Abstract

A.L., a 42-yr-old man has been in treatment at our out- patient clinic since 1992 suffering from psychotic manifestations following a second severe closed-head injury. The patient had his first contact with a psychiatrist 3 yr after his first severe head injury in 1962 (when 10 yr old). During his first hospitalization (in 1994) he presented with signs of affective flattening and behavioural problems and indications of borderline intellectual functioning or mild mental retardation. The patient underwent several surgical interventions. The early inter-operative period was complicated by behavioural problems and a lack of motivation. At that time his intellectual tests (WAIS) showed a decline of results to a level of 60-80 in verbal tests, with a significant decrease in performance results. However, after further surgery, his intellectual condition improved enabling him to complete a secondary-school education, get married and start work as an industrial worker. From that time onwards he had no contact with psychiatrists, nor did he receive any medication treatment.

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