Mild or Major Neurocognitive Disorder Due to Traumatic Brain Injury

Dementia includes symptoms of cognitive decline which is mainly characterised by memory impairment.  When dementia is a direct result of head trauma the category of Mild or Major Neurocognitive Disorder (NCD) Due to Traumatic Brain Injury is provided to the patient.  

Major neurocognitive disorder includes a significant decline from a previous level of performance in either complex attention, executive function, learning and memory, language, perceptual-motor, or social cognitive based on concern of a person who knows the informant or the clinical; and the impairment is documented by a standardised neuropsychological test or another quantified clinical assessment.   Lastly the cognitive deficit is not better explained by another medical condition.  On the other hand, mild neurocognitive disorder is when the person has a modest cognitive decline from a previous level of performance and the deficits does not interfere with the ability to be independent but needs greater effort or compensatory strategies are needed to cope.  

The criteria for Mild or Major  (NCD) that is mentioned above needs to be met for the diagnosis of mild or major NCD due to traumatic brain injury to be provided.  However the evidence of traumatic brain injury precedes the NCD symptoms either immediately after the brain injury or immediately after recovery of consciousness that persists.

Traumatic brain injury is an impact to the head that can cause loss of consciousness, post traumatic amnesia, disorientation and confusion, neurological signs (e.g., seizures, visual field cuts).  

The symptoms of Mild or Major (NCD) Due to Traumatic Brain Injury include aphasia, attentional problems, increased aggression, apathy, affective lability, irritability, anxiety, depression, or other changes in personality.  The person with have a variety of behavioural symptoms with or without motor or sensory deficits.  

Sports people such as footballers or boxers usually receive the diagnosis of Dementia due to Head Trauma.  Sometimes symptoms of dementia will occur years after the head trauma.  If it is one blow to the head, then the diagnosis not is progressive, however several blows will cause progressive neurodegeneration.  People with head trauma are usually risk takers.  

​Source:
​American Psychiatric Association. (2013). Neurocognitive disorders. In Diagnostic and Statisical Manual of Mental Disoders DSM-5 (pp. 591-643). Arlington, VA: American Psychiatric Association.