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Understanding Neurocognitive Disorder Due to Traumatic Brain Injury

Neurocognitive disorder due to traumatic brain injury is a mental health condition that sometimes arises in the long-term aftermath of a physical injury that results in brain damage. The American Psychiatric Association (APA) classifies this condition along with other types of neurocognitive disorder in the reference text for mental health professionals called the Diagnostic and Statistical Manual of Mental Disorders. Some people affected by neurocognitive disorder due to traumatic brain injury experience symptoms that are severe enough to degrade their ability to lead independent lives, while others experience milder symptoms and retain most of their day-to-day mental function.

Traumatic Brain Injury Basics

Traumatic brain injury (TBI) is the general term for any form of damage to the brain’s tissues that stems from significant, abrupt impacts to the head. Depending on individual circumstances, such an injury can come in mild, moderate or severe form. Mild TBIs (concussions) produce a loss of consciousness that lasts for less than half an hour, or fail to produce loss of consciousness at all, the Alzheimer’s Association explains. Moderate TBIs produce a loss of consciousness that lasts for 30 minutes to 24 hours. Severe TBIs produce a loss of consciousness that lasts for longer than one full day. In addition to short-term unconsciousness, common symptoms of a mild traumatic brain injury include dizziness, headaches, disorientation, blurry vision, abnormal fatigue, ear ringing, unusual sleepiness, speaking difficulties, moodiness, memory disruption, an inability to concentrate or think clearly, and displays of uncharacteristic behavior. People with moderate or severe TBIs typically experience these same symptoms in an increasingly intensified form. Additional symptoms associated with a moderate or severe TBI include seizures, persistent or worsening headaches, recurrent vomiting, abnormal pupil dilation, notable slurring of words, numb or weakened limbs, impaired muscle coordination, unusually agitated or restless states of mind, and a failure to wake up after falling asleep. Initial treatment for a traumatic brain injury typically centers on stabilizing the patient and taking steps to limit the potential for worsening or long-term brain damage. People with severe TBIs frequently require some sort of surgery to address the effects of their injuries. Potential lingering or permanent problems that can arise in the aftermath of a traumatic brain injury include impaired higher-level reasoning skills, impaired communication or motor skills, stupor and coma.

Neurocognitive Disorder Due to Traumatic Brain Injury

Neurocognitive disorder due to a traumatic brain injury comes in both major and mild forms. People with the major form of the disorder have symptoms that the general public commonly refers to as dementia (including such things as memory problems, a declining ability to think logically, and a declining ability to make decisions or control one’s behavior). Up until May 2013, the American Psychiatric Association also used the term dementia when referring to these symptoms. However, as part of a series of changes made in the new fifth edition of the Diagnostic and Statistical Manual (DSM 5), the APA decided to stop using dementia as a diagnostic term and replace it with major neurocognitive disorder. People with mild neurocognitive disorder due to a traumatic brain injury don’t have dementia-like symptoms; instead, they have less dramatic changes in their mental function that can worsen over time. Mild, moderate and severe traumatic brain injuries all have the potential to produce a neurocognitive disorder. People who experience moderate or severe TBIs increase their lifelong chances of developing Alzheimer’s disease or some other dementia-producing condition by 100 percent to 300 percent, according to the results of a study review published in 2012 in the Archives of Neurology. While no scientific evidence supports a link between a single mild traumatic brain injury and increased future risks for neurocognitive disorder, people who experience multiple mild TBIs apparently have increased risks for a specific dementia-producing condition known as chronic traumatic encephalopathy. Fairly common activities that can lead to repeated episodes of mild TBI include participation in football, boxing, soccer or hockey.

Considerations

Some people may have a specific genetic variation in their brains that increases their risks for developing major neurocognitive disorder due to traumatic brain injury (TBI dementia), the Alzheimer’s Association reports. In addition, current research shows that Alzheimer’s disease and traumatic brain injury may both produce similar neurocognitive disorder-promoting changes in basic brain chemistry. Generally speaking, the nature of the treatment used to combat TBI-related neurocognitive disorder varies according to the specific dementia-producing condition present in any given individual.

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