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M.E.

M.E. DOB: 22/7/72 Hx: Congenital heart defect (aortic stenosis) 5/12/85: Aortic valve replacement – resulted in CVA (thromboembolism) CT: Large parietal infarct. Initial signs: L hemiparesis (largely resolved) L neglect Severe constructional apraxia – barely able to write his own name.

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M.E.

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  1. M.E. • DOB: 22/7/72 • Hx: Congenital heart defect (aortic stenosis) • 5/12/85: Aortic valve replacement – resulted in CVA (thromboembolism) • CT: Large parietal infarct

  2. Initial signs: • L hemiparesis (largely resolved) • L neglect • Severe constructional apraxia – barely able to write his own name

  3. Returned to school • Teacher reported that failed to answer items on the left side of the page Assessment 10/3/86 (A.S.) • Gross denial of both he and his family • Verbal abilities were preserved (extremely articulate) • Unable to copy even simple designs • Rey Fig – one attempt. Father argued that he would not be able to copy the drawing • Refused to continue session or contact

  4. Persuaded to return for review (1987) • Admitted to “minor” problems • Unable to catch a ball • Tendency to forget some material (medication) • Difficulty with mathematics • P/T position at McDonalds – difficulty in assembling burgers and packing them into containers

  5. Testing: Extremely limited as refused to attempt most visuospatial tasks • Ongoing contact: Counselling re: realistic work goals, temper control, motivation, relationships

  6. 7/8/92: MTBI (20 years) • Struck by a car while crossing a road • PTA (mother’s report): several days • Assessment 22/9/92

  7. WAIS-IV Information = 11 Vocabulary = 13 Similarities = 14 Digit Span = 6 Arithmetic = 7 VCI = 110 WM = 75

  8. V. Puzzles = 6 M. Reasoning = 7 Block Design = 5 Symbol Search = 4 Coding = 7 PRI = 71 PSI = 67 FSIQ: Not meaningful

  9. Auditory M. = 107 Visual M. = 72 Trail Making Test Part A = 76” (<10th percentile) Part B = 131 (<10th percentile)

  10. COWAT Words = 42 (x= 42, SD = 6.8) Errors = 0 WCST Categories = 6 Errors = 14 Perseverative Responses = 7

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