Complex rehabilitation and therapeutic care involving a polytraumatized patient with traumatic brain injury, cervical spinal cord injury and multiple associated lesions - case report

Abstract

Introduction: Neurotrauma within polytrauma, defined as “an ensemble of troubles due to many lesions with traumatic origin, among which, at least one, threatens patient’s life”1, is the subject matter of the present scientific paper – approved by the ethics commission of SCUBA, no. 9181, of 11.04.2018 – which encompasses the complex therapeutic and rehabilitation management of a polytraumatized patient with severe traumatic brain injury and cervical spinal cord injury, that led to serious functional consequences – cognitive, motor, sensitive, autonomic. Material and Methods: A 45 years-old, male, patient, suffered severe traumatic neurological injuries and multiple bone fractures and visceral contusions after a traffic accident (driver). The stabilized patient is admitted in our Clinic’s Division for the following reasons: cognition impairment (minimally conscious state), neuromotor impairment in the form of right hemiplegia, dysphagia, neurogenic bladder and gut and eschars. Results: After a serialized, two-year, multidisciplinary rehabilitation approach, aggravated by many complications, the patient has a favorable outcome, both cognitive – in the present moment he can communicate relatively satisfying by pronouncing words correctly, without motor speech disorders and motor: he can maintain the sitting posture for long periods of time and walk several steps with support from another person. These acquisitions are confirmed by the improvement of the following evaluation scales: AIS, FIM, QoL (motor AIS-scale improved with 4 points, motor FIM-scale with 3 points, QoL-scale doubled). Conclusions: This case represents an exhaustive example of multidisciplinary and therapeutic neurorehabilitation approach, with both clinical and scientific impact.