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Agitation/Aggression/Apathy After Brain Injury

Condition: Agitation, aggression, and apathy (lack of motivation) are seen in many people who have had a traumatic brain injury (TBI) or who have other brain disorders, such as stroke and dementia.

Background: Between a quarter and half of patients with TBI or dementia become agitated or aggressive. Apathy is seen in about a third of stroke patients and most patients with Alzheimer’s disease. The symptoms seem to be caused by damage to certain parts of the brain. 

Risk Factors: Agitation and aggression are more common in people with a history of substance abuse, depression, or other problem behaviors.

History and Symptoms: Brain injured patients usually become less agitated as they recover from their injury. With dementia, agitation and aggression may increase as the disease gets worse.   

Physical Exam: The doctor will take a detailed health history and check all systems in the body to rule out other problems that could be causing agitation or aggression. Testing how well the patient can do certain tasks may also help the doctor understand what is causing the behaviors.   

Diagnostic Process: Blood tests, and sometimes tests of the spinal fluid, will be done to look for infections or chemical changes in the body that might be causing agitation or aggression. Brain imaging may also be ordered. Rating scales are also used to show how severe the problems are.   

Rehab Management: Some symptoms will improve by keeping the patient in a quiet, relaxed place and limiting contact with others. Occupational, physical, and recreational therapy may also be helpful. In some cases, drugs are also used to treat symptoms.

Other Resources for Patients and Families: Education helps families understand what is happening and how to deal with, and possibly reduce, these behaviors.

For Patients and Families:

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