Impact of psychiatric and neuropsychological sequelae of traumatic brain injury on the duration of legal time periods

Abstract

Introduction. In the forensic setting, diagnosis of sequels and determination of the legal periods are central to the assessment of traumatic brain injury (TBI). The analysis of the relationship between descriptors of TBI and legal periods is undertaken.

Method. Retrospective study of 50 TBI. Demographic information, severity and characteristics of the TBI, neuroimaging data, treatments, legal periods and sequels were gathered. Descriptive statistics and correlational analysis were performed.

Results. Glasgow Comma Scale was available in 47 cases but coma duration and posttraumatic amnesia only in 21. There was information on early TAC in 48 cases and followup neuroimaging (after three months) was available in 46. 26 patients received the diagnosis organic personality disorder and this correlated with longer legal periods. Affective disorder (N=6), anxiety disorder (N=5) and postconcussional syndrome (N=5) were less prevalent. Average “time in hospital” was longer than two months. “Healing time” and “disability time” were on average longer than a year. “Healing time” and “time in hospital” were longer with left sided lesions.

Conclusion. In the forensic assessment of TBI, availability of information regarding the duration of coma and posttraumatic amnesia shoud be improved. Left sided lesions and the presence of organic personality disorder predict longer legal periods. Understanding of these facts requires a more detailed analysis.