Traumatic Brain Injury(TBI) of any severity can result in broad and persisting biopsychosocial sequelae. Depression after TBI occur at a greater frequency than in the general population, with estimates approaching 25% to 50% for major depression, and 155 to 30% for dysthmia. Acute onset depressions are related to lesion location and may have their etiology in biological response of the injured brain, whereas delayed onset depressions may be mediated by psychosocial factors, suggesting psychological reactions as a possible mechanism. Anxious depressions are associated with right hemisphere lesions, whereas major depressions alone are associated with left dorsolateral frontal and left basal ganglia lesions. However, there is insufficient information to postulate a specific neuroanatomic model for TBI-related depression.
Basal Ganglia ; Brain ; Brain Injuries* ; Craniocerebral Trauma ; Depression* ; Psychology

OBJECTIVES: To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. METHODS: According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. RESULTS: The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P<0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P<0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （ P>0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. CONCLUSIONS The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.
Craniocerebral Trauma/pathology* ; Humans ; Personality ; Personality Disorders/psychology* ; Personality Inventory ; Psychotic Disorders/psychology*

OBJECTIVES: To understand the current status of appraisal of post-concussion syndrome disability and the reasons for the changes in re-appraisal opinions. METHODS: The cases that were judged as "post-concussion syndrome and ten-level disability" in the first appraisal and re-appraised for psychiatric impairment by the Academy of Forensic Science in 2019 were analyzed retrospectively. RESULTS: There were 75 cases, including 58 cases with pre-hospital emergency medical records, among which 39 cases were clearly recorded to be without a history of coma; 74 cases had emergency medical records, among which 44 cases were recorded of having a history of coma; 43 cases had follow-up medical records, among which 24 cases had a history of psychiatric follow-up. The most complained symptoms of the appraisee in appraisal and examination include headache, dizziness, poor sleep at night, irritability, memory loss, fatigue and inattention. The main reasons for the re-appraisal application include doubts about the history of coma, doubts about the credibility of mental symptoms, post-concussion syndrome didn't meet the disability criteria, and objections to the original appraisal procedure or the original appraisal agency. The appraisal opinions of a total of 47 cases were changed. Seven of them did not meet the disability criteria, and the main reason was that there was no clear history of coma and no head injury was admitted; the coma history of the 40 other cases had to be confirmed by the court before they can be clearly identified as disabilities. The reason was that the records about the history of coma were inconsistent or there were alterations and additional information. CONCLUSIONS In the past, the conditions for appraisal of post-concussion syndrome disability were too lax and must be further standardized and strictly controlled.
Brain Concussion/diagnosis* ; Craniocerebral Trauma ; Headache/psychology* ; Humans ; Mental Disorders ; Post-Concussion Syndrome/psychology* ; Retrospective Studies

OBJECTIVETo investigate the effects of mild head injury (HI) on the victims'intelligence by measuring their intelligence quotient (IQ).

METHODSThis cohort study was performed in Khatam-ol-Anbia Hospital, Zahedan, Iran and the IQs of 30 mild HI patients were measured right after the injury (IQ0) and six months later (IQ6). The IQs of 90 close relatives of the patients were also measured at the same period of time as the non-exposure group. The IQs were measured with Wechsler adult intelligence scale-revised (WAIS-R). The IQ0, IQ6 and their differences (IQ change) were compared in HI patients and their relatives using the Student's t test.

RESULTSThe mean IQ0 of the HI patients was similar to their relatives. The IQ6 of HI patients appeared to be less than those of their relatives. Moreover, the IQ6 of the HI patients appeared to be less than their initial scores. HI was associated with more decrease in IQ6 compared with IQ0 and the female subjects showed more decrease in IQ6 compared with their IQ0.

CONCLUSIONHI seems to be associated with decrease in IQ six months after the injury and it is more evident in female HI patients.

Adult ; Cohort Studies ; Craniocerebral Trauma ; psychology ; Female ; Humans ; Intelligence ; Iran ; Male

C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.
Brain ; Consciousness ; Craniocerebral Trauma ; Disability Evaluation ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Odontoid Process ; Spine ; Unconscious (Psychology) ; Young Adult

OBJECTIVE: To explore characteristics of the head traumatic children's intelligence. METHODS: The authors investigated 43 head trauma children and 50 normal children, using Wechser Intelligence Test (C-WISC). Data were analyzed by SPSS10.0 on computer. RESULTS Head trauma children had lower FIQ, VJQ, PIQ than normal children. Pervaded head trauma has more contribution to the damage of the children's intelligence.
Accidents, Traffic ; Adolescent ; Child ; Child Development ; Craniocerebral Trauma/psychology* ; Female ; Humans ; Intelligence ; Intelligence Tests ; Language ; Male ; Wechsler Scales

OBJECTIVETo explore the effective methods for evaluating the consciousness and speech status of patients with special types of cerebral injuries.

METHODSA total of 96 patients with injury in the language center and in coma were treated with operative and correlated conventional therapies. Then their recovery status of consciousness and speech was observed.

RESULTSAll the patients were recovered to consciousness. Sixty-nine patients with aphasia were cured completely, but 7 patients were complicated with incomplete ataxic aphasia, 15 with incomplete sensory aphasia, and 5 with incomplete mixed aphasia.

CONCLUSIONSFor the patients with injury in the language center, evaluation of the conscious state with GCS scoring system has certain limitations and conscious behaviours are advantageous evidences to evaluate the consciousness recovery of the patients. The patients with conscious disturbance and injury in the language center should be considered to have aphasia.

Adult ; Aged ; Aphasia ; diagnosis ; Consciousness ; Craniocerebral Trauma ; psychology ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Speech

OBJECTIVE: To explore the change of brain cognition function in severe head injury and the correlation between P300 in event-related potential (ERP) and intelligence quotient (IQ). METHODS: Auditory P300 was measured and intelligence quotient was tested by Wechsler Adult Intelligence Scale Revised in China (WAIS-RC) in 40 severe head injury patients. Auditory P300 was measured in 40 normal healthy people as control group. RESULTS: The latencies of P300 in severe head injury patients group were longer than in control group. There was a significant difference between the two groups (P< 0.01). There were significant negative correlations between P300 latency and VIQ and FIQ respectively (r=-0.335,-0.344, P<0.05). CONCLUSION ERP might be taken as an objective index for measuring the change of the brain cognition function in patients with severe head injury.
Adolescent ; Adult ; Aged ; Cognition ; Craniocerebral Trauma/psychology* ; Event-Related Potentials, P300 ; Female ; Humans ; Intelligence ; Male ; Middle Aged ; Reaction Time ; Trauma Severity Indices ; Wechsler Scales ; Young Adult

Cerebrospinal disease or injuries frequently result in defecatory difficulty. Management of these patients requires an understanding of the alterations in the mechanisms regulating colorectal function in the cerebrospinal disease. Rectal sensation is usually impaired in cerebrospinal disease and this is one of the pathogenic mechanisms of defecatory difficulty Aim : This study was carried out to evaluate a biofeedback treatment in the patients with impaired rectal sensation after cerebrospinal disease. Subjects : Thirteen patients (5F, 8M, mean age 36 years, range 14~56) with impaired rectal sensation and constipation over 6 months duration developed after brain or spine operation were studied. These included 7 traumatic head injury (5: temporoparietal epidural hematoma, 2: frontal lobe epidural hematoma) and 6 HNP (3: L4~5, 3: L5 ~S1) operation. METHODS: These patients were evaluated by questionnaire, office examination, colon transit studied, anorectal manometry including rectal sensation, balloon expulsion studies, and defecography. All patients underwent biofeedback treatment twice a week for 2 or 3 months. Results : Six brain hematoma and two HNP patients had impaired rectal sensation with anismus and the remaining 5 had only impaired rectal sensation. One brain hematoma (temporoparietal) had anosmia. All patients had normal anal basal pressure, squeeze pressure, rectal compliance, and intact rectoanal inhibitory reflex. Colonic transit time was delayed, but the delay was accounted for by prolonged rectal transit time. The mean volume at which anal relaxation first occurred were 12 ml (range 5~15 ml). The mean threshold volume at which these patients experienced rectal sensation were 90 ml (range 60~130 ml). Biofeedback conditioning in these 13 patients led to normal sensory threshold (mean 20m1, range 10~30 ml) in all patients. Biofeedback also provided spontaneous good passage of stool. Conclusion : Biofeedback treatment appears to be effective in impaired rectal sensation after cerebrospinal operation. Also central neural mechanism may be involved in the pathogenesis of anismus.
Biofeedback, Psychology ; Brain ; Colon ; Compliance ; Constipation ; Craniocerebral Trauma ; Defecography ; Frontal Lobe ; Hematoma ; Humans ; Manometry ; Olfaction Disorders ; Surveys and Questionnaires ; Reflex ; Relaxation ; Sensation* ; Sensory Thresholds ; Spine

In recent years, mental disability estimation are more than ever in the practice of forensic psychiatric expertise. The standards about mental disability estimation in the Disability Evaluation Criteria of Traffic Accident Injury are ambiguous and difficult to operate, it cause to different understanding in one case. This article discuss some common questions through 3 aspects in mental disability expertise according to some typical cases, there are the first, we should compare the IQ score before and after injurious in intelligence estimate. The second, the mental disability estimation should be done at least one year after the end of medicine treatment. The third, mental estimate scale should be used in mental disability estimation.
Accidents, Traffic ; Adolescent ; Craniocerebral Trauma/psychology* ; Disability Evaluation ; Expert Testimony/standards* ; Female ; Forensic Psychiatry/legislation & jurisprudence* ; Humans ; Intelligence ; Male ; Persons with Mental Disabilities ; Wechsler Scales ; Young Adult