Traumatic brain injury

Resolved question:
Hello. My husband had a fall onto his head from about 10 feet in January of 2013. He was quite badly concussed, but was not knocked out. He hit at the back of his head, and the force of the fall burst his head open at the top...it was quite a blow. They never did any scans, they just stitched him up (it required two layers of stitches as it burst right to the skull. He was concussed quite badly for 10 days and was "normal" again after three weeks but after that he developed depression. He started to have problems sleeping, was irritable, less motivated. We had a very, very stressful year and in November 2013 he had a complete breakdown, after which he has been very deeply depressed. So much so that he left our family and lives on his own. He started Citalopram three weeks ago for the depression, and has started counselling. However, his behavior is often strange. He has turned very heartless and mean, where he was very kind before. He feels no emotions. He is sometimes hyper and says inappropriate things and has worrying memory problems and confusion (forgetting the day of the week and going to the wrong appointments). He is ike a stranger really. His doctor says it is just depressions but I am concerned there is some link to the head injury. Should he insist on a scan or seeing a specialist? Or is it more likely there is no link and he is just depressed due to the extreme stress he has experienced recently?

Submitted: 4 Days
Category: Family Physician-GP

Expert:  Dr. Jaydeep Tripathy replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Yes, you should insist on a scan - preferably MRI brain with contrast. The depression and other cognitive symptoms seem to have evolved after the head injury and hence a traumatic brain injury has to be ruled out. The change in character - from kind to heartless and mean, lack of emotions could be due to a injury in the frontal lobe.

Other symptoms including the depressive symptoms does not fit into a traumatic brain injury or post concussion syndrome. But still there is a probability that these are related to the past injury and so it has to be ruled out by taking an MRI.

Does he have any other behavioural symptoms ? Any change in urination pattern (like urinating in public ?), lack of inhibition in general ? lack of smell etc ?

Hope this helps
Thank you

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