POST DEPLOYMENT SUBDURAL HAEMORRHAGE, POST CONCUSSION SYNDROME AND ORGANIC MOOD DISORDER IN A NIGERIAN SOLDIER: A CASE REPORT

Introduction: Traumatic Brain Injuries (TBI) is random and unpredictable complication of deployment, and its presentations vary depending on the etiological factors and perhaps frequency of exposure to such factors. Organic psychosis is a well recognized presentation of Chronic Traumatic Encephalopathy (CTE) and symptoms include mood and behavioral disturbances, progressive decline of memory and executive functioning, cognitive deficits and sometimes dementia, if early intervention is not instituted. The rationale for this report is perhaps to highlight the need for early involvement of a psychiatrist in behavioral disorders with highly suspected organic etiologies as this may significantly reduce cases of missed diagnosis.

Case Presentation: 45 year old private soldier, who returned from Operation Lafia Dole, in Maiduguri, which is code name for the counter insurgency operations against Boko Haram insurgents, referred from the 2 Brigade Medical Reception Service with complains of abnormal behavior, low mood, weepy spells, sleeplessness, with poor response to psychotropic medications. CT-SCAN revealed Subdural Hematoma with hypodense lesions. Was subsequently referred to the University of Port Harcourt Teaching Hospital (UPTH) for Burr hole draining, which was done with good outcome.

Conclusions: Psychiatric symptoms like depression, psychosis and apathy, are common in neurological disorders that affect the brain and this contributes to the suffering and disability of the patients. Diagnostic puzzle can occur which can be resolved with Neuro-imaging.