Diagnostic and therapeutic approaches in rehabilitation correlated to a case of tetraparesis (with predominance of paraparesis) after severe CCT - bifronto - basal and bitemporal contusion.

Abstract Introduction. Cranio-cerebral trauma (CCT) can be defined as a brain damage caused by an external factor. It may or may not penetrate the skull. Examples of CCT causing sources can be: car accidents, falls (from height or same level), blows with blunt objects, shooting, etc. The diagnosis is generally easy to establish through anamnesis with the patient or witnesses, then by tomography. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethic committee’s approval, N.O. 17464 per 14.06.2019, this article presents the evolution of a 32-year-old male, tetraparetic with predominance of paraparesis, bradylalia and cerebrastenia (with significant improvement) and disgraphy, following a severe CCT - bifronto-basal and bitemporal contusion. Operated temporo-parieto-occipital fracture (right parietal decompression flap) - all by falling off the horse (affirmative). Joint stiffness in the knees (by Pellegrin-Shida heterotopic periosteal calcifications). Total post-traumatic optic atrophy RE and partial optic atrophy LE. Multiple bedsores. Neurogenic bladder (carrier of indwelling urinary catheter). UTI with Proteus Mirabiris (etiologically treated) was admitted in the Neurorehabilitation Clinic of the Teaching Emergency Hospital”Bagdasar Arseni” (TEHBA) for tetraparesis motor deficit, retention sphincter disorders, locomotor and severe auto-care dysfunctions, specialized recovery and nursing treatment with favorable development. Discussion: The peculiarity of this case is the good evolution of a patient with severe CCT and multiple associated complications. Last but not least, we can highlight how the CCT was produced, namely by falling off the horse. This tells a lot about the importance of the precautions and equipment needed during a sport, in our case wearing a helmet. Key words: cerebral cranial trauma, tetraparesis, paraparesis, recovery,