Dramatic neurobehavioral disorder in two cases following bilateral anteromedial frontal lobe injury: Delayed psychosis and marked change in personality

This paper describes two cases of closed head injury causing bilateral frontal lobe contusions that resulted in enduring changes in self-control, perception, mood and cognition. In the first case the primary feature was delayed-onset psychosis. In the second case the patient developed mood lability, poor impulse control, a dramatic change in personality and impaired cognition. Midline, anterior frontal regions were most severely affected in both cases. The diagnostic evaluation and the clinical course are described. The neuropsychiatric syndromes are discussed with reference to lesion location and the literature on the neurobehavioral sequelae of closed head injury.