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

OBJECTIVE

The presented case study describes the beneficial results of the neuropsychological rehabilitation of a gunshot victim, even with late initialization 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.