Care for patients with traumatic brain injury

Traumatic brain injury (TBI) as well as Attention Deficit Disorder with or without hyperactivity (ADHD) are very common problems that affect children. It is known that patients who suffer a traumatic brain injury may present symptoms of ADHD, which often go unnoticed in the acute period, especially when there are more serious injuries that hide them and are only evident when the patient returns to their regular cognitive activity after discharge. Symptoms can vary depending on the mechanism of injury, the location in the brain where the trauma or its effects occur, complications, and the severity of the injury. Some symptoms of TBI are identical to those of ADHD, making the diagnosis of these patients more difficult to discern either because the patient or their parents report them together or when the patient already had pre-existing ADHD. We describe some clinical scenarios in this article in which there is an interaction between these two processes that are explained in part because both can affect similar nerve conduction pathways and neurotransmitters. The clinician must recognize attention problems in patients with TBI and other presentations and offer appropriate and timely treatment when symptoms interfere with the patient's functioning. Treatment of ADHD in patients with TBI uses accommodations and medications similar to those used in patients who only have ADHD, but depending on the severity, they can vary in duration.