Dementia is defined as impairment in memory that occurs along with other defects of cognition. Injury to the head occurs when an external force strikes the head region in such a manner that it causes the brain to move severely within the cranium. This external force can lead to twisting, contusion, shaking and even a sudden alteration in the normal movement of the brain, causing concussion.
It is a known fact that damage to the normal tissues of the brain can prevent them from functioning normally. This damage can disrupt any movement or function of the body, as the brain is responsible for numerous functions. The brain is capable of healing its damaged tissues after an injury, this means that not all injuries to the head can cause permanent damage, but even after healing, there is some form of alteration or impairment in the optimal functioning of the brain. A mild to moderate injury to the head can also cause damage in the long term, which impairs the main function of the brain called cognition.
Cognition and Dementia:
Cognition is the ability of the brain to think, understand, remember, and provide reasoning and also to communicate. Emotional and behavioral changes are also a complication of head injuries, and a combination of all these complications is termed as dementia.
The location and type of the head injury sustained can describe the nature or form of dementia that the person can suffer from. There may be various changes in a person’s overall personality after sustaining this injury including emotional instability, behavioral problems, difficulty or inability of solving problems and making decisions. Other symptoms depend upon the portion or part of the head that was damaged in the injury.
The extent and severity of the symptoms that manifest in patients depend upon the extent and severity of the head injury, but this may not be true. In case of a mild to moderate injury, the symptoms may not be permanent and may resolve after a certain period of time. However, direct injury to the brain and its tissues is associated with only a portion of all complications associated to head injury. It may lead to intracranial bleeding and clot formation, fluid accumulation that can lead to a condition called hydrocephalus, and also bacterial infections. One of the most common complications of direct injury or trauma to the head is seizures, or epilepsy.
Causes and Incidence:
According to various surveys that have been conducted across America, it has been reported that two out of one thousand people have suffered from some form of head trauma. A significant portion of these never seek medical attention assuming that the problem will resolve spontaneously. Approximately 500,000 people in the United States are hospitalized with head injuries every year.
It has also been concluded that younger people have more chances to sustain head injuries in contrast to older people. Following infection and excessive alcohol consumption, head injury is the commonest cause of dementia across the globe especially in people who are under 50 years of age. Studies also show that head injury can lead to dementia and may also be linked with Alzheimer’s disease.
In case of an older person sustaining injury to the head, there are more complications and greater chances of developing dementia. Children receiving severe injuries to the head region can also manifest dangerous complications most of which are permanent in nature. Younger men and women are more likely than the older people to sustain an injury to the cranial region.
Some of the leading causes of head injuries among civilians include road accidents, falls, gunshot wounds as well as assaults, extreme sports which include likely blows to the head including boxing and other activities, and excessive alcoholism. The causes of head injuries are different with different age groups, for example children are the most likely to sustain an injury to the head while bicycling. A syndrome which is associated with head injuries in children is called Shaken Baby Syndrome, and is related to head injuries received by the child in a form of child abuse.
Head injury can have different signs and symptoms, and these mostly depend upon the type of injury caused to the patient. Dementia results if the injury makes a person lose conscious control of cognition. The following can also result along with dementias:
Seizures: these can develop after sustaining an injury to the head. They are not part of dementia but can complicate the situation.
Depression: a person may show signs of sadness, lethargy tearfulness, loss of weight and sleep disorders can also develop
Anxiety: dementia may be accompanied with anxiety in patients that disrupts everyday life and also adds a strain on relationships.
Mania: this state is a mental disorder and is a state of exceptionally high excitement, insomnia, hyperactivity, impulsiveness and poor judgment.
Psychosis: in his condition a person tends to lose touch with reality. The person also suffers from hallucinations, delusions or both.
Obsessive-compulsive disorder: Development of uncontrolled and irrational thoughts and obsessions coupled with odd behaviors called compulsions that are carried-out in order to control the obsessions and compulsions. It also makes a person obsessively preoccupied with rules, details or orderliness.
Increased risk of suicide: a feeling of worthlessness or having thoughts that the world would be better off without the patient or that life is not worth living at all may cause a person to attempt suicide. This is especially true if dementia is very severe and the person cannot live a normal life.
People with head trauma may require medicines to treat dementia and other symptoms like mania, depression, psychosis, irritability, aggression, insomnia, mood swings, apathy, and impaired concentration. Medicines can also help with headaches that start.
These medicines include:
- Dopaminergic Agents
- Antiepileptic Drugs
- Mood Stabilizers
Blueprints Psychiatry Michael J Murphy, Ronald L. Cowan, Lloyd I Sedere