Brian Case Study


*This is a fictional case study and character(s) based on a variety of real situations.

Brian is a 42 year old man who is married to Irina; he has three children. He’s an avid mountain biker and active dad. He likes to escape to the trials to free his mind from the rigors of his work life and busy household. While out on the trails one day, he caught a root which caused him to flip over his handlebars, resulting in him hitting his head on a tree, before landing in a crumpled heap in the dirt. He was badly dazed, but his first thought was being thankful that he recently bought the new expensive helmet he was wearing. As he was riding on his own, he didn’t have much choice but to ride out – he was near the end of the trail so he just took it easy while riding to the car. He was still feeling a bit dizzy and had a cracking headache when he arrived at the car, but felt well enough to drive home. Initially, he thought that he had gotten off lightly from the big spill. However, the next few days proved to be some of the toughest of his life. He constantly felt nauseous, the headaches were excruciating and he was so tired all the time. He struggled to be in the living areas around his kids who he felt were painfully loud, so he shut himself in a room in the basement with the curtains closed. After two days, Irina persuaded him to visit the Emergency Department as she was very concerned. He was given a CT scan which didn’t show any major red flags, and he was discharged with a diagnosis of concussion. He was sent home with some painkillers and advised to follow up with his doctor in a week. Fast forward 2 months and Brian had not returned to work, was still struggling to pull his weight around the home – putting more pressure on his wife and causing stress – and he was struggling with his thinking. His mood was increasingly low as he felt little improvement over the weeks.

Long Story Short

  • Irina did a Google search, and found Living By Design. She called Tom the occupational therapist and explained Brian’s situation, as Brian did not feel up to talking about it. They arranged for an initial visit.
  • During the initial visit, Brian told Tom of his post concussion experience and expressed a degree of hopelessness towards his recovery.

  • A cognitive assessment was conducted, identifying that Brian had some cognitive deficits, providing objective evidence of the difficulties he sensed he was having. This came as somewhat of a relief for Brian as it provided him with a baseline to work from.

  • They agreed that Brian would commence the 12 week CogWorks 1 cognitive rehabilitation program.

  • Throughout the program, Brian was provided with guidance on his recovery and after 12 weeks, a cognitive reassessment was administered. Brian showed great improvement.

  • While still feeling some ongoing concussion symptoms, at this point, Brian was able to return to work with some modifications to his duties and he was increasingly involved in home activities.