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Case Studies 
Head Injury /Headaches
KF  62 yr female:

KF experienced frequent urination (4x per night) that started at age 35 after her ovaries were removed in Vienna as a form of birth control.

 

During the procedure she also had her bladder lifted.

She has also suffered from fatigue since 12/07.

KF received her first Ondamed treatment 6/16/08.

During her next treatment on 6/18/08 KF reported that her urination decreased to three times during the night. She also noticed increased stool activity (double her normal activity). She also felt that she had a heavy feeling in her head in the morning (toxins) that dissipated. She did not have any headache.

Her next treatment was on 6/19/08 and she reported that the urination was still three times during the night.

Her stool activity now increased from double to triple compared to normal. She still had absolutely no headaches. Although the stool activity increased she did not have any diarrhea.

During her 6/23/08 treatment KF reported that she did not have any headaches or fatigue. She was still urinating three times during the night and she still experienced increased stool activity. She may have a dropped uterus that needs to be confirmed by her physician. Although she did not receive a treatment on 7/30/08 she reported to the practitioner that she was urinating 2-3 times per night. KF started a bio-identical hormone and nutrition plan in an effort to further improve her frequent urination. If her headaches and/or fatigue return she will seek further Ondamed treatment.  

(Case Study conducted by Dr. Shari Lieberman)

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Basilar Skull Fracture  
SR a 60-year old female
Fell hitting her head against the floor

There was positive loss of consciousness of about 30 minutes. She was transferred to Trauma Center at JMH. Her Glaswco Coma Scale upon arrival was 15. She was alert and disoriented 3x. Her admitting diagnosis was Basilar Skull Fracture, Altered State of Consciousness, Convulsions. She was discharged home the same day. SR should not have been released given her severe brain injury.

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She was readmitted again on 2/19/07 with convulsions and was again discharged home the same day which was once again, inappropriate. She was evaluated by a psychiatrist. Neurological work indicated non displaced fracture on the right occipital bone, extending to the skull base, epidural hematoma, subdural hematoma extending along the left frontal, temporal, and parietal convexities, adjacent to the subarachnoid hemorrhage, multiple hemorrhagic contusions of bilateral frontal lobe and in the left anterior temporal lobe, fracture of the medial aspect of the right orbital roof and cribriform plate.

Her diagnoses were:

•  Severe Traumatic Brain Injury
•  Brain Contusion
•  Evolving Bifrontal Contusions
•  Subdural Hematomas - Left Frontal and Left Front Parietal regions
•  Post traumatic headaches
•  Post traumatic seizure
•  Post traumatic anxiety disorder
•  Cognitive Deficits
•  Asomnia

SR was prescribed Topomax 50 mg twice daily. Other medications included Boniva, Lipitor 20 mg, Metomorfin 500 mg 2x daily, Aleve as needed. SR was admitted to a Intensive Outpatient Brain Injury Program at Baptist Hospital in Miami, in April 2007.


She had not received any type of rehabilitation prior to this. She presented with decreased cognitive communication skills, characterized by mildly impaired memory for details and information, moderately impaired word retrieval, moderately impaired executive functions, working memory deficits, psycho-motor retardation, decreased problem solving abilities, decreased organizational skills, decreased visual perceptual functions, dizziness, inability to ambulate independently and she required verbal cues for safety.

I did a neuropsychological evaluation on 5/15/07. She demonstrated a few minutes of retrograde amnesia and 12 days of anterograde amnesia. The results of the testing indicated the main areas of deficits were in complex attention, working memory, executive functions and mental and written calculations. All of these functions are related to frontal lobe dysfunction. In addition, she had moderate impairment in her immediate and delayed memory for both visual and verbal information.

SR was left with a change in personality, post traumatic anxiety and depressed mood. I referred the patient for Neurofeedback. She started on May 22, 2007. She was getting Neurofeedback sessions 2 x per week. Initially, there was not much improvement.

 

Once the ONDAMED treatments started on 5/29/07, there was a significant improvement in her performance on the Neurofeedback. She received 2 ONDAMED sessions per week, generally before the Neurofeedback session. SR has continued to receive cognitive retraining, Neurofeedback, ONDAMED and individual psychotherapy. She reached a plateau in the Neurofeedback. However she has made incredible functional progress in spite of having evidence of blood in her bifrontal lobes as per recent CT scan of the brain with continuing ONDAMED treatment. She is driving, totally independent, seizure free and less anxious. I am planning to discharge her from cognitive remediation in the middle of October. I will repeat the Neuropsychological Testing for comparison purposes before she goes back to work as an administrator, in December.

10/17/07 Topomax was completely discontinued 5 weeks ago.   

(Case Study Provided by Dr. E.J. Miami, FL)

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