Neuropsychiatry of Traumatic Brain Injury (TBI) – Pathogenesis, Comorbidity and Treatment
Phineas Gage in 1848 suffered a terrible accident that resulted in an iron rod driven into his left frontal lobe after he placed the iron on an explosive device. Despite the seriousness of the injury, he was able to walk up to a cart which took him to the hospital.
Following this, he showed a pronounced change in personality and behaviour changing from a responsible and social well-adapted man to being becoming disrespectful, lacking in social skills, irresponsible and soon lost his job.
Traumatic brain injury (TBI) is called the silent epidemic as many of the symptoms are not readily detectable despite TBI being a worldwide public health issue.
Epidemiological studies in the US show that annually up to 2 million people experience a traumatic brain injury (TBI). Of these, almost 300,000 are hospitalised, and over 50,000 will die from their injuries. 
Trauma registries show that approximately 5.3 million Americans are living with TBI-related disabilities. 
The 2010 Global Burden of Disease survey shows that in most countries, motor vehicle accidents are the most prevalent cause of TBIs. 
In regions of the world that are currently experiencing fighting and hostilities (Central America, the Middle East and Central Africa), military combat is the most prevalent cause of TBI. 
This article does not cover chronic traumatic encephalopathy (CTE), a syndrome characterised by a range of mood, behavioural and cognitive symptoms described in boxers and other sportspeople who have sustained repetitive acceleration-deceleration forces to the brain . We will cover this in another article.