ABSTRACT

Traumatic brain injury (TBI) is defined as “an acquired injury to the brain caused by an external physical force”. The prevalence of psychotic disorder associated with head trauma was found to be 0.7%. It is frequently seen in the age range of 25-75 years. Our case presents the treatment and follow-up of psychiatric disorders developing after childhood multiple traumas. A-17 year old, single high school student, living with his family had a motorbike accident approximately 1.5 months prior to admission. After the accident, he was operated by orthopaedics, plastic surgery and neurosurgery and after intensive care and ward follow-ups were completed, levatiracetam 2x500 mg and diazepam 1x5 mg were started for the risk of post-traumatic epilepsy and he was discharged. After discharge, the patient was referred to paediatric neurology by neurosurgery because of complaints of being suspicious of people, believing that he would see evil, irritability, sudden anger, withdrawal from society, not wanting to eat, exhibiting grandiose ideation and not being able to sleep. Cerebral magnetic resonance imaging and electroencephalography were ordered in the paediatric neurology outpatient clinic. The imaging revealed haemorrhagic sequelae in the left thalamus, bilateral frontal lobe cortical-subcortical area, left parietal lobe subcortical white matter and appearances which may be compatible with trauma. As a result of psychiatric interview and psychometric tests, the patient was diagnosed with post-traumatic psychosis and post-traumatic stress disorder. The patient continued to be followed up at the child psychiatry outpatient clinic with partial improvement with sertraline and valproate treatment. Both neurologic and psychiatric symptoms often accompany post-TBI patients. In this case report, neurologic and psychiatric findings developing after TBI are discussed in detail and the treatment process is described.