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Dissociative Flashbacks After Right Frontal Injury in a Vietnam Veteran With Combat-Related Posttraumatic Stress Disorder

Received March 3, 2000; June 27, 2000; accepted July 7, 2000. From the Department of Medicine and Dermatology, University of Málaga, Spain, and the Service of Nuclear Medicine. Department of Radiology, Carlos Haya University Hospital, Málaga, Spain. Address correspondence to Dr. Berthier, Facultad de Medicina, Departamento de Medicina y Dermatología, Universidad de Málaga, Campus Universitario Teatinos 29071, Málaga Spain. E-mail: mberthier{at}telenet.es

ABSTRACT

A Vietnam veteran with a combat-related posttraumatic stress disorder developed recurrent dissociative flashbacks (related to the atrocities of a specific war incident) several months after suffering a traumatic brain injury. CT disclosed a small lesion in the right dorsolateral prefrontal cortex. SPECT demonstrated more extensive functional changes in prefrontal and anterior paralimbic brain regions, mainly in the right hemisphere. This case further implicates the provocative effect of physical stimuli (brain damage) in reawakening old dormant memories and the preferential role of the right hemisphere for the storage of traumatic memories.

Key Words: Posttraumatic Stress Disorder • Anxiety • Memory

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