A Case Study on the Management of the Behavioral Sequelae of Traumatic Brain Injury

• Published in: Journal of the Academy of Consultation-Liaison Psychiatry 2022-07, Vol.63 (4), p.316-323
• Main Authors: Bajamundi-Plyler, Clare, Hatfield, Rachael, Rosier, James Tyler, Roy, Durga
• Format: Article
• Language: English
• Subjects: behavioral therapy, psychopharmacology; neuropsychiatry; traumatic brain injury
• ISSN: 2667-2960; 2667-2960
• DOI: 10.1016/j.jaclp.2022.01.002

Background: We present the case of a 46-year-old male with a history of post-traumatic stress disorder and opioid use disorder who sustained a severe traumatic brain injury secondary to motor vehicle accident and was brought to the attention of our psychiatry consultation liaison team owing to significant physical and verbal aggression. Objective: This article will detail the specific behavioral and pharmacological management for this patient’s symptoms. Additionally, experts in the field of consultation and liaison psychiatry will provide guidance based on their experience and a review of the available literature. Key teaching topics include the pathophysiology and cognitive evaluation of traumatic brain injury, conducting a behavioral analysis and developing a behavioral management plan and finally how to utilize appropriate symptom-based pharmacology while taking into account evidence-based treatment. Conclusions: Neuropsychiatric symptoms in traumatic brain injury are often challenging to manage owing to the varied symptom profile. Thus, treatment requires continued re-evaluation and a mixture of behavioral therapy and psychopharmacologic approaches.