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  1. Mental disorders in traumatic brain injury
  2. Mental disorders in the long term and treatment after traumatic brain injury

Signs of long-term effects of TBI are fatigue, personality changes, syndromes associated with organic brain damage. In the late period after TBI may develop traumatic psychosis. They appear, as a rule, due to the additional effects of psychogenic or exogenous toxic nature. The clinical picture is dominated by affective psychosis traumatic, hallucinatory-delusional syndromes that develop on the background of existing organic basis manifestations of fatigue. Personality changes appear in the form of the characteristic features of the instability of mood, irritability until manifestations of aggressiveness, affective symptoms bradifrenii overall stiffness with the weakening of critical thinking abilities.

For long-term effects of closed cranial trauma include such mental disorders as asthenic syndrome (an almost constant phenomenon), often hysterical reactions occur, there may be momentary delirium, epileptiform seizures, impaired memory, hypochondriacal disorder. Personality changes are kind of secondary organic psihopatizatsii with weakening intellectual-mental functions. Variety of neurotic and psychotic disorder not only as a possible long-term consequences of severe injuries, they may be the result of light and are not accompanied by a disturbance of consciousness, brain injuries. This pathology can be found in the coming months after the injury, and a few years after her.

Traumatic epilepsy develops due to the presence of local scarring in the brain, most often it is caused by an open skull injury and bruises and contusions of the brain. Jackson-type seizures occur, generalized convulsive paroxysms. Significant is the role of precipitating factors (alcohol, mental stress, fatigue). Such patients may develop transient twilight states of consciousness or convulsive paroxysms equivalents affective (dysphoria). Has implications for the locality of TBI clinic. When lesions of the frontal lobes of the brain, for example, changes in the structure of the individual prevail lethargy, confusion, viscosity, total bradifreniya. Progresses apathy, indifference to the disease. In traumatic lesions of the frontal part of the brain can develop violation bill (dyscalculia), simplifying and flattening the thought process of the formation of dementia, a tendency to perseveration, marked reduction motor, volitional activity (avolition). Such symptoms are due to a lack of volitional impulse that does not allow what was started before the end due to inactivity. These patients are characterized by lack of consistency, dispersion, negligence in everything, including clothing, inadequate action, carelessness, carelessness. Loss of initiative, spontaneity and activity due to a sharp decline in "frontal momentum" sometimes leads to the impossibility of unassisted to perform daily activities (eating, bathing, going to the toilet).

In the later (initial) stages of the disease expressed a complete lack of interest, indifference to everything, scarcity of vocabulary and thinking skills (cognitive deficit).

If the damage of the basal portions of the temporal lobe of the brain develop severe personality changes with severe manifestations of mental indifference, coldness, disinhibition instincts, aggression, antisocial behavior, perverted assessment of his personality, his ability.

Any damage to the temporal lobe leads to epileptic features: lack of sense of humor, irritability, mistrust, slowing of speech, motor skills, contentious disposition. Temporally-basal traumatic brain injury are the cause irritability, aggressiveness, hypersexuality. When combined with alcohol detected promiscuity, immorality, cynicism. Very often marked sexual pathology with increased libido and erectile function weakening, observed phenomenon of premature ejaculation when interested (localized disease) paracentral lobules.

Treatment

Therapy patients after TBI, provides compliance in the acute period of rest (for three to four weeks), conducting dehydration therapy using intravenous or intramuscular magnesium sulfate, Lasix, diakarba orally. Appointed nootropics (Nootropilum, piracetam, piriditol, mexidol cerebrolysin Akatinol-memantine semaks). Vitamins recommended, especially in groups, drugs that improve cerebral blood flow (sermion, tanakan, instenon). Tranquilizers are used in cases where expressed insomnia (lorafen, phenazepam radedorm - short courses up to 10 days). When epileptiform paroxysms used anticonvulsants (phenobarbital, carbamazepine, Finlepsinum, valproate). Carbamazepine (Finlepsinum, Tegretol) as a mood stabilizer helps to stabilize mood, relieves irritability phenomenon, temper, aggression, dysphoria, softens psychopathic manifestations, so that may be imposed in the absence of convulsive paroxysmal states. When resistant asthenia shown aktovegin, noben, ademetionine, adaptogens (aloe, Chinese magnolia vine, ginseng, etc.)

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