Remarkable recovery in a comatose patient with traumatic brain injury: A case study from Prince Sultan Military Medical City, Saudi Arabia.

Abstract

This case study examines the clinical process of a 19-year-old male who sustained a severe traumatic brain injury (TBI) at age 17 following a road traffic accident (RTA), initially managed in intensive care unit (ICU) at a local private hospital, and subsequently transferred to a major tertiary hospital for advanced trauma care. The patient experienced critical complications, including elevated intracranial pressure (ICP), requiring decompressive craniotomy and placement of an external ventricular drain (EVD). Persistent cerebrospinal fluid (CSF) leaks and infections, including a Staphylococcus epidermidis infection, necessitated multiple surgical interventions and antibiotic treatments. Following initial stabilization, the patient was transferred to Prince Sultan Military Medical City (PSMMC) where he continued treatment and rehabilitation, including coma stimulation therapy (CSP), physical and occupational therapy, and medication adjustments. The patient's condition evolved from a comatose state with a Glasgow Coma Scale (GCS) score of 8/15 to a GCS score of 14/15. He showed significant improvements in cognitive function, including the ability to recognize and name action verbs, and progress in automatic speech. Despite ongoing severe dysarthria and cognitive impairment, notable gains in cognitive, functional, and speech capacities were observed through intensive rehabilitation efforts. This case highlights the complexity and necessity of a comprehensive and adaptive care strategy in managing severe TBI, underscoring the potential for recovery with a robust, individualized treatment plan.