13 - Peter: successful rehabilitation following a severe head injury with cerebrovascular complications

Summary

Peter was one of the early clients at the Oliver Zangwill Centre for Neuropsychological Rehabilitation and this chapter gives a typical picture of the process of assessment and rehabilitation for our clients. We begin with a summary of the report from his preliminary (one-day) assessment as this details his major problems, his own and his wife's perceptions of his difficulties together with the staff's assessment of these.

Preliminary assessment report

History of injury

Peter was involved in a road traffic accident in July 1997 in which he sustained a severe traumatic head injury. At the time he was 33 years old. He was taken to the nearest hospital and then transferred to the Regional Neurointensive Critical Care Unit where he remained for one week, before being referred back to his local hospital. He stayed there for seven weeks. It is not clear how long he remained unconscious, but the notes from the Critical Care Unit say he had a head-on collision in a built-up area. His Glasgow Coma Score at the scene was 15 but by the following day had deteriorated to 11 and then to 7. It would appear that he had a post-traumatic amnesia of around 5–6 weeks. His retrograde amnesia, however, lasted only a few seconds. A CT scan of Peter's brain showed bilateral areas of attenuation in the temporo-parietal regions consistent with a cerebrovascular accident. This was subsequently found to be due to bilateral carotid artery dissection.