B - 53 Neuropsychological Functioning after a Bi-Parietal Penetrating Traumatic Brain Injury in a 28-Year-Old Hispanic Male

Abstract Objective In the U. S. there are approximately 115, 000 non-fatal firearm injuries each year, resulting in an annual cost of over 229 billion. Of these injuries, some result in penetrating brain injuries where an object enters and lodges within the cranial cavity, with the severity of damage determined by the shape, mass, and energy released of the projectile as it passes through the brain. This case follows a 28-year-old right-handed Hispanic male with no premorbid medical history, 16 years of education, who experienced bi-parietal lesions as a result of a gunshot wound to the head one year prior. This trajectory is rare, with little literature detailing the effects of penetrating injuries to both parietal lobes. Method The gunshot wound resulted in a bullet trajectory from the left frontoparietal region to the right parietal calvarium with multiple displaced ballistic fragments. Since the injury, he presented with resolving right-sided weakness and sensory changes, reduced balance, memory complaints, and bilateral parietally mediated findings. Results Neuropsychological testing showed right-sided suppression (tactile, auditory, and visual in the lower quadrant), reduced sensation in his right hand, alexia with agraphia, acquired apraxia of speech without aphasia, Gerstmann’s Syndrome, topographical disorientation, visuospatial dysgnosia, and constructional apraxia. There was also indication of inattentiveness, memory impairments, and processing speed deficits. Conclusions The present case study delineates the neuropsychological sequalae after a penetrating brain injury to the right parietal lobe and left frontoparietal region, resulting in significant cognitive deficits consistent with pronounced bilateral parietal lobe findings.