A Case of a Surgeon with Higher Brain Dysfunction due to Right Frontal Lobe Infarction：Return to Work with Psychological Support and Employment Assistance
- VernacularTitle:右前頭葉梗塞により高次脳機能障害を呈した外科医の1例─心理的サポートと就労支援による復職─
- Author:
Masaharu SAWAKI
1
;
Masahiko YAMAMOTO
2
;
Toshiyuki HABUKI
1
;
Koei ITO
1
;
Osamu SAITO
3
;
Toru INAGAKI
3
Author Information
- Keywords: cerebral infarction; white matter; cognitive rehabilitation; psychological support; employment assistance
- From:The Japanese Journal of Rehabilitation Medicine 2025;62(8):856-864
- CountryJapan
- Language:Japanese
- Abstract: We have experienced a surgeon who had a previous left putaminal hemorrhage and presented with higher brain dysfunctions due to a new right frontal lobe infarction. The patient was a right-handed man in his 50s with inattention, constructive disorder, left hemispatial neglect, and executive dysfunction. The lesions were localized not only in the right inferior and middle frontal gyri but also in deep white matter including the right frontal aslant tract and superior longitudinal fasciculus. The patient gradually resumed work early on with multidisciplinary support and returned to work within 3 months after the onset of the disease. In this case, direct attention training, metacognitive strategy training including time pressure management, and visual search training from the acute stage were successful. Even after the completion of cognitive rehabilitation, an improvement in attention and processing speed was confirmed, suggesting that highly personalized cognitive rehabilitation tailored to higher brain dysfunctions have a lasting effect. However, the improvement of higher brain functions and the resumption of work increased self-awareness and anxiety, leading to a decrease in self-efficacy. Cognitive rehabilitation including metacognitive strategy training, together with psychological support, is important for step-by-step return to work.
