BRAIN INJURY & CRIMINAL BEHAVIOR Introduction

Traumatic brain injury (TBI) accounts for the single most important cause of neurological morbidity and mortality in the United States population under the age of 40. Severe TBI results in nearly 40 percent mortality and only 30 percent to 40 percent return to normal neurological functioning after serious brain injury. Subdural hematoma is the most lethal head trauma; diffuse axonal injury is the second most lethal head trauma. Minor brain injuries can result in a post-concussive syndrome with psychiatric manifestations of reactive depression, suicidal, and homicidal behavior (Diaz, p. 131; & Imao, 1996, p. 324).

TBI effects approximately two million Americans annually at an overall cost of around 38 billion dollars. Problems associated with TBI include headache, fatigue, impaired memory, concentration, attention, and information processing, depression, aggression, anxiety, irritability, sleep disturbances, and sexual problems. Personality and behavioral changes are the most common concern. From six months to two years after injury, TBI p

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ead injuries present symptoms of memory loss, dizziness, and confusion. Neuropsychological deficits are not found to be lasting, despite somatic complaints (Diaz, pp. 134-135). TBI can be followed by abnormalities that range from simple and limited to states of permanent coma. Mental diseases may follow a severe head injury. Obsessive-compulsive neurosis, bi-polar manic depressive disorders, and severe manic disorder described as schizoaffective have been demonstrated. In a study of 1,250 inmates, half of whom were violent criminal offenders, it was found that 57 percent of a random sample of 333 subjects, had bilateral EEG abnormalities in the frontal lobes (sample had no other major neurological abnormalities). Only 12 percent of the non-violent inmates had comparable EEG abnormalities (Diaz, p. 136). Studies show that acquired brain dysfunction results in antisocial behavior. Patients are irritable with temper outbursts and decreased self-control. Spouses become verbally abusive or threaten with physical violence. Patients described as ill-tempered or irritable do not tend to change over time, threats of violence may increase. Relatives have been assaulted and patients may to be in trouble with the law. In a study
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