Mental disorders due to traumatic brain injury
Introduction
Introduction to mental disorders caused by traumatic brain injury There are two common types of mental disorders caused by traumatic brain injury. One type is characterized by persistent mental function defects, such as memory impairment; the other type is more common with mood disorder and powerlessness, and is often overlooked because symptoms are not easily detected. In addition to organic factors, the individual's neural type, quality characteristics, and post-traumatic psychosocial factors also play a role in the occurrence and development of the disease. basic knowledge The proportion of illness: the incidence rate of patients with brain trauma is about 0.1% - 0.3% Susceptible people: no special people Mode of infection: non-infectious Complications: Dementia syndrome
Cause
Causes of mental disorders caused by traumatic brain injury
Brain contusion (35%):
When the skull is damaged by brain tissue caused by external force, it is called brain contusion. This type of trauma is characterized by a more severe and persistent disturbance of consciousness (more than half an hour). Clinical manifestations, in addition to whole-brain symptoms, may have focal symptoms, and are often associated with traumatic subarachnoid hemorrhage due to cerebral vascular injury.
Concussion (25%):
Concussion refers to a temporary disorder in which brain function occurs after the head has been subjected to violence. It is the lightest type of craniocerebral injury, and most have no evidence of organic damage, but there are also very few deaths.
Head injury (28%):
Subdural hematoma can occur sharply or later after a brain injury. Headaches are inevitable, but more importantly, changes in consciousness state, patients can recover from acute brain injury coma, when the patient's performance is irritating or chaotic, mental state due to the day, and even from time to time. The most common signs are hemiplegia or central facial paralysis. Symptoms of chronic subdural hematoma are similar, but mild to severe intellectual impairment can occur. The patient may not be remembered for the initial injury.
Intracranial hematoma, intracranial hemorrhage during brain injury, such as gathering in a certain part of the cranial cavity and reaching a considerable volume, when the brain tissue is compressed and causes the corresponding clinical symptoms, it is called "intracranial hematoma". Most of the intracranial hematoma encountered in the psychiatric department is subdural. Patients often forget the process of head trauma, and the hematoma develops unconsciously. The incidence of subdural hematoma after craniocerebral trauma is said to be 10%. In a group of 3100 psychiatric patients, a subdural hematoma was found in 8% (Kolb, 1973). Subdural hematoma can be associated with a variety of psychotic conditions, especially in the elderly, epilepsy, alcoholism and paralytic dementia, because these people are prone to head trauma.
Prevention
Prevention of mental disorders caused by traumatic brain injury
The disease is a traumatic disease, pay attention to safety, drive carefully, keep the home environment bright, walk carefully, watch children, avoid trauma, pay attention to daily psychological care after craniocerebral trauma.
Complication
Complications of mental disorders caused by traumatic brain injury Complications dementia syndrome
Some patients with severe brain injury can gradually develop into dementia syndrome.
Symptom
Symptoms of mental disorders caused by traumatic brain injury Common symptoms Ventricular pressure shift Disgusting nausea tension Recent oblivion Anxiety illusion Flashback Dementia Paraplegia Coma
First, acute mental disorders
1. Disorder of consciousness: seen in closed brain trauma, may be the result of a large degree of rotational movement of the brain tissue in the cranial cavity, the degree of concussion consciousness is relatively mild, can occur after the injury, and the duration is more than half an hour. The severity of consciousness disorder in patients with brain contusion can range from several hours to several days. In the process of waking, poor orientation, nervousness, fear, excitement, rich illusions and hallucinations, called traumatic paralysis, such as brain After the initial coma at the time of trauma, after the waking period of several hours to several days, when the disturbance of consciousness occurs again, the subdural hematoma should be considered.
2. Amnesia: When a patient's consciousness recovers, there is often a memory disorder. The period of amnesia after trauma refers to the recovery from normal time of injury to normal memory. It is not common for retrograde amnesia (ie, forgetting about a period of experience before injury). More than a few weeks to recover, some patients can have long-lasting memorization, fiction and misconfiguration, called post-traumatic amnesia syndrome.
Second, the late mental disorders
1. Post-traumatic syndrome: more common, showing headache, head weight, dizziness, nausea, easy fatigue, attention is not easy to concentrate, memory loss, emotional instability, sleep disorders, etc., usually called post-concussion syndrome, symptoms are generally sustainable In a few months, some may have an organic basis. If long-term prolonged unhealed, it is often related to psychosocial factors and susceptibility to quality.
2. Neurosis after traumatic brain injury: There may be symptoms such as suspicion, anxiety, snoring, such as convulsions, deafness, hemiplegia, paraplegia, etc. The onset may be related to psychological factors in trauma.
3. Traumatic traumatic psychosis: less common, may have a schizophrenia-like state, with illusion delusion as the main symptom, most of the victimized content, can also present a state of depression.
4. Traumatic traumatic dementia: Partially severely punish patients with long-term traumatic coma, can be demented, with near memory, poor understanding and judgment, slow thinking, often accompanied by personality changes, lack of active initiative, emotional retardation or Irritability, euphoria, loss of shame, etc.
5. Traumatic epilepsy.
6. Post-traumatic personality disorder: more often occurs in severely punishing craniocerebral trauma, especially in frontal lobe injury, often coexisting with dementia, becoming emotionally unstable, irritating, self-control ability diminished, defamatory, rude, stubborn, selfish and loss Enterprising.
Examine
Examination of mental disorders caused by traumatic brain injury
Brain ultrasound (positive lateral position, skull base) brain ultrasound diagnosis, EEG, brain CT examination and psychological test.
CT examination of the brain is a method of examining the brain by CT. Head CT is a convenient, rapid, safe, painless, non-invasive new examination method that clearly shows the anatomical relationship of different cross sections of the brain and the specific brain tissue structure. Therefore, the detection rate of the lesion and the accuracy of the diagnosis are greatly improved. In general, CT is better for soft tissue imaging than for soft tissue. Head CT examination is important for the diagnosis of most diseases of the brain, skull, and scalp (including trauma, tumor, inflammation, vascular disease, poisoning, degeneration, and metabolic diseases).
Diagnosis
Diagnosis and diagnosis of mental disorders caused by traumatic brain injury
It is not difficult to differentiate the diagnosis based on medical history and examination. It is necessary to distinguish from mental disorders caused by schizophrenia, affective disorder, pathological personality, chronic subdural hematoma and other brain organic diseases. Schizophrenia is a group of severe psychiatric diseases with unknown etiology. It is often slow or subacute onset in young and middle-aged patients. It is often manifested as a syndrome with various symptoms, involving many obstacles such as perception, thinking, emotion and behavior. And the inconsistency of spiritual activities. The patient is generally conscious and the intelligence is basically normal, but some patients will suffer cognitive function damage during the disease process. The course of the disease is generally delayed, recurrent, aggravated or worsened. Some patients eventually experience depression and mental disability, but some patients can be cured or basically healed after treatment.
