What is the pathophysiology of dementia in postconcussive syndrome (PCS)?

Updated: Jul 25, 2019
  • Author: Roy H Lubit, MD, PhD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Regarding pathophysiology, specifically of dementia after head injury, the pattern of symptoms reflects the nature of the injury and the location of tissue damage. Symptoms related to particular brain areas include the following:

  • Prefrontal cortex - Disinhibition, apathy, personality change (coarsening, flattening), decreased fluency of speech, obsessions, hypochondria, delusions

  • Basal ganglia - Depression, mania, tremor, cogwheeling, bradykinesia, obsessions, compulsions

  • Thalamus - Apathy, irritability, pathological crying, paresthesias, pain, hypersomnia

  • White matter - Apathy, lability, loss of spontaneity, transient hemiparesis or hemiplegia, bradykinesia, bradyphrenia

  • Cerebellum/pons - Mild avolition, disinhibition, cerebellar signs, loss of ability to execute motor routines automatically


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