Article

Soldiers with a traumatic brain injury (TBI) present with an array of
neuropsychiatric symptoms that can be grouped into nosological clusters: (1)
cognitive dysfunctions: difficulties in memory, attention, language, visuospatial
cognition, sensory-motor integration, affect recognition, and/or executive
function typically associated with neocortical damage; (2) neurobehavioral
disorders: mood, affect, anxiety, posttraumatic stress, and psychosis, as well as
agitation, sleep problems, and libido loss, that may have been caused by damage
to the cortex, limbic system, and/or brain stem monoaminergic projection systems;
(3) somatosensory disruptions: impaired smell, vision, hearing, equilibrium,
taste, and somatosensory perception frequently caused by trauma to the sensory
organs or their projections through the brain stem to central processing systems;
(4) somatic symptoms: headache and chronic pain; and (5) substance dependence.
TBI-related cognitive impairment is common in veterans who have served in recent
conflicts in the Middle East and is often related to blasts from improvised
explosive devices. Although neurobehavioral disorders such as depression and
posttraumatic stress disorder commonly occur after combat, the presentation of
such disorders in those with head injury may pass undetected with use of current
diagnostic criteria and neuropsychological instruments. With a multidimensional
approach (such as the biopsychosocial model) applied to each symptom cluster,
psychological, occupational, and social dysfunction can be delineated and
managed.

Langue : ANGLAIS