Head injury, dissociation and the Ganser syndrome

To describe the clinical characteristics and psychiatric correlates of the Ganser syndrome following mild traumatic brain injury (TBI).

A retrospective chart review of patients with mild TBI assessed in a tertiary care outpatient clinic.

Of 513 patients reviewed in a 1 year period, four subjects with a diagnosis of Ganser syndrome, with the hallmark syndrome of approximate answers ('vorbeigehen') were identified. In three of these patients, symptoms of Acute Stress Disorder (ASD) and/or Post-traumatic Stress Disorder (PTSD) were found. Only one patient was pursuing litigation.

While no epidemiologic conclusions can be drawn from the data, clinicians should, nevertheless, be alert to the possibility of patients presenting with Ganser syndrome following TBI. The findings are discussed in the light of data linking the syndrome to dissociative and post-traumatic stress related disorders.