The records of 34 patients who showed evidence of emotional
deterioration 6 months or more following traumatic brain injury were
compared with a group of patients matched for severity of initial
neuropsychiatric impairment who did not show deterioration. The
deterioration group was more likely to have been involved in assaults and
less likely to have been involved in a motor vehicle accident than the
improvement group. The deterioration group was also more likely to have a
prior history of alcohol abuse and to have sustained a skull fracture with
left parietal lobe injury than the improvement group. Agitation, hostility,
apathy, lability of mood, emotional withdrawal, and depression were the
symptoms most likely to worsen over time. This deterioration may have been
due to premorbid personality characteristics or to the nature of long-term
neuronal response to injury.
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