Post Traumatic Amnesia

Neuropsychological problems

Brain and head injury trauma can result in a range of neuropsychological problems.  Depending on the part of the brain affected and the severity of the injury, the result on any one individual can vary greatly.  Personality changes, memory and judgement deficits, lack of impulse control and poor concentration are all common.

These behavioural changes can be stressful for families and care givers, who often have to relearn their communication techniques and also their expectations of what the impaired person can or cannot do.

Traumatic brain injury impairs the ability to think, do, and know, so it is hardly surprising that the memory, mood and attention are the top three complaints by brain injury patients.  There may be intellectual dullness, and mental rigidity, which are also common signs.  Rapid mood swings may also be coupled with waxing and waning energy levels.

It is important for the family that they avoid comparing the impaired person to the way that they were prior to the injury. Personality changes are often an exaggeration of the person’s pre-injury personality in which personality traits become intensified.

Post Traumatic Amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury, in which the injured person is disorientated and unable to remember events that occur after the injury. The person may be unable to state his or her name, where he or she is, and what time it is.

The definition of PTA is: The inability to remember continuous events, after a blow to the head which causes an alteration of consciousness, even when the person is apparently awake.”

The awake injured person whilst appearing to be awake,  is behaving or talking in an uncharacteristic manner. The person has no continuous memory of day to day events, and recent events may be equally affected. They may be unable to remember what happened a few hours ago, or even a few minutes ago. PTA can sometimes occur without the person having been unconscious beforehand.

There are two types of amnesia: retrograde amnesia (loss of memories that were formed shortly before the injury), and anterograde amnesia (problems with creating new memories after the injury as taken place).

The most obvious symptom is the loss of memory for the present time. The person may be confused, anxious, distressed or agitated. They may well behave in a completely uncharacteristic way showing signs of violence or aggression. They may also become sexually disinhibited or believe they are a child or a much younger person themselves.  They can be at risk of further accident by wandering off, or trying to get out of bed even if they have an intravenous infusion in situ.

The loved ones should try and stay as calm as possible, and not make the patient agitated by correcting him. PTA may last for a few minutes, hours, days, weeks or even months. The duration of the time is a good indicator of the severity of the head injury and its likely long-term effects.

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