B - 76 Neurobehavioral Sequela Following Hypoxic-Ischemic Brain Injury to the Bilateral Hippocampi and Globus Pallidus: a Clinical Case Study.

Abstract

Hypoxic-ischemic brain injury (HIBI) occurs when there is deficient oxygen supply and blood flow to the brain. HIBI can be precipitated by various factors including drug overdose. Brain regions that have high vulnerability to HIBI include the hippocampus and basal ganglia. Even when damage is limited to these two regions, research suggests that diffuse cognitive deficits and changes in behavior-emotional functioning can be observed. This case study presents on a 29-year-old female who sustained HIBI to the bilateral hippocampi and globus pallidus secondary to an opioid overdose which required a 3-day hospitalization. The patient was discharged from the hospital on suboxone therapy and completed outpatient interventions which included physical therapy as well as speech-language therapy with cognitive rehab. Although improvements in her functional status were noted, she reported having persisting difficulties with cognition in addition to post-injury behavioral-emotional changes. As such, she was referred for neuropsychological testing and the evaluation was completed 6months after her hospitalization. Testing showed prominent memory impairments along with deficits in language, visuospatial skills, executive functioning, and attention. On questionnaires, she endorsed having concerns for depression, attention, and executive functioning in daily life whereas her mother endorsed concerns for executive functioning. The patient's neurobehavioral profile was consistent with broad ranging sequela that can be observed with HIBI. Recommendations included medication consultation for mood, compensatory cognitive strategies, and vocational rehab for individuals with neurological disabilities. Overall, this case study demonstrates the important role of neuropsychologists in the assessment and treatment of individuals recovering from HIBI.