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A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis
Journal article   Open access   Peer reviewed

A Sub-acute Cerebral Contusion Presenting with Medication-resistant Psychosis

Ashley N. Rubin, Eduardo D. Espiridion and Daniel H. Lofgren
Curēus (Palo Alto, CA), v 10(7), e2938
06 Jul 2018
PMID: 30202669
url
https://doi.org/10.7759/cureus.2938View
Published, Version of Record (VoR) Open

Abstract

General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
The most common symptoms of a cerebral contusion include headache, dizziness, concentration problems, and memory loss. Insomnia is reported by more than half of the patients and can exacerbate symptoms. A 24-year-old previously healthy male presented with psychosis, acute personality changes, auditory and visual hallucinations three weeks after falling 15 feet with concurrent head trauma. A right-sided cerebral contusion with concussion was diagnosed on initial admission with increasing homicidal and suicidal ideations after 26 hours of insomnia. The patient accomplished rest after seven days of medication-resistant insomnia with the final combination of ziprasidone and lorazepam. After one night of sleep, the patient was alert and oriented with normal mood, affect, and cognition. The insomnia appeared to exacerbate this patient's symptoms, and an atypical insomnia treatment regimen was required to induce somnolence and restore function in this patient. The combination of this abnormal patient presentation along with the unorthodox medication regimen makes this case unique compared to other traumatic brain injury symptoms and treatments.

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Web of Science research areas
Clinical Neurology
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