Hanna David, Priven Sonya, Carroll Nathan, Ekladios Heba, Fitzsimmons Adriana
Psychiatry, Hackensack Meridian School of Medicine, Nutley, USA.
Psychiatry, Rowan-Virtua School of Osteopathic Medicine, Stratford, USA.
Cureus. 2024 Nov 1;16(11):e72849. doi: 10.7759/cureus.72849. eCollection 2024 Nov.
Psychotic disorders following traumatic brain injury (TBI) are a significant concern in psychiatry, with chronic sequelae often overlooked. The pathophysiology of post-TBI psychosis involves neuroplasticity and neuronal remodeling, potentially exacerbating vulnerabilities to chronic psychotic disorders. Differentiating post-TBI psychosis from primary schizophrenia and other psychotic conditions is crucial for appropriate treatment. This case report discusses a 63-year-old male with a history of TBI from a gunshot wound sustained in adolescence, who later developed schizophrenia. The report explores the patient's psychiatric symptoms, cognitive dysfunction, personality changes, and imaging findings. The report examined the complex relationship between TBI and psychotic symptoms, considering genetic, neurobiological, and psychosocial factors. The potential for TBI to increase the risk of psychotic conditions, especially in genetically predisposed individuals, was discussed. The challenges in establishing a direct causal link between TBI and schizophrenia were addressed.
创伤性脑损伤（TBI）后出现的精神障碍是精神病学中一个重要的关注点，其慢性后遗症常常被忽视。创伤性脑损伤后精神病的病理生理学涉及神经可塑性和神经元重塑，这可能会加剧患慢性精神障碍的易感性。将创伤性脑损伤后精神病与原发性精神分裂症及其他精神疾病区分开来对于恰当治疗至关重要。本病例报告讨论了一名63岁男性，他在青少年时期因枪伤有创伤性脑损伤病史，后来患上了精神分裂症。该报告探讨了患者的精神症状、认知功能障碍、人格改变及影像学检查结果。报告研究了创伤性脑损伤与精神症状之间的复杂关系，同时考虑了遗传、神经生物学和社会心理因素。讨论了创伤性脑损伤增加患精神疾病风险的可能性，尤其是在有遗传易感性的个体中。还探讨了确立创伤性脑损伤与精神分裂症之间直接因果关系所面临的挑战。
