How is agitation evaluated in traumatic brain injury (TBI)?

Updated: Mar 02, 2020
  • Author: Percival H Pangilinan, Jr, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Posttraumatic agitation is common after TBI. Baguley and colleagues found that 25% of patients with TBI were classified as being aggressive during the follow-up periods in their 5-year study. [49] Furthermore, aggression was consistently associated with depression or young age at the time of injury.

Corrigan developed a 14-item instrument, the Agitated Behavior Scale (ABS), to quantify levels of agitation after TBI (see image below). [50] Bogner and colleagues found the ABS a reliable instrument for measuring agitation in patients following TBI. [51]

Agitated Behavior Scale, developed by John D Corri Agitated Behavior Scale, developed by John D Corrigan, PhD, ABPP, Professor, Department of Physical Medicine and Rehabilitation, The Ohio State University. Permission for publication granted by Dr. Corrigan.

Before posttraumatic agitation is treated, other medical conditions should be considered. After TBI, the patient may be uncomfortable, and impaired recognition and an inability to communicate are often agitating factors. Pain is a common (but often overlooked) cause of posttraumatic agitation. Combined with a diminished ability to communicate and/or an inability to cope with pain, agitation is not surprising. Furthermore, clinicians should consider the possibility of infection, electrolyte imbalance, adverse effects of drugs, psychosis, and insomnia.

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