From Falls to Frontal Lobe Dysfunction: A Case Report on the Neurodevelopmental Impact of Pediatric Traumatic Brain Injury

Abstract

This case report examines the presentation and management of late‐onset frontal lobe syndrome (FLS) following early‐life traumatic brain injury (TBI). It illustrates the diagnostic challenges of this condition and the rationale for an individualized pharmacological approach. The case focuses on a young adult male who sustained two head injuries in early childhood, the more severe being a frontotemporal trauma at age 5, with debilitating FLS symptoms, including marked emotional lability and executive function deficits, emerging at age 17. This delayed presentation, characteristic of late‐onset FLS, often complicates diagnosis and treatment. Prior to referral, the patient experienced significant interpersonal conflicts, strained family dynamics, and an inability to maintain employment due to his FLS symptoms. Recognizing the profound impact of his condition, a tailored pharmacological intervention strategy was implemented, focusing on mood stabilization and emotional regulation. This approach utilized mood stabilizers, specifically lithium and valproic acid, alongside the selective serotonin reuptake inhibitor (SSRI) paroxetine. Over follow‐up, the patient demonstrated gradual improvements across multiple domains. His emotional lability decreased, alongside improved interpersonal relationships, reduced family conflict, and a greater capacity for sustained occupational engagement. Additionally, he reported subjective improvements in his overall quality of life, experiencing greater emotional well‐being and increased self‐efficacy. This case highlights the importance of considering long‐term neurological consequences of TBI, even in the absence of immediate symptoms. It also illustrates the potential value of tailored pharmacological management within a broader multidisciplinary approach.