Open AccessClinical and rehabilitative considerations in a complex case of spastic tetraplegia, mixed aphasia, secondary encephalopathy – post severe traumatic brain injury with hemorrhagic and is-chemic lesions – with favorable late evolution and post-symptomatic status after SARS-COV-2 infection
Author(s) -
Ruxandra Postoiu,
Elena-Madalina Mocanu,
Simona Schek,
Magdalena Lăpădat,
Carmen Chipăruș,
Gelu Onose
Publication year - 2022
Publication title -
balneo and prm research journal
Language(s) - English
Resource type - Journals
eISSN - 2734-8458
pISSN - 2734-844X
DOI - 10.12680/balneo.2022.485
Subject(s) - medicine , traumatic brain injury , aphasia , physical therapy , physical medicine and rehabilitation , glasgow coma scale , ptosis , spastic , surgery , psychiatry , cerebral palsy
The traumatic brain injury remains a current research topic considering the severity and the in-creased incidence of this pathology. Both physical and neuro-psychological sequelae require a complex rehabilitation program. Material and methods. We describe the evolution of a 20-year-old case, victim of a severe traumatic brain injury due to physical aggression, with spastic te-traplegia, extended ischemia in the left cerebral hemisphere, mixed aphasia, post-traumatic en-cephalopathy, left eyelid ptosis, right paresis of nerve III, post remitted status of left subdural hematoma, post remitted status of right fronto-parietal subarachnoid hemorrhage, severe joint stiffness (right elbow and fist, bilateral hips and knees), cachexia and SARS-COV-2 infection. In our clinic the patient followed medical, complex kinetotherapeutic treatments and was functio-nally assessed using the following scales: modified Ashworth, Penn Spasm Frequency Scale ( Penn), Life Quality Assessment ( QOL ), Montreal Cognitive Assessment ( MoCA ), FAC Interna-tional Scale, Glasgow Outcome Scale-Extended (GOS-E), modified Rankin scale (mRS ). Results. During the hospitalization, the patient presented a favorable late evolution with a great impro-vement of motor and neurological deficit, aphasia in remision, improvement of eyelid ptosis and joint stiffness, fact also confirmed by the increasing scores from the evaluated scales. Con-clusions. Consequently in traumatic brain injury the proper medication, personalized rehabilita-tion program, ergotherapy, speech therapy, a great deal of involvement and documentation of current information is required to improve the patient's quality of life.Keywords: traumatic brain injury, neuro-rehabilitation program, spastic tetraplegia