Neuropsychology Central

[j555]

A young old male fell from a window, the patient landed on his chin, damaging the roof of the mouth and the underlying neural tissue.
Went into a coma for 3 weeks and recovering with a severe personality change. Becomes uncaring of self and others. Eats alot till he is forced to stop. Gained several pounds. Becomes violent at times. The patient is restless, distracted, and his breathing is loud and labored.

What exactly is wrong with his brain? He has no numbness, visual or hearing problems. But I'm guessing a motor problem? And his personality change is caused from what? And what areas are damaged?

[Helix]

Hello j555,

having excluded a delirant state due to somatic complications, I would check for coup-contrecoup lesions of the brainstem (coma, hypothalamic obesity? ), frontal and orbitofrontal lobes (inhibition, personality change). Damage of white matter tracks enabling communication between frontal and subcortical structures could be damaged as well. Didn't the neuropsychological testing reveal anything? Has a CT been done?

Obesities can appear in the presence of hypothalamic injury, search for "brain damage and obesities" in PubMed.

Personality change due to brain damage is a well known symptom of frontal lobe lesions. Check the literature, e.g. books by the Damasio's or articles concerning frontotemporal dementia. The orbitofrontal lobes seem to play an important role in modulating social behaviour, e.g. by surpressing unwanted acts of agression. These might stem from mere reactive emotions like frustration, uncertainty and fear which in turn cannot be canalized appropriately because of underlying cognitive deficits. Therefore, a behavioral-psychotherapeutic program by a trained clinical neuropsychologist should be considered, too.

Bye,
Helix

[j555]

what about his breathing problem