title: An unusual recovery from traumatic brain injury in a young man.
abstract: BACKGROUND
  Traumatic brain injury (TBI), a complex neurological traumatic incident where brain function is disrupted due to physical trauma, can be categorized in multiple ways and is commonly scored using the Glasgow Coma Scale. Severe closed head injury is a form of TBI with a Glasgow Coma Scale less than 8. The outcomes and prognosis are not uniform in the population but mortality is estimated at 30-50 percent. In this case of severe closed head injury, the patient was able to make a near full recovery after several neurosurgery and medical treatments and intercessory prayer to Saint Luigi Guanella.
  
  
  RESULTS
  A 21-year-old male patient received a severe closed head TBI and bilateral hemotympanum while rollerblading without a helmet. After imaging, a left frontal craniotomy and evacuation of epidural and subdural hematomas and resection of a left frontal contusion were performed. Intracranial pressure increased and the patient experienced a transtentorial herniation. He underwent a right frontotemporal and subtemporal craniectomy and evacuation of a frontotemporal subdural hematoma. The patient had intraventricular hemorrhage to which a ventriculostomy was performed and later converted to a ventriculo-peritoneal shunt for recurrent hydrocephalus. The patient was not expected to regain consciousness, but made a recovery after 24 days in the hospital and 10 days in rehabilitation. The patient followed up 6 months after injury for a cranioplasty and soon after returned to near baseline.
  
  
  CONCLUSIONS
  In this extraordinary case, the severe closed head injury the patient sustained required intensive neurosurgical and medical treatment and the prognosis for recovery of consciousness was very poor; however, with treatment and rehabilitation and intercessory prayer to Saint Luigi Guanella, this patient was able to recover close to baseline from a Glasgow Coma Scale of 7.
  
  
  BACKGROUND
  Head injuries vary in severity and traumatic brain injuries can be extremely serious leading to bleeding, loss of consciousness, and can affect verbal responses, muscles movement in motor responses, and responses with eye movement. Traumatic brain injuries require medical care to assess the severity and treat the injury. In this case report, we discuss a patient's very severe closed head injury while rollerblading without a helmet from which he was not expected to make a full recovery, but did so following intensive medical treatment, rehabilitation, and intercessory prayer to Saint Don Guanella to combat the initial injury and subsequent issues.
authors.affiliation: University of Missouri, Kansas City, USA.
authors.forename: Denesh
authors.initials: D
authors.lastname: Ratnasingam
authors.affiliation: Saint Luke's Marion Bloch Neuroscience Institute.
authors.forename: Darren S
authors.initials: DS
authors.lastname: Lovick
authors.affiliation: Don Guanella Village, Archdiocese of Philadelphia, Philadelphia, PA, USA.
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Weber
authors.affiliation: Department of Neurosurgery, Crozer-Keystone Medical Center, Chester, PA, USA.
authors.forename: Richard V
authors.initials: RV
authors.lastname: Buonocore
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Williams
keywords: Glasgow Coma Scale; Saint Luigi Guanella; Traumatic brain injury; cerebral contusion; closed head injury; coma