Dr. Bibhuti Bhusan Das, Prof Dr. A. Mathiyash Arthur


INTRODUCTION: To study post traumatic neuropsychiatric changes in all patients admitted in a peripheral tertiary
care center with head injury, GCS in between 8 to 13 and subsequently improved to GCS 14 to 15.
MATERIALS AND METHODS: This is a retrospective study, having a group of patients of age group 14 to 50 years of
age, admitted and treated from August 2018 to July 2019, all patients having Glasgow Coma Score of 8 to 13 at the time of
admission. Total number of patients 45.
Ÿ Patients age group in between 14 years to 50 years.
Ÿ GCS in between 8 to 13 at the time of admission.
Ÿ CT scan brain having normal study.
Ÿ Patients below the age of 14 years and above 50 years
Ÿ Patients having other visceral and skeletal injuries.
Ÿ Patients having GCS less than 7 and 14 to 15.
Ÿ Patients having previous history of psychiatric disorders.
Ÿ Patients having previous head injury.
Ÿ Patients unwilling to be included in study group.
RESULTS: Diffuse axonal injury patients having GCS 8 to 13 at the time of admission, after treatment and having GCS 14
to 15 and significant neuropsychiatric changes. Also the result is dependent on the mode of head injury, age group of
patients, time of arrival to hospital. Some factors got improved and some factors got worsened.
CONCLUSION: Although the patients with diffuse axonal injury admitted with GCS 8 to 13 and discharged with GCS 14
to 15, there are significant neuropsychiatric changes at the time of discharge which are required to be considered for
FUNDING: No Funding were received by any one of the presenters for this study.

Full Text:



Rao V, Lykestos C. Neuropsychiatric Sequelae of traumatic brain injury. Psychosomatics 2000; 41: 2; 95-103. . Jones NC, Constantin D, GibsonCL, Prior MJ, Morris PG,

Marsden CA, Murphy S. A detrimental role for nitric oxide synthase-2 in the pathology resulting from acute cerebral injury.

J Neuropathol Exp Neurol. 2004;63:708-20.

. Ciallella JR, Yan HQ, Ma X, et al: Chronic effects of traumatic brain injury on hippocampal vesicular acetylcholine transporter

and M2 muscarinic receptor protein in rats. Exp Neurol 1998; 152:11–19.

Dixon CE, Ma X, Marion DW: Reduced evoked release of acetylcholine in the rodent neocortex following traumatic brain injury.

Brain Res 1997; 749:127–30.

Biegon A, Fry PA, Paden CM, Alexandrovich A, Tsenter J, Shohami E. Dynamic changes in N-methyl-D-aspartate receptors after closed head injury in mice: Implications for treatment of neurological and cognitive deficits. Proc Natl Acad Sci U S A. 2004;101: 5117-22.

Leishman WA. Organic Psychiatry, 3rd ed. Oxford:Blackwell.1998,161- 217.

Symonds CP: Mental disorder following head injury. Proceedings of the Royal Society of Medicine 1937; 30:108.

Koponen S,Taiminen T, Portin R et al. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study.

Am J Psych 2002;159:1315–21.

Fann, J.R., Burington, B., Leonetti, A, Jaffe, K., Katon, WJ., Thompson, RS. Psychiatric Illness Following Traumatic Brain

Injury in an Adult Health Maintenance Organization Population. Arch Gen Psychiatry 2004;61:53-61.

Chatterjee SB, Kishore R. Psychiatric disability in brain trauma. Ind J Psychiat 1979; 21: 279-82.

Keshvan MS , Channbasavanna SM, Reddy GNN. Post-traumatic psychiatric disturbances : patterns and predictors of outcome.

Br J Psychiat 1981, 138:152-60.

Sabhesan, S., Ramaswamy, P., Natarajan, M. Early behavioural sequelae after head injury. Neurol Ind 1990; 38: 169-75.

Chaudhury S, John TR, Bhatoe HS, Rohatgi S. Evaluation of Pitrowski’s organic signs of head injury. SIS J Proj Psy & Mental Health 1999; 6:53-57.

Dockree PM, Kelly SP, Roche RA, Hogan MJ, Reilly RB, Robertson IH. Behavioural and physiological impairments of

sustained attention after traumatic brain injury. Brain Res Cogn Brain Res 2004; 20: 403-14.

Menon P, Rao SL. Memory storage and encoding in patients

with memory deficits after closed head injury.

NIMHANS Journal 1997;15: 83-92.

Jones RD, Anderson SW, Cole I, Hathaway-Nepple J. Neuropsychological sequelae of traumatic brain injury. In: Rizzo M, Tranel D (eds). Head injury and post-concussive syndrome. New York: Churchill Livingstone, 1996: 395-414


Levin HS, Gary HE, Eisenberg HM et al. Neurobehavioral outcome one year after severe head injury. Experence of the Traumatic Coma Data bank. J Neurosurg 1990;73: 699-709.

McCunny RJ, Russo PK. Brain injuries in boxers.Phys Sports Med. 1984; 12:53-67


Walker W, Seel R, Gibellato M, Lew H, Cornis-Pop M, Jena T, Silver T. The effects of Donepezil on traumatic brain injury

acute rehabilitation outcomes.Brain Injury 2004;18: 739-50

Tureci E, Dashti R, Tanriverdi T, Sanus GZ, Oz B, Uzan M. Acute ethanol intoxication in a model of traumatic brain injury: the protective role of moderate doses demonstrated by immunoreactivity of synaptophysin in hippocampal neurons.Neurol Res 2004; 26: 108-12.

Arciniegas DB, Harris SN, Brousseau KM. Psychosis following traumatic brain injury. Int Rev Psychiatry 2003;15: 328-40.

Fujii D, Ahmed I. Psychotic disorder following traumatic brain injury: a conceptual framework. Cogn Neuropsychiat 2002; 7: 41-62.


  • There are currently no refbacks.