Psychosis secondary to traumatic brain injury

Background: Traumatic brain injury (TBI) can result in serious and disabling neuropsychiatric disorders. Method: The authors report a case of a 51-year old male, admitted to the psychiatric ward for acute psychosis and suicidal ideation, probably associated with TBI. After a temporal head trauma he initiated auditory/verbal hallucinations and subsequently developed paranoid delusions. The electroencephalography showed slow bilateral temporal activity and the neuropsychological testing showed several impairments. The patient improved with olanzapine at a dosage of 20 mg daily. Results: This case shows the difficulty of differential diagnosis between schizophrenia and psychotic disorder due to traumatic brain injury. Conclusions: The authors conducted a revision of literature about the diagnosis, epidemiology, clinical aspects, laboratory and structural investigations and the treatment of this condition. Based on this revision work, the authors sketch some recommendations about the work-up that should be done when faced with this diagnostic hypothesis.