A female, approximately 18 years old, presented with a history of surviving a gunshot wound in the head two years prior, presumably during a suicide attempt. The bullet entered the cranial vault around the greater wing of the sphenoid and exited the other side of the skull just above the greater wing of the sphenoid. After multiple surgeries in the months that followed, both life-saving and cosmetic, she was left wheelchair-bound. She was a partial quadriplegic, insomuch as motor function of the lower extremities was negligible, but she retained some motor control of the upper extremities. Cognitive function was still very good, but dysphasia was present. AK MMT was not possible, so other indicators, such as range of motion and palpation, were used. IRT was performed to all the areas of her surgeries and gunshot wound. On the second visit, the patient reported that she had remarkable sensory improvement in the upper extremities. While cold/hot differentiation had proven difficult, after the first visit she could feel the difference in cold and hot water underneath the running water of the sink for the first time since the incident.
-DR. MARCELLO CASO, FOLSOM, CA
