Traumatic brain injury (TBI) is frequently associated with significant neuropsychiatric sequelae. Recovery trajectories are highly variable; injury severity is only one influence. Other factors, including preexisting psychiatric or psychological factors and psychosocial contexts also influence recovery. In this clinical challenge, we present the case of a young woman with a history of psychiatric comorbidity who developed complex neuropsychiatric symptoms after sustaining a TBI following a motor vehicle accident. Her clinical presentation included posttraumatic headache, chronic pain, visual disturbances, difficulty returning to work, and prominent anxiety and posttraumatic stress disorder symptoms. These challenges required a coordinated, multidisciplinary approach to treatment, focused both on symptom management and functional recovery. Psychotherapy played a central role, with a modified exposure-based approach augmented by biofeedback tools and pharmacotherapy. Over time, this integrative strategy resulted in meaningful improvement in the patient’s neuropsychiatric symptoms and functional recovery. This case highlights the role of collaborative, tailored treatment for patients with overlapping neurological and psychiatric sequelae of TBI. It also underscores the unique contribution of psychotherapy when combined with medication and technology-enabled interventions, demonstrating how these strategies can optimize recovery in complex outpatient presentations of TBI.
Zhang et al. (Tue,) studied this question.