Die psychischen Störungen nach Hirntraumen: Akute traumatische Psychosen und psychische Spätfolgen nach Hirnverletzungen

Neuropsychological studies of the frontal lobes.

“…Because of the large size and comparatively great distance from essential, more cen-trally located brain structures, significant frontal damage is often compatible with life, leaving the person behaviorally disturbed but otherwise relatively intact. The literature contains many excellent descriptions of such individuals (Faust, 1960;Feuchtwanger, 1923;Kleist, 1934a) and a great deal of the knowledge of frontal lobe psychiatric symptomatology stems from this source (Lishman, 1966). It must be recognized, however, that brain injury is never totally focal, and the wide variety of both neighborhood and distant symptomatology contaminating these studies represents another source of confusion in the clinical descriptions of frontal phenomenology.…”

“…Many descriptions of frontal lobe personality changes came from the physicians who cared for the brain-injured of the two World Wars. Sizeable numbers of individuals survived with major frontal lesions, and their residual psychiatric and personality disorders were carefully recorded (Faust, 1960;Kleist, 1934a;Lishman, 1966). Again, large lists of symptoms were presented by most authors but some grouping by phenomena was done.…”

On Organically Based Hallucinatory-Delusional Psychoses

“…This must be looked into spe cially carefullly, as our patients stood out precisely due to their affective changes. Con ditions were described of shorter lasting manic excitation [9,13,42,43,46], up to chronic expansive and confabulatory psy choses [13,42,46], syndromes of suggestion and happiness, and states of depressive stu por [42,47,48] [29], a euphoric discord can be in duced by damage to the diencephalon. Some of the manic-type psychoses were marked by a tendency to fantastic confabulations [42], In this connection, case 5 from Elsässer and Grünewald [12], after a grenade splinter wound to the basal temporal lobe near the basal ganglia, thought he had a fortune of 7,000 million, had shattered the stratosphere with atoms and had placed the sun and moon directly facing each other.…”