PERFIL NEUROPSICOLÓGICO PÓS-TRAUMATISMO CRANIOENCEFÁLICO: HÁ SEMPRE EXTENSAS SEQUELAS COGNITIVAS?

Resumo Prejuizos neuropsicologicos, neurologicos, psiquiatricos e funcionais de pacientes vitimas de traumatismo cranioencefalico (TCE) sao largamente descritos na literatura internacional. Entretanto, no Brasil, a avaliacao neuropsicologica de pacientes pos-TCE e incipiente, pois nao ha a disponibilizacao desta avaliacao na grande maioria dos servicos de saude publica e privada do pais. Frente aos diversos deficit neurocognitivos e a escassez de estudos nacionais sobre o perfil destes pacientes, ressalta-se a importância de estudos de caso com tal finalidade. Neste trabalho, objetivou-se caracterizar o perfil neurocognitivo de um paciente pos-TCE grave, com 45 anos, em seus aspectos socioculturais, psiquiatricos, neuropsicologicos e funcionais. O paciente apresentou classe socioeconomica C1, 11 anos de escolaridade formal, alta frequencia de habitos de leitura e escrita, TCE grave com complicacoes (craniotomia descompressiva) em estado cronico. Foi realizada uma avaliacao com instrumentos normatizados e em desenvolvimento, entrevistas, questionarios e observacao clinica. Foram encontrados deficit executivos de velocidade de processamento, iniciacao e tomada de decisao. Destaca-se a recuperacao surpreendente apos o trauma ilustrando a hetereogeneidade do quadro de TCE e possiveis variaveis relacionadas ao prognostico favoravel. Palavras-chave : traumatismo cranioencefalico; avaliacao neuropsicologica; funcoes executivas; neurocognicao. Abstract The neuropsychological, neurological, psychiatric and functional deficit in victims of traumatic brain injury (TBI) have been extensively described in the literature. However, studies involving the neuropsychological assessment of patients with TBI are still incipient in Brazil, and there is a pronounced lack of neuropsychological assessment services in both the private and public health sectors. Given the extent of  neurocognitive deficit reported in TBI and the scarcity of scientific research on the topic in Brazil, there is a need for studies of the neuropsychology of TBI in the Brazilian population. The objective of this case report was to explore the neuropsychological profile of a forty-five years old patient with severe TBI in connection with sociodemographic, psychiatric, neuropsychological and functional variables. Data was collected by means of a neuropsychological assessment battery composed of instruments with normative data for the Brazilian population, interviews, questionnaires and clinical observation. Executive function deficit in processing speed, initiation and decision making were identified. Evidence of patient recovery over time was also obtained, highlighting the heterogeneity of patients with TBI and the need to investigate favorable prognostic factors.  Keywords : traumatic brain injury; neuropsychological assessment; executive functions; neurocognition.