Doctor's Notes on Dementia in Head Injury
Head injury occurs when an outside force hits the head hard enough to cause the brain to move violently within the skull. This force can cause shaking, twisting, bruising (contusion), or sudden change in the movement of the brain (concussion). Violent jarring of the brain can damage brain tissue and tear nerves, blood vessels, and membranes. Even a mild head injury can cause prolonged or permanent declines in cognition called dementia, which describes problems that affect thinking and concentration, memory, communication, personality, interactions with others, mood, and behavior.
Symptoms of dementia resulting from head injuries may include problems thinking clearly, memory loss, difficulty concentrating, slowed thought processes, irritability, easy frustration, impulsiveness, mood swings, inappropriate behavior in social situations, grooming and dressing becomes eccentric or neglected, restlessness, agitation, insomnia, aggression, combativeness, hostility, headache, fatigue, apathy, and other vague, nonspecific physical symptoms.
Dementia in Head Injury Symptoms
Dementia-related symptoms in head injury are those that affect thinking and concentration, memory, communication, personality, interactions with others, mood, and behavior.
- These are only some of the symptoms that might be experienced after a head injury.
- Individuals experience different combinations of these symptoms depending on the part of the head injured, the force of the blow, the damage caused, and the person’s personality before the injury.
- Some symptoms appear rapidly, while others develop more slowly.
- In most cases, symptoms have at least started to appear in the first month after the injury.
Symptoms of dementia in head-injured persons include the following:
- Problems thinking clearly
- Memory loss
- Poor concentration
- Slowed thought processes
- Irritability, easily frustrated
- Impulsive behavior
- Mood swings
- Inappropriate behavior in social situations
- Grooming and dressing eccentric or neglected
- Restlessness or agitation
- Aggression, combativeness, or hostility
- Vague, nonspecific physical symptoms
Some people develop seizures after a head injury. These are not part of the dementia, but they can complicate diagnosis and treatment of dementia.
Major mental disorders may develop after head injury. Two or more of these may appear together in the same person.
- Depression - Sadness, tearfulness, lethargy, withdrawal, loss of interest in activities once enjoyed, insomnia or sleeping too much, weight gain or loss
- Anxiety - Excessive worry or fear that disrupts everyday activities or relationships; physical signs such as restlessness or extreme fatigue, muscle tension, sleeping problems
- Mania - State of extreme excitement, restlessness, hyperactivity, insomnia, rapid speech, impulsiveness, poor judgment
- Psychosis - Inability to think realistically; symptoms such as hallucinations, delusions (false beliefs not shared by others), paranoia (suspicious and feeling of being under outside control), and problems thinking clearly; if severe, behavior seriously disrupted; if milder, behavior bizarre, strange, or suspicious
- Obsessive-compulsive symptoms - Development of obsessions (uncontrolled, irrational thoughts and beliefs) and compulsions (odd behaviors that must be carried out to control the thoughts and beliefs); preoccupation with details, rules, or orderliness to such a degree that the larger goal is lost; lack of flexibility or ability to change
- Suicide risk - States feelings of worthlessness or that life is not worth living or that world would be better off without him or her, talks about suicide, states intention to commit suicide, develops plan to commit suicide
Dementia in Head Injury Causes
The following are the most common causes of head injury in civilians:
- Motor vehicle accidents
- Assault or gunshot wound
- Sports, such as boxing (dementia pugilistica), or other recreational activity
Use of alcohol or other substances is a factor in about half of these injuries.
Certain groups are more likely than others to sustain head injury.
In 1906 Auguste Deter, a woman in her early 50s, became the first person diagnosed with Alzheimer's disease, a form of dementia. The disease is named after the doctor who first described it, Alois Alzheimer. The disease is characterized by odd behavior, memory problems, paranoia, disorientation, agitation, and delusions. After Deter’s death, Alzheimer performed a brain autopsy and discovered dramatic shrinkage and abnormal deposits in and around nerve cells.
In 1910 the term “Alzheimer’s Disease” was formally used. In 1974 Congress established the National Institute on Aging (NIA), the primary federal agency supporting Alzheimer’s research.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.