Aaron’s Recovery from Traumatic Brain Injury

Traumatic brain injury (TBI) is a significant medical condition that can affect every aspect of a person’s life—from physical health and cognitive abilities to emotional stability and interpersonal relationships.

This case study follows the recovery journey of Aaron, a 16-year-old who had a TBI following a bicycle accident. Aaron’s story is not only a clinical example of the complexities of brain injury but also a testament to the resilience of the human spirit when supported by integrated care. His path to recovery highlights the intricate and interconnected processes involved in healing the body and mind after trauma.

Aaron was biking home from school when he was struck by a car that failed to yield at an intersection. He was not wearing a helmet. Witnesses called 911, and paramedics arrived within minutes. Upon arrival, Aaron was unconscious and showed signs of a significant head injury. In the emergency room, he scored an 8 on the Glasgow Coma Scale (GCS), indicating a moderate to severe traumatic brain injury (TBI).

A computed tomography (CT) scan was performed. CT imaging uses X-rays taken from multiple angles to produce cross-sectional views of the brain. The scan revealed a subdural hematoma (sub- = under; dural = dura mater; hematoma = blood swelling), which was causing dangerous pressure inside his skull. Neurosurgeons immediately performed a craniotomy (crani/o = skull; -tomy = incision), surgically opening part of the skull to relieve the pressure and remove the accumulated blood.

After surgery, Aaron was moved to the intensive care unit (ICU). There, doctors monitored him for signs of encephalopathy (encephal/o = brain; -pathy = disease), a general term for brain dysfunction often caused by injury or infection. The first few days were critical. He remained in a semiconscious state, occasionally opening his eyes but unable to respond clearly to verbal commands.

His care team noted that Aaron experienced both post-traumatic amnesia (PTA) and retrograde amnesia. Post-traumatic amnesia (post- = after; trauma = injury; -ia = condition) refers to the state of confusion and inability to form new memories immediately following a head injury. Retrograde amnesia (retro- = backward; -grade = step; -ia = condition) is the inability to recall events that occurred before the trauma. Understanding the difference between these two conditions was important in assessing Aaron’s neurological recovery.

Once stable, Aaron was transferred to the neurological ward where he began a structured rehabilitation program. His symptoms included cephalgia (cephal/o = head; -algia = pain), poor concentration, and frequent emotional outbursts. He met regularly with a neurologist and an occupational therapist to address cognitive and motor skill deficits.

Occupational therapy began with simple tasks—identifying objects, recognizing family members, and playing memory games. These activities stimulated neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections. The goal was to rebuild pathways that had been disrupted by the injury.

Aaron's rehabilitation also included physiotherapy (physi/o = nature; therapy = treatment). Physical exercises were designed to restore coordination and strength, addressing the muscle stiffness and balance issues caused by both the injury and prolonged bed rest. Each milestone, from walking unaided to holding a pen steadily, was celebrated.

In addition to the physical and cognitive challenges, Aaron faced significant emotional difficulties. Feelings of anxiety, frustration, and sadness were common. The care team introduced a trauma counselor named Kate, who specialized in helping young patients navigate the emotional aftermath of serious injuries.

Kate employed several techniques including guided imagery, mindfulness, and journaling. Guided imagery allowed Aaron to mentally visualize safe and relaxing environments, helping to calm his nervous system. Mindfulness exercises helped him stay grounded in the present moment and better manage overwhelming emotions. Journaling served as an outlet for expression and a record of his emotional progress.

Family support played a key role in Aaron’s emotional healing. His parents and younger brother visited daily, helping to jog his memory with family stories and photos. These emotional connections reinforced his emerging identity and created a sense of continuity between his pre- and post-accident life.

Dr. Ramirez, Aaron’s primary neurologist, made sure Aaron and his family understood the medical terms used in his care. For instance, he explained that a concussion is actually a mild form of TBI. Dr. Ramirez shared that “trauma” referred to the injury mechanism, and “encephal/o” referred to the affected structure: the brain. This simple clarification helped reduce the anxiety caused by complex medical jargon.

To enhance understanding, Dr. Ramirez also broke down key medical terms:

• Encephalopathy = encephal/o (brain) + -pathy (disease): a condition involving brain dysfunction
• Cephalgia = cephal/o (head) + -algia (pain): head pain or headache
• Craniotomy = crani/o (skull) + -tomy (cut): a surgical procedure to open the skull
• Laceration = lacer (tear) + -ation (process): a deep cut or wound
• Neurological = neur/o (nerve) + -logy (study) + -ical (pertaining to): related to the study of the nervous system

After a month in the hospital, Aaron was discharged with a detailed care plan. This included outpatient occupational therapy, weekly counseling, and academic accommodations. At home, he tracked his symptoms in a journal and practiced memory exercises daily.

Returning to school part-time was daunting. Noise, crowds, and a fast-paced environment overwhelmed him initially. However, with support from school counselors and teachers, Aaron adjusted. He received extra time for assignments, took tests in a quiet room, and gradually built up his stamina.

An unexpected outcome of his experience was a growing interest in the human brain. Aaron became fascinated with neuroscience and began reading books and watching documentaries on brain plasticity and recovery. He even expressed interest in becoming a neurologist someday, inspired by his journey and the care he received.