitive function and communication, all of which can impair an individual’s ability to function independently. Changes in cognition may occur in the areas of attention, memory/learning, and executive function such as planning, organizing, initiating, goal setting, problem solving, and self-awareness. Communication deficits can be characterized by difficulties in understanding or expressing both spoken and written language, or in the areas of pragmatics.
PY was a 53-year-old man found unconscious for an unknown duration outside his home and taken by ambulance to the hospital. Imaging revealed left subdural hematoma (SDH), extensive subarachnoid hemorrhage, and right temporal bone fracture. He underwent emergency craniotomy for SDH evacuation in the context of a decreasing Glasgow Coma Scale score, reflecting a decline in his level of consciousness based on objective evaluation of eye, verbal, and motor responses. He remained in the acute hospital setting for 2 weeks, followed by 2 weeks in acute inpatient rehabilitation. His posttraumatic amnesia was estimated at more than 4 weeks.