[Psychosis secondary to traumatic brain injury with manifestation of prominent grandiosity delusion: a case study with a 4-month follow-up]

ABSTRACT

Traumatic brain injury [TBI] has been known as one of rare etiological factors of psychotic disorder. In this case study we investigated the trend of evaluation, diagnosis and treatment of a patient with psychosis secondary to TBI who developed prominent grandiosity delusion. The patient was a young 35-year-old man who was hospitalized due to a motorcycle accident and developed decreased level of consciousness, restlessness and nausea. CT findings indicated contusion of the left temporal lobe. Moreover, loss of consciousness [LOC], cognitive impairment, post-traumatic amnesia [PTA], disorientation, lack of attention and concentration, memory disturbances, aggression and grandiosity delusions were observed during psychological evaluations. 27 days after TBI, he was diagnosed as a case of psychosis secondary to TBI based on DSM-IV-TR in psychiatric examinations. Then, the patient gradually recovered after medical treatment and the symptoms of injury disappeared during a follow-up period of 4 months. Presentation and treatment of this patient cannot clarify the vague relationship between TBI and psychosis secondary to TBI; however, the results of this study emphasize the importance of psychological evaluations, investigation of serious symptoms of mental disorders, monitoring and protection of these patients for proper treatment. Identifying the risk factors of secondary psychosis complicating TBI can be helpful to rule out differential diagnoses, detect those with higher risk of psychosis and facilitate timely implementation of management strategies for this disorder before the onset of its advanced symptoms