Physical treatment in patient with severe disorders after muti-organ trauma. Case study

Patients with multi-organ injuries, who have undergone neurosurgical decompression of a hematoma within the central nervous system are common in rehabilitation units. Patients of this kind are placed in the rehabilitation unit after metabolic disturbances accompanying severe CNS injuries have been adequately managed. At this stage of treatment, cases lacking metabolic stabilization are uncommon. However, the case presented by our team demonstrates that such instances cannot be entirely ruled out. Case report: A 64-year-old patient was referred to the Rehabilitation Clinic following a multi-organ injury. The patient sustained an intracranial hemorrhage in the left hemisphere, which required surgical intervention. In the initial days at the Rehabilitation Clinic, the patient’s general condition suddenly deteriorated to a critical level, characterized by severe bradycardia and a significant drop in arterial blood pressure. The extensive diagnostics performed revealed severe thyroid and parathyroid insufficiency. Gradual rebalancing of the patient's metabolic condition led to a significant improvement of his clinical condition. This article presents a case of exceptionally severe thyroid insufficiency, a condition rarely encountered even in endocrinology clinics, as patients with such a critical state are most likely to succumb before reaching a hospital setting.We also present a modern therapeutic approach to the rehabilitation of a patient with a severe CNS trauma, whose general condition is internally unstable. We hope that the case will make readers aware of a potential possibility of the occurrence of thyroid gland disturbances in post-trauma patients which is important as thyroid problems become more and more common in the population.