An SLP evaluates a 22-year-old man with brain injury, unconscious for days, with prolonged posttraumatic amnesia. Which domain is most likely impaired?

• A. Visual construction
• B. Attention and memory
• C. Speech
• D. Language

Answer: (B)

When someone has prolonged posttraumatic amnesia after a brain injury, the key problem is with forming and maintaining new memories and with sustaining attention to ongoing events. PTA reflects disruption of memory encoding and retrieval processes, along with reduced alertness and ability to attend to new information. Since learning and remembering new information depend on attention and memory systems, this domain is most likely impaired.

Visual construction would require visuospatial and motor planning abilities and isn’t the primary issue in PTA. Speech and language problems point to language production or comprehension deficits from focal left-hemisphere damage, not to the memory/attention disruption typical of prolonged PTA.