The Connection between Traumatic Brain Injury (TBI) and Attention-Deficit/Hyperactivity Disorder, Therapeutic Approaches

Abstract

A Traumatic Brain Injury (TBI) is an injury to the brain caused by an external force (vehicle, accidents, violence, sports injuries, industrial accidents, falls). Brain trauma can occur either from an object penetrating the skull or from rapid acceleration (speeding up), or deceleration (slowing down or stopping suddenly) of the brain. Traumatic Brain Injury (TBI) is a major cause of mortality and disability, especially in children and young adults. Based on the Glasgow Coma Scale (GCS), the neurological scale used to measure a person’s level of consciousness after a brain injury, traumatic brain injury is classified as: mild (GCS 13 - 15), moderate (GCS 9 - 12), severe (GCS 8 or less), and evaluates the following functions: Eye Opening (E), Motor Response (M), and Verbal Response (V), to determine a patient’s overall GCS, add together the scores from eye opening, motor response and verbal response. Scores range from 3 to 15. A score of 8 or less signifies coma. Symptoms can vary depending on the severity of the head injury. An individual with a mild traumatic brain injury can remain conscious, or may experience a loss of consciousness for a few seconds or minutes. Other symptoms may include headache, confusion, dizziness, vision changes, ringing in the ears or changes in hearing, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and cognitive and/or executive functioning problems. People with a moderate or severe traumatic brain injury may show the same symptoms, but may also have a headache that gets worse, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation. Attention-Deficit/Hyperactivity Disorder secondary to Traumatic Brain Injury (TBI) is one of the most common neurobehavioral consequences of Traumatic Brain Injury (TBI), occurring in 20% to 50% of individual’s post-injury ( Irastorza, 2011 ). Some of the most persistent problems include impairment in memory, attention and concentration, language, executive skills, social judgment, social behavior, and impulsiveness. Previous studies have shown that Traumatic Brain Injury (TBI) is a major cause of mental health problems and increases the risk of Attention-Deficit/Hyperactivity Disorder ( Schachar et al., 2015 ). According to studies ( Ilie et al., 2015 ), physical brain injury contributes to the development of Attention-Deficit/Hyperactivity Disorder. Because the risk of Attention-Deficit/Hyperactivity Disorder development after Traumatic Brain Injury (TBI) remains high over an extended period, and some of the most persistent problems include impairment in memory, attention and concentration, language, executive skills, social judgment, social behavior, and impulsiveness; this master thesis shows the importance of an early prompt intervention after brain injury, and the need to establish a therapeutic plan in order to treat the Attention-Deficit/Hyperactivity Disorder development and evolution. The purpose of the present study is to investigate the association between Traumatic Brain Injury (TBI) and Attention-Deficit/Hyperactivity Disorder, and also to show the importance of prompt intervention and preventive therapy in order to stop the Attention-Deficit/Hyperactivity Disorder development and evolution.