Forensic aspect of late subjective complaints after traumatic brain injury

G. Misic-Pavkov, Z. Novovic, K. Bozic, K. Kolundzija, S.I. Kovacevic, D. Drakip, T. Lukic, M. Jelkić

Clinical Centre of Vojvodina, Clinic of Psychiatry, Hajduk Veljkova 1-7, Novi Sad, Serbia. gmisicpavkov@gmail.com

 

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• Psychiatry

BACKGROUND: The subjective complaints in patients with TBI (Traumatic Brain Injury) may persist for years. The most frequent complaints are headache, dizziness, drowsiness, mood disturbances, and memory and concentration disturbances. It is assumed that these complaints are caused by injury itself on one hand and psychological, emotional and motivation factors on the other.

AIM: Evaluation of late posttraumatic complaints in patients with TBI more than a year after the trauma, and establishing their correlations to the severity of TBI and involvement in the lawsuits for financial compensation (litigation).

MATERIALS AND METHODS: Ninety patients with the diagnosis of TBI were divided, according to the severity of the injury, in two groups: mild and with moderate-to-severe. The second classification criterion was litigation. A subjective complaints scale has been designed for the purpose of this research taking into consideration both anamnesis and hetero-anamnesis data.

RESULTS: Cognitive disturbance, aggressiveness and sleep disturbance are more frequently reported by the subgroup of moderate-to-severe TBI patients, and they have not been related to the litigation. Posttraumatic headache (PTH) turned out to be a distinctive complaint regarding both classification criteria. Vegetative disturbances are significantly related to litigation, but not to the degree of injury.

CONCLUSIONS: Predictive complaints reflecting the severity of TBI are memory deficit, concentration problems, and aggressiveness and sleep disturbance. Vegetative disturbances are predictive in relation to compensation claims. PTH is important from the forensic point of view for the patients with moderate to severe TBI.

 

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