4.2 Multiple Focal Brain Injuries

 

Case Study 4 (continued)

 Medical reports received at the rehab hospital revealed the patient had multiple focal brain injuries and memory problems.  

Describe the most likely reason for the multiple focal brain injuries.

  1.  The patient likely sustained a contra-coup injury.
     
  2. Most commonly bruising of cerebral (cortical) tissue on under surface of frontal lobe (inferior frontal or orbitofrontal area) and anterior temporal lobe, regardless of the site of impact.
     
  3. Also damage to the occipital lobes on the contra-coup impact.
     
  4. May produce focal deficits.
     
  5. Not directly responsible for LOC following trauma.
     
  6. May occur from relatively low velocity impact, such as blows and falls.

What would be the likely focal contusions suffered after TBI?  How would these contusions effect rehabilitation?


Most commonly bruising of cerebral (cortical) tissue on under surface of frontal lobe (inferior frontal or orbitofrontal area) and anterior temporal lobe

Frontal Lobe Dysfunction

  • Difficulties with working memory, problem solving, behavioural and executive function;
     
  • Need for rehabilitation plan that provides external structure and organization and multiple opportunities for learning because of the compromised learning abilities. 

Temporal Lobe Dysfunction

  • Impaired memory and difficulties with word finding;
     
  • Rehabilitation planning must inherently address the need for multiple trials to learn new pieces of information and teach strategies to deal with memory difficulties.