Stephane is a 45-year-old man who suffered a severe TBI on January 11 in a bicycle-car collision. His initial Glasgow Scale score was 8. He remained in a coma for 5 days. The duration of post-traumatic amnesia (PTA) is estimated to be 10 days. He suffered multiple bilateral cerebral hemorrhagic contusions, mainly in the frontal region, as well as multiple fractures: C2-C3 cervical (Miami 24/24 collar), facial mass (orbit, skull base), right clavicle, right humerus. Stéphane had a convulsive episode 48 hours after coming out of the coma. On February 9, his medical condition was stabilized and he was admitted to the ICU.
He had no previous health problems other than chronic low back pain and was not taking any medication.
Stéphane is married and has two children. He has worked as an engineer in a consulting engineering firm for several years. His work weeks vary between 40 and 50 hours. He uses his car to get to work. He is an avid cyclist and trains on a regular basis and occasionally participates in competitions. In his spare time, he is busy renovating the family home.
Those close to him describe him as hyperactive, organized, a perfectionist, hard-working and concerned about the well-being of others. He is described as action-oriented, rather reserved, but enjoys humor and the company of others. He is generally calm and good-humoured, but can become angry, especially at himself, when he makes a mistake. Stephen is very demanding of himself, feels responsible for others and is not in the habit of asking for help.
His wife has a full-time job. She was able to take a sick day to support her husband, but will have to return to work gradually in mid-March. The children attend elementary school. The family has a good social network.
The couple owns a duplex. The second floor is occupied by tenants. Before the accident, the couple shared all the tasks. The wife did the shopping and meal planning. Stephen was involved in preparing dinner on a daily basis. The wife was responsible for other household tasks. Stephen was responsible for the exterior maintenance of the house and the renovations. He also managed the maintenance and repairs of the car. Finances were managed jointly on a monthly basis.
At the first interdisciplinary team meeting on February 24 (6 weeks post-TBI), rapid and encouraging progress was noted. A first weekend outing was made at home, but without sleeping. A second outing (with sleeping) is planned in a week. Stéphane’s clinical picture is as follows.