A fight for life and dignity: A case of massive traumatic brain injury and the paths for treatment and neurorehabilitation

Abstract

We present a clinical case of treatment and neurorehabilitation of a patient with severe neurological deficit due to extensive traumatic lesion of the left hemisphere of the brain. Until recently, such cases were considered incurable and remained marginalized throughout their lives. This clinical case illustrates the compensatory brain possibilities under long-term integrated multidisciplinary treatment and neurorehabilitation with mandatory application of medical, medico-psychological, medico-pedagogical, and medico-social methods, the importance and intensity of which vary at different stages of the disease. This process is addressed in the individual patient. The greatest efficiency of the neurorehabilitation treatment of patients with severe consequences of a stroke and traumatic brain injury can be reached under the following conditions: the earliest possible start of rehabilitation with a sufficient duration and intensity; interdisciplinary and integrative rehabilitation process at various stages of rehabilitation treatment; systematic clinical and neuropsychological diagnostics; systematic monitoring of somatic, neurological, psychiatric, and psychological condition of the patient; assistance with sociopsychological and labor issues; and problem-solving support.

Everyday technology to support basic communication and leisure of individuals with extensive neuro-motor and speech impairments

“…The results indicate that participants with extensive neuro-motor impairment and lack of speech used the new technology-aided program for engaging in communication and leisure events independently. These results corroborate previous findings in the area (D'Amico et al, 2019;Lancioni et al, 2019Lancioni et al, , 2020 and provide new evidence about the relevance of technology-aided interventions for improving the situation of individuals with special needs (Brunner et al, 2017;Pereira et al, 2012;Shklovsky et al, 2016).…”

“…At the same time, they may not qualify for the use of complex and expensive technology solutions (e.g. eye-gaze systems) (Brunner et al, 2017;Shklovsky et al, 2016). In order to improve their condition (helping them with communication and leisure), simple technology-aided programs were recently developed (D'Amico et al, 2019;Lancioni et al, 2019Lancioni et al, , 2020.…”

A Qualitative Pilot Study of Spirituality in Long-term Recovery in Acquired Brain Injury

“…Demarcating stages of psychological and spiritual recovery in ABI -however artificial -may lend a clearer insight into how best to support and augment these stages. A case study by Shklovsky et al (2016) supports the development of life-long psychological, social, occupational and medical support for ABI recovery, particularly in very severe cases, with an emphasis on globally increased quality of life to optimize both individual and community outcomes. Trexler, Parrott, and Malec (2016) promote access to medical, psychological, social and occupational services specific to the needs of the person across the spectrum of the disability and course of recovery.…”

After 55 Years of Neurorehabilitation, What Is the Plan?

“…The roadmap aiming to obtain maximum effectiveness of a neurorehabilitation treatment of patients with moderate-to-severe neurological disabilities should take into account, as a minimum, an earliest possible start of the treatment, sufficient duration and intensity, multidisciplinary and cross-sectoral integrative processes at different stages, systematic assessment/monitoring of the patient’s somatic, cognitive and psychological condition, and systematic problem-solving support for ADLs [ 71 , 72 ]. Additionally, a careful definition of adjustment variables and their timing should be incorporated.…”