Format

Send to

Choose Destination
See comment in PubMed Commons below
BMJ Case Rep. 2016 Dec 21;2016. pii: bcr2016216767. doi: 10.1136/bcr-2016-216767.

Missing the point: self-inflicted traumatic brain injury in psychosis.

Author information

1
Department of Psychiatry, Yale University, New Haven, Connecticut, USA.
2
Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA.

Abstract

A 36-year-old man was brought to the emergency department by emergency medical services after being found acting unusually at a gas station with blood on his head and clothing. He presented acutely psychotic and reported that he had a pen in his head. Medical evaluation was notable for a superficial puncture wound to the right temple, and he was medically cleared for psychiatric evaluation. After he developed nausea and headache later that evening, the CT scan revealed a temporal bone fracture, pneumocephalus, intraparenchymal haemorrhage and the presence of a metal pen tip lodged in the brain parenchyma. The full nature of the injury went undiscovered in the emergency department for 16 hours due to the superficial appearance of the injury and his acute psychosis with prominent delusional thought content and disorganisation. He underwent craniotomy with removal of the pen and subsequent hospitalisation for intravenous antibiotics, followed by a prolonged psychiatric hospitalisation for psychosis.

PMID:
28003228
DOI:
10.1136/bcr-2016-216767
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center