An older rehabilitation inpatient with severe neurogenic orthostatic hypotension: a case report

This case reports the inpatient rehabilitation course of an 81-year-old male patient with a traumatic brain injury resulting from severe neurogenic orthostatic hypotension (OH). Diagnostic workup of OH revealed the coexistence of Parkinson disease, hypocortisolism due to traumatic brain injury, and deconditioning, among other contributing factors. The patient’s lengthy rehabilitation course involved intensive inpatient rehabilitation activities, pharmacological management of OH, and treatment of underlying medical conditions. Over a 90-day period, the patient’s Functional Independence Measure score increased from 53 to 83, and he regained the ability to ambulate. This case is unique in providing a previously unpublished therapeutic approach to diagnosing and treating a severe, multifactorial barrier to rehabilitation commonly seen in older rehabilitation inpatients.