Neurocirugía y psicorrehabilitación como trabajo multidisciplinario en el tratamiento de un hematoma epidural frontotemporoparietal izquierdo: estudio de caso

Epidural hematoma is a neurosurgical emergency whose cognitive and behavioral sequelae require a multidisciplinary approach. The objective was to describe its neurosurgical and psychorehabilitation treatment in a 46-year-old man who fell from a height of about 2 meters under the influence of alcohol. After a lucid interval, he was admitted 12 hours later with a Glasgow score of 12/15, which dropped to 7/15. Computed tomography showed a left frontotemporoparietal epidural hematoma with mass effect; an emergency craniotomy was performed (Glasgow 6/15), with evacuation of about 100 ml of clots. At 72 hours he developed a frontal syndrome with irritability, aggressiveness, disorientation, executive impairment and emotional lability. Psychorehabilitation combined cognitive restoration, acceptance and commitment therapy, art therapy, behavior modification, training in activities of daily living and family counseling. The patient was discharged without neurological focal signs or cognitive impairment.