Traumatic-Brain-Injury-Case-Vaughan

Case：Vaughan from South Africa

Nationality：

South Africa

Age：

25 years old

Diagnosis：

Traumatic Brain Injury

Admission Date：

Jan, 2015

Background

Vaughan, a 25-year-old, was diagnosed with acute lymphoblastic leukemia in June 2012. This form of cancer, characterized by the rapid growth of abnormal white blood cells in the bone marrow, immediately set the stage for a challenging battle against the disease.

In an attempt to combat the cancer, Vaughan underwent an extensive series of chemotherapy treatments. Chemotherapy, while a standard and often effective treatment for leukemia, involves the use of powerful drugs to kill cancer cells. However, despite these aggressive efforts, the cancer proved to be tenacious. The tumors, defying the effects of chemotherapy, began to spread. First, they spread from the bloodstream, where the leukemia initially took hold, to the spinal cord, and then unfortunately, advanced further to the brain.

On January 8th, 2015, in search of new hope and treatment options, Vaughan came to our hospital for stem cell treatment. Stem cell therapy holds the potential to replenish the body's supply of healthy blood-forming cells and may offer a new approach to fighting the cancer that has spread so widely.

Pre-Treatment Condition（Before Stem Cell Treatment）

Consciousness/Nutrition:
- Comatose state; tube-fed (soft fluids only);
2. Mobility:
- Functional paralysis:
- Unable to sit independently；
- Upper limb paralysis (no grasping ability);
3. Sensory/Expression:
- Absent facial expressions (no non-verbal communication).
- Absent sensation in lower body (buttocks, legs, toes; pressure injury risk).
4. Sleep Pattern:
- Severely fragmented sleep (1-2hr cycles) with circadian rhythm disruption.

Treatment Plan

One course of stem cell therapy
Surgical method: Lumbar puncture+Stereotactic brain surgery
Efficacy monitoring plan over 1 to 12 months post-treatment

After the First Course ofTreatment (1 day)

1. Behavioral Improvement:
- Spontaneous smiling observed for the first time in 4 years;
2. Social Interaction:
- Initiated humor (attempted jokes with family);
- Playful engagement (pretended to sleep during care, demonstrating restored playfulness);
3. Affective Recovery:
- Emotional responsiveness evident (non-verbal expressions of joy and connection);
4. Cognitive-Emotional Milestone:
- Intentional social behavior (pranks/interactions) indicating improved mental engagement.

After the First Course ofTreatment(The discharge day)

【Start数字编号】

1. Restored Sensory Awareness:

- Perceived wheelchair impact (jolt from collision) and expressed discomfort via non-verbal communication (head-shaking);

2. Conscious Interaction:

-Demonstrated intentional responsiveness to caregiver inquiries

(acknowledged pain/discomfort);

3. Functional Communication:

- Transitioned from passive non-responsiveness to active signaling of needs (e.g., safety/comfort);

4. Recovery Milestone:

- First observed context-appropriate interaction with family, validating treatment efficacy. 【End数字编号】

After the First Course ofTreatment(One week back home)

1. Communication/Social Interaction:
- Restored facial expressions (emotional responsiveness);
- Active visual engagement (focused attention on books/scenery);
2. Motor/Sensory Recovery:
- Regained sensation in lower body (buttocks, legs, toes);
- Toe mobility and voluntary limb activity (attempts to grasp objects);
3. Daily Living:
- Normalized sleep cycle (9-10hrs/night);
- Oral diet resumed (3 meals + snacks, including solid foods).

Symptom	Improvement
Comatose state; no responsiveness.	Restored facial expressions (emotional awareness); active visual engagement (focused on books/scenery);
Tube-fed (soft fluids only).	Oral diet resumed (3 meals + snacks, including solids);
Paralysis: Unable to sit/grasp objects; no limb mobility.	Voluntary limb movement (toe/finger activity, grasping attempts);
Absent sensation (lower body).	Regained sensation (buttocks, legs, toes);
Severely fragmented (1-2hr cycles).	Normalized sleep (9-10hrs/night);
No non-verbal communication.	Intentional interactions (humor, pranks, head-shaking responses).

Progress Summary & Future Outlook

The patient's recent progress is highly encouraging, portending a bright future. With enhanced facial expressions and visual engagement, we can expect continued cognitive development. The normalized sleep pattern will further support overall well-being, potentially leading to more energy for daily activities.

As the sensation in his lower body and limb activity improve, he may gradually regain full mobility, perhaps even walking independently in the near future. His new interest in exploring the world through touch and grabbing things could lead to better hand-eye coordination and more complex interactions.

The transition to a regular diet will fuel his body for further recovery. Overall, there's great potential for him to lead a much more normal and fulfilling life.