Psychiatric sequelae of acquired brain injury

Improvements over recent decades in acute care of the brain-injured now ensure that all but the most severely injured survive. The legacy of that survival is an increasing number of people with enduring organic mental disorders. Here, I will focus upon the psychiatric sequelae of five types of severe single-insult brain injury: head trauma, subarachnoid haemorrhage, and hypoxic, hypoglycaemic and postencephalitic injury. Thrombotic stroke is a common and important cause of brain injury but the psychiatric consequences have been more extensively studied and are fairly well-known (Robinson & Price, 1982; Starkstein et al, 1987). Damage due to alcohol and associated malnutrition is also well-documented (Jacobson & Lishman, 1987, 1990). Neither will be specifically addressed here, though some of the consequences of brain injury are similar, regardless of cause.