02 October 2008
Med Sci Monit 2008; 14(10): CS110-124 :: ID: 869399
Traditionally, in both medicine and neuropsychology, symptoms are defined as significant deviations in a given parameter from a "physiological" norm largely based on statistical studies of large populations. Thus the goal of rehabilitation is to bring the patient's performance within the bounds of acceptable variation from the norm, and this is what defines a good outcome. Although this model seems reasonable for "average" patients, in the case of "exceptional" patients an "average" outcome may not be acceptable.
Material and Method
The present study describes the symptoms and successful rehabilitation of a prominent Polish artist, who was referred for rehabilitation after a right hemisphere stroke, and whose chief subjective complaint was the loss of artistic vision. The patient (female, ambidextrous) suffered an RH stroke at the age of 61. In traditional rehabilitation many symptoms resolved and others were well compensated, but the patient continued to complain that she had a "hole" in her brain and could not paint. A special program of rehabilitation was designed for her, based on art therapy, but including many unique elements, using a microgenetic, "bottom-up" approach to energize creativity and bypass obstacles. Ultimately the patient was able to resume her artistic career, thanks to the heuristic, holistic approach to therapy.
The case described here raises a number of theoretical questions about art, imagination, and creativity in the brain, and the goals of rehabilitation in the case of talented and gifted individuals.
Keywords: Outcome Assessment (Health Care), Neuropsychological Tests, Imagination, Brain Ischemia - rehabilitation, Stroke - rehabilitation, Recovery of Function, Paintings, Art Therapy, Art, Activities of Daily Living
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