Case Study On A Patients Neuropsychological Assessment

Case Study On A Patients Neuropsychological Assessment TL was referred for a follow-up neuropsychological assessment to determine current symptomatology and level of functioning in light of executive dysfunction potentially manifesting itself, following traumatic brain injury incurred during a motor vehicle injury in November, 2008. TL is a 44 year old, right-handed male. Leaving school at age 15, he pursued a career in media and publishing. Prior to injury, he had been living and working in Asia for the past 13 years, where his wife and child remain to date. TL presently finds himself unable to mentally cope with previous working environment demands, where resultant financial challenges make catering for his family unfeasible. History of alcohol abuse since age 16 has necessitated repeated AA involvement. He currently leads a very restricted lifestyle, living alone in a single room and unable to handle normal daily challenges. He has served as an inpatient in hospital, as well as having had a package of care set up at home. TL exhibits no recollection of the accident itself, where upon regaining consciousness, required time to orient himself. Irregular retrograde amnesic episodes have been reported since, where he considers day-to-day memory to have improved markedly. TL has also experienced sporadic tonic seizures, for which he is receiving anti-epileptics. Most noticeably, he experiences challenges structuring daily life through multi-tasking and organization, where reliance on a notebook provides security, but is maintained somewhat chaotically. Magnetic-resonance-imaging revealed damage to large portions of the left frontal lobe and anterior temporal pole, as well as superficial sclerosis following intra-cerebral haemorrhages in the cerebrospinal fluid. TL expressed frustrations about inability to work and the implications for reunifying his family, but seemed generally optimistic that with time, normality would return. Formal assessment Behaviour during testing TL attended the session unaccompanied and punctually, appearing sober. He was attentive and oriented to time, location and the investigator. There was no evidence of speech or hearing impairments, and motor movements and dexterity appeared normal. He was co-operative and motivated to engage with presented tasks but was ardent about minimizing severity of his condition, insisting on marked improvements and anticipated return to normality. Based on these observations, test results are deemed legitimate estimates of present cognitive functioning but caution was undertaken in assessing self-reports in light of tendencies to minimize difficulties and restricted insights to own condition. General intellectual abilities Taking into consideration educational and occupational background, his pre-morbid functioning as interpreted by the National-Adult-Reading-Test-(NART-FSIQ) was average. Intellectual assessment using the Wechsler-Adult-Intelligence-Scale-(WAIS-III) suggests that verbal IQ was preserved, with abilities in vocabulary skills by defining words, reasoning skills and simple arithmetic falling within normal range. In contrast, his performance IQ, reflecting attention to detail, sequencing and abstract conceptualization abilities, was markedly reduced and estimated below average, highlighting significantly impaired problem-solving abilities since the accident. Memory function Formal memory assessments indicated a severe global deficit in ability to consolidate and recall information in both immediate and delayed tasks, substantiating memory deficits documented in everyday life. This impairment extended to both verbal and non-verbal items, presenting marked difficulties in immediately recognizing words and faces (