Plummer Patrick D, Banu Fahima, Nwabueze Christian, Nisenoff Carolina D, Jolayemi Ayodeji
Department of Psychiatry, Interfaith Medical Center, Brooklyn, USA.
Cureus. 2022 Oct 18;14(10):e30416. doi: 10.7759/cureus.30416. eCollection 2022 Oct.
Traumatic brain injury (TBI) is an intricate process in which the chemical balance and physical structure of the brain are altered. This medical condition's effects range from altered mental status to an irreversible comatose state, and in severe cases even death. TBI affects millions of individuals worldwide on an annual basis. In the United States, approximately 2.87 million TBI-related emergency department (ED) visits were reported in 2014, and nearly 43% of these cases will experience long-term disabilities. These disabilities have both short- and long-term consequences on health, ranging from physical, emotional, and psychosocial changes in an individual. The goal of this case report is to highlight the morbidity of patients with TBI, with a key focus on TBI-induced secondary psychosis. While many patients recover from their symptoms of TBI within weeks to months, a subdivision of patients with TBI has permanent damage that will significantly affect the quality of their daily lives. TBI-induced secondary psychosis is the new onset of psychosis that can comprise visual, auditory, and tactile hallucinations, delusions, and disorganized thoughts. In this case report, the patient is a 22-year-old African American male who suffered a TBI at the age of 16. Prior to the patient's TBI sustained in 2016, the patient did not have a hospital record of past psychiatric illness. In addition, the patient's family history did not show evidence of schizophrenia, bipolar, or depression in close or distant relatives. The patient presented to the ED for a psychiatric evaluation due to psychotic behavior. In this case report, we will discuss the pathogenesis, clinical presentation, and other secondary causes of TBI-induced secondary psychosis.
创伤性脑损伤(TBI)是一个复杂的过程,在此过程中大脑的化学平衡和物理结构会发生改变。这种医学状况的影响范围从精神状态改变到不可逆转的昏迷状态,在严重情况下甚至会导致死亡。TBI每年影响着全球数百万人。在美国,2014年报告了约287万次与TBI相关的急诊科(ED)就诊,其中近43%的病例将经历长期残疾。这些残疾对健康有短期和长期的影响,包括个体的身体、情感和心理社会变化。本病例报告的目的是强调TBI患者的发病率,重点关注TBI诱发的继发性精神病。虽然许多患者在数周或数月内从TBI症状中恢复,但一部分TBI患者有永久性损伤,这将严重影响他们的日常生活质量。TBI诱发的继发性精神病是精神病的新发症状,可包括视觉、听觉和触觉幻觉、妄想以及思维紊乱。在本病例报告中,患者是一名22岁的非裔美国男性,16岁时遭受了TBI。在该患者于2016年遭受TBI之前,其没有既往精神疾病的医院记录。此外,患者的家族病史在近亲或远亲中未显示出精神分裂症、双相情感障碍或抑郁症的证据。该患者因精神病行为到急诊科进行精神科评估。在本病例报告中,我们将讨论TBI诱发的继发性精神病的发病机制、临床表现及其他继发原因。