Medicina legal

 
|REV CHIL NEURO-PSIQUIAT 2006; 44(3): 178-186 |
|Artículo Original |
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|Trastorno por estrés postraumático (TEPT) en pacientes con traumatismo encéfalo craneano (TEC) |
|Post-traumatic stress disorder in patients following traumatic brain injury |
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|César Carvajal A.1, Allister Gibbons F.2, Beatriz Casanova M.2 y Carmen Gloria Carbonell M.3 |
|1 Facultad de Medicina, Universidad de los Andes. Santiago, Chile. |
|2 Licenciados en Medicina. Universidad de los Andes, Santiago Chile.|
|3 Psicóloga. Servicio de Salud Mental, Hospital del Trabajador de Santiago, Chile. |
|Dirección para correspondencia |
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|Introduction: Controversy exists as to whether post-traumatic stress disorder (PTSD) may occur after traumatic brain injury (TBI). |
|Objective: To describe the clinical presentation and course of a group of patients that developed PTSD following a work-related TBI. |
|Methods: Clinical records of patients with PTSD treated inHospital del Trabajador between years 1987 and 2001 were examined. Those |
|cases in which a TBI had occurred were selected and compared with those in which a TBI had not preceded the PTSD. Results: 32 patients|
|were identified as suffering PTSD preceded by TBI. All patients had suffered mild TBI; 62.5% of them as a result of a traffic |
|accident. On average, patients were referred formental health consultation 70 days after TBI had occurred, and 31.2% of them received|
|specialized treatment for less than three months. When discharged 25% were asymptomatic. When compared with 453 patients suffering |
|PTSD, with no history of previous TBI, treated during the same period, those who had suffered TBI presented a greater proportion of |
|physical lesions, more prolongedtreatment periods, and a greater proportion of them were still symptomatic when discharged. |
|Discussion: In a group of patients suffering PTSD, history of mild TBI was a factor associated with a worse prognosis. |
|Key words: Traumatic brain injury, loss of consciousness, post-traumatic stress disorder, head injury. |
|RESUMEN|
|Se ha discutido la aparición del TEPT en pacientes que han presentado un TEC. Aunque algunos autores señalan que ambos diagnósticos no|
|pueden coexistir (ya que la amnesia post TEC impediría el procesamiento de la experiencia traumática), otros refieren que no existen ||diferencias en cuanto a la frecuencia y clínica del diagnóstico de TEPT al comparar pacientes con y sin TEC. Objetivos: Describir las |
|características clínicas y terapéuticas en un grupo de pacientes accidentados del trabajo que han presentado un TEPT después de un |
|TEC. Método: Se revisaron las fichas clínicas de todos los pacientes con diagnóstico de TEPT entre los años 1987 y 2001, se...