Alcohol, head injury, and neuropsychological function

Abstract

Evidence is reviewed indicating that the extent of alcohol abuse alone cannot account for the neuropsychological deficits observed in alcoholics, and that alcohol abuse and head injury may interact in some patients to influence neuropsychological status. Alcohol abuse both increases the risk for head trauma and potentiates the resulting brain injury, which can lead to negative neuropsychological consequences. Clinicians involved in the treatment of addiction should assess patients for history of head injury, and neuropsychological deficits consequent to both head injury and ethanol. These deficits may limit patient ability to comply with addiction rehabilitation programs. Conversely, clinicians in acute care and rehabilitation of the sequelae of head trauma should routinely assess their patients for substance abuse, because such abuse can have a significant impact on recovery from brain injury.

Executive Functioning Early in Abstinence From Alcohol

“…Given the high rates of head injury among abusers of alcohol (Solomon and Malloy, 1992), we included participants with this history (if not severe) and recorded its presence and severity to evaluate any effect on our outcome analyses. Head injury was reported in 33% of the controls and in 52% of the substance abuse patients.…”

“…In general, alcohol-related cognitive impairment seems to attenuate over time after cessation of drinking (De Soto et al, 1985;Grant et al, 1987;Munro et al, 2000;Reed et al, 1992), although factors such as age (Munro et al, 2000;Rourke and Grant, 1999), poor nutrition (Lotfi and Meyer, 1989;Skinner et al, 1989), and medical comorbidity (Adams and Grant, 1986;Edwin et al, 1999;Solomon and Malloy, 1992) seem to diminish the extent and prolong the time course of recovery. There is gathering evidence that executive functioning may also recover with the cessation of drinking, though systematic studies have been lacking.…”

Alcohol abuse in individuals exposed to trauma: A critical review.

“…As these latter two issues are not a focus of this article, the interested reader is referred to reviews on the associations between alcohol abuse and stressful life events (Beckman, 1976;Benson & Wilsnack, 1983;Straussner, 1985 ) and alcohol abuse and physical trauma (Solomon & Malloy, 1992). Although con-I thank Richard J. McNally and Robert O. Pihl for their helpful comments on drafts of this article.…”

Neuropsychological Impairment and Relapse following Inpatient Detoxification in Severe Alcohol Dependence

“…That is, this group is more likely to experience deficits in executive dysfunction due to their long drinking history and severity of dependence. With the large prevalence of head trauma in alcohol dependence, it is also likely this group may have been more susceptible to the damaging effects of alcohol misuse (Solomon and Malloy 1992).…”