Case Vignette. Brain Injury Can Make One Better!

Abstract

SS is a 58-year-old woman who had a history of anxiety and depression and severe gambling addiction. At the age of 54, she was hit by a car at a zebra crossing while walking to local shops and as a result suffered a severe traumatic brain injury. Her Glasgow Coma Scale (GCS) was very depressed at 6/15, and she had a protracted period of posttraumatic amnesia (PTA) of greater than 2 weeks. A CT scan showed bilateral small acute subdural hematomas and multiple contusions especially in both temporal lobes as well as fractures of the skull vault and base of the skull. She was treated conservatively in the hospital and discharged to a local rehabilitation unit where she demonstrated significant cognitive, emotional, and neurobehavioral problems. She refused interventions and was deemed to lack insight. She made gradual improvement though showed a lack of insight into her difficulties and lacked awareness of her neuropsychiatric problems and functional ability. She was discharged home and subsequently refused further carer or rehabilitation input.