Case Study: Functional and cognitive improvements ten years post stroke



By Lara Fernandez, Stroke and Neurological Programs Manager

Gary is a 57-year man who is now 10 years post-acute brain injury secondary to a vertebral aneurysm and subarachnoid haemorrhage.

While Gary recovered physically, his main deficit was frontal lobe dysfunction and anterograde amnesia. His attention span was five minutes and he was unable to sit still. This impacted so greatly on his function that it requires him to have 24-hour care in a residential facility.

Recently, Gary’s family noticed cognitive changes and he was referred to MetroRehab for a rehabilitation review and subsequently one on one occupational therapy for cognitive retraining. Gary expressed he was feeling that he had no control and did not know what his days entailed.

When first seen by the occupational therapist, Gary was impulsive and unable to sit or focus on a task for longer than five minutes. Over several weeks of rehabilitation, his attention gradually improved to the full 60 minute session. He also recalled the learnings from session to session to including remembering the clinician’s name, the room where therapy was completed and strategies to assist with his memory.

Today, Gary uses a diary to assist him to prepare and feel in control of his life. While he still requires support and prompts, his behaviour is less impulsive and he continues to improve functionally, psychologically and in formal testing of cognition.

Gary’s story highlights that recovery can occur at any time, and rehabilitation input is not just for the period immediately post stroke.

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