A 24 year old female, an engineering graduate, previously working in a private firm was admitted to Advanced Trauma Centre of Postgraduate Institute of Medical education and Research, Chandigarh following a road traffic accident. She presented with a history of loss of consciousness and vomiting. Her Glassgow Coma Scale score was 8 (E2 V2 M4), classified as severe TBI. She was diagnosed to have left parieto-occipital EDH and left temporal pole EDH. She had to undergo two surgical procedures: i) left parieto-occipital craniotomy, posterior fossa craniotomy and evacuation of EDH and ii) left temporal craniotomy and evacuation of EDH. She had no past history of any medical or psychiatric illness. She had no associated physical or neurological deficits. At the time of discharge her Glassgow Outcome score was 4 indicating a good outcome. She was referred for neuropsychological assessment and rehabilitation at 11/2 months post injury with complaints of forgetfulness, inattention, difficulty naming objects, inability to read, increased irritability and anxiety.
With the consent of the patient and family a detailed assessment was carried out at 11/2 months (pre-intervention) and 9 months (post-intervention) using following tools:
PGI Battery of Brain Dysfunction: It is a measure of cognitive impairment consisting of following subtests:
Verbal Adult Intelligence Scale
Revised Bhatia's Short Battery of Performance Tests of Intelligence
PGI Memory Scale
Nahor and Benson Test: a measure of perceptuo-motor functions
Bender Visuo-Motor Gestalt Test: a measure of perceptuo-motor functions
Selected tests from NIMHANS Neuropsychological Battery
Digit Symbol Substitution Test : a measure of information processing speed
Digit Vigilance Test : a measure of sustained attention
Controlled Oral Word Association Test : a measure of phonemic fluency
Animal Names Test : a measure of category fluency
Dysfunctional Analysis Questionnaire: measures dysfunction in the area of social, vocational, personal, familial and cognitive functioning.