Does a regular Wessex Head Injury Matrix assessment identify early signs of infections in people with Prolonged Disorders of Consciousness?

Background & Objective: Patients with brain injury are at high risk for infections. Although infection and cognitive deterioration are established for people with dementia, this has not been shown for patients with a prolonged disorder of consciousness (PDOC). This study determines whether regular Wessex Head Injury Matrix (WHIM) assessments can identify early signs of infections in patients with PDOC.

Brugada syndrome and the story of Dave.

Brugada syndrome (BrS) is a little known genetic condition that causes severe disturbances in cardiac rhythm and may result in sudden unexpected cardiac death in an apparently healthy person. The heart structure is typically normal but there are problems with electrical activity. The syndrome is named after Spanish brothers who are cardiologists, Pedro and Josep Brugada.

Sheehan's syndrome and sickle cell disease: the story of Natasha.

Sheehan's syndrome (SS) is one of the pituitary disorders caused by severe blood loss during childbirth leading to necrosis of the pituitary gland. Diagnosis is made following severe haemorrhage, failure to produce milk and failure to menstruate. Rare in countries with good obstetric care, SS is still frequent in those countries with poor healthcare services.

Alexander's disease and the story of Louise.

We describe the rare condition known as Alexander's disease or Alexander's leukodystrophy, which is essentially a childhood dementia. We then present the case of Louise Davies (we are using Louise's real name with the permission and special request of her mother), a woman who was diagnosed with this disease at the age of 5 years and is still alive at the age of 38, making her the longest known survivor of this condition. Although now severely impaired, both physically and mentally, and able to do very little, she has lived far longer than expected.

Seeing red: Relearning to read in a case of Balint's Syndrome.

Background And Aims: Balint's Syndrome is a rare condition, often associated with hypoxic brain damage. The major characteristic is an inability to localise objects in space, another is simultanagnosia frequently resulting in reading difficulties. We present RN, a 37 year old woman whose major problem with reading was her inability to recognise individual letters correctly in either lower or upper case.

The natural history of continuing improvement in an individual after a long period of impaired consciousness: The story of I.J.

Aim: Recovery of consciousness and recovery of function among patients with prolonged disorders of consciousness rarely occur. Those patients who do regain consciousness typically remain with severe disability. The aim of this retrospective study is to suggest that continuing improvement is possible in a survivor of catastrophic brain injury after being in a prolonged state of disordered consciousness.

Paradoxical improvement of function more than 2 years after onset of tuberculous meningitis.

Objective: To document the unexpected improvement made by a 50 year-old patient over 2 years after being diagnosed with tuberculous meningitis (TBM).

Methods: Regular neuropsychological assessments were carried out, initially with a test for patients in reduced states of awareness and later with more demanding tests.

Results: The patient was diagnosed with TBM in November 2008 and was mute, stuporous and barely more than minimally conscious for over 2 years.

A case study of locked-in-syndrome: psychological and personal perspectives.

Objectives: Although patients with Locked-In-Syndrome (LIS) are often stated to have normal cognitive functioning, the few reports of neuropsychological assessment in these cases suggest this is not always true. This paper (a) reviews published reports of neuropsychological assessments of LIS patients, (b) presents a detailed neuropsychological assessment of a patient to determine if she has normal cognitive functioning and (c) presents the views of the patient on what has happened to her.

Methods And Procedures: An in-depth single case report assessing the cognitive and emotional functioning of a young woman with LIS plus a personal account from the patient.