Adapting AVATAR Therapy: Using available digital technology for people living with Auditory Verbal Hallucinations in Low and Middle Income Countries

ABSTRACT

A 22 year old male presented with symptoms of fast-escalating cognitive degeneration and behavioral impairment after a period of clinical recovery post severe traumatic brain injury (TBI). Neuroimaging found extensive mild-moderate cortico-cerebral atrophy not really corresponding to his primary TBI lesions. A diagnosis of dementia [ICD F02.8] was made and patient was treated accordingly, in conjunction with Neurology services, with emphasis on neuro-cognitive rehabilitation. Extensive testing could not find any other likely causes for this condition, which was then postulated to be generalized secondary post-TBI neurodegenerative changes. His symptoms are currently improved and stabilized with ongoing maintenance-phase management, but as this condition is not reversible – this case report discusses likely etiopathological processes and corresponding management options (both presently available and those likely to become so in near future) to be aware of..