Hearing voices” is not a symptom that is limited only to patients with psychosis, said a group of doctors in Switzerland. The experts described a case that illustrates how auditory hallucinations occur when there are neurological problems that affect the parts of the brain that are used to process and control speech.

The 63-year-old patient, with previous good health, suffered a brain injury in an accident with a bicycle in August 2006, reported the team of Dr. Daniela Hubl, of the University Hospital of Psychiatry in Bern. Magnetic resonance imaging (MRI) showed brain bleeding due to the rupture of an aneurysm in the left middle cerebral artery. Also, the damage was observed in the left frontal, temporal and parietal lobes.

On the third day, the team explained in the medical journal The Lancet; the patient was intervened to relieve the pressure on the brain. The woman regained consciousness seven days after the accident, with paralysis on the right side of the body and loss of speech. Both disorders responded well to rehabilitation, although the patient had problems speaking and understanding.

At the end of October, the patient’s speech condition was suddenly aggravated, and an electroencephalogram (EEG) indicated epilepsy. The problem improved with treatment, although the woman used only loose words and short sentences.

At the end of December, the patient began to have auditory hallucinations. She described them as thoughts of her own, fragments of previous conversations and voices of the hospital staff. He said that the views sounded like any other, “except that they used straightforward and short sentences,” just like their speech pattern at that moment.

The doctors performed another EEG, which showed that the patient was having a crisis in the left front temporal region of the brain. When medication was changed to drugs to control these crises, the hallucinations stopped and did not reappear at the time of his last follow-up visit in June 2007.

According to the team, the patient’s experience supports the hypothesis that auditory hallucinations “derive from internal speech incorrectly identified as coming from outside the self-due to a control error.”

Young people with brain injuries can behave violently

After a light stroke, the brain experiences long-term changes in cognition, language, and emotion.Brain injuries are one of the leading concerns of public health. Each year, 1.7 million people suffer head contusions and, although these injuries are mostly mild and their consequences imperceptible, in the long term they can alter the language or emotions, as well as increased irritability, impulsivity, and violent behaviors. This conclusion has come researchers from the University of Michigan (in the United States), who say that young people who have suffered a head injury throughout their lives are more likely to behave violently in certain situations.

Each year, 1.7 million people suffer traumatic brain injuries. Approximately 75% of these injuries are mild, and many of those injured do not receive medical attention. Lesions of this type do not interrupt brain function. However, their long-term impact can lead to changes in cognition, language, and emotions, including irritability, impulsivity, and violent behavior. The report, which appears in the current issue of Pediatrics, is one of the few studies conducted to date to examine the long-term effects of head injuries among the young population. The majority of similar investigations have been carried out among the prison population.