Head trauma: neurobehavioral aspects

Alfredo Ardila PhD (Dr. Ardila of Florida International University has no relevant financial relationships to disclose.)
Martin R Farlow MD, editor. (Dr. Farlow of Indiana University received research grant support from Accera, Biogen, Eisai,  Eli Lilly, Genentech, Roche, Lundbeck, Chase Pharmaceuticals, Novartis, Suven Life Sciences Ltd, and Boehringer Ingelheim; honorariums from Eisai, Forest Laboratories, Pfizer, Eli Lilly and Company and Novartis for speaking engagements; and fees from Accera, Alltech, Avanir, Axovant, Biogen, Eisai Med Res, Inc., Eli Lilly and Company, FORUM Pharmaceuticals, Genentech, Inc., Grifols, Helicon, INC Research, Lundbeck, Medavante, Medivation, Merck, Neurotrope Biosciences, Novartis, Pfizer, Prana, QR Pharm., Riovant Sciences Inc., Roche, Sanofi-Aventis, Schering-Plough, Toyama Pharm, Stemedica Cell Technologies Inc., vTv Therapeutics and UCB Pharma for consultancy. His spouse was employed by Eli Lilly.)
Originally released November 1, 1994; last updated September 2, 2015; expires September 2, 2018

This article includes discussion of head trauma: neurobehavioral aspects, posttraumatic syndrome, and neuropsychiatric disturbances of head trauma. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Traumatic brain injury and its consequences has become an epidemic, primarily due to the widespread use of motor vehicles. The specific neurobehavioral aspects of traumatic brain injury include (1) acute concussional syndrome, (2) the postconcussional disorder, (3) diffuse traumatic brain injury, (4) focal traumatic brain injury, (5) secondary complications of acute traumatic brain injury, (6) delayed deterioration, (7) posttraumatic dementia, and (8) posttraumatic neuropsychiatric disorders. Even mild head injury may result in cognitive consequences. Patients with mild head injury demonstrate deficits in attention, nonverbal fluency, and verbal memory. Long-term cerebral atrophy has been correlated with injury severity and duration of posttraumatic amnesia. Impairments can be found in different cognitive measures many years after the injury.

Key points

 

• Head trauma can be associated with a diverse variety of neurobehavioral manifestations, including cognitive impairments and neuropsychiatric disorders.

 

• Acute concussion syndrome is a brain dysfunction without any macroscopic structural damage induced by an acute mechanical force and potentially associated with attention deficits, amnesia, loss of consciousness, and a diverse range of cognitive defects.

 

• Specific neuropsychiatric syndromes include depression, mania, psychosis, aggressive behavior, and personality changes.

Historical note and terminology

The ancient Egyptians and Greeks wrote on the neurobehavioral effects of traumatic brain injury. Over the centuries, the study of war wounds, particularly penetrating injuries, made a major contribution to our understanding of brain-behavior relationships. During the 20th century, traumatic brain injury and its consequences became an epidemic, primarily due to the widespread use of motor vehicles. In recent years, investigators have demonstrated that even mild traumatic brain injury can result in neurobehavioral changes.

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