Head injury, dissociation and the Ganser syndrome

Objective: To describe the clinical characteristics and psychiatric correla tes of the Ganser syndrome following mild traumatic brain injury (TBI). Method: A retrospective chart review of patients with mild TBI assessed in a tertiary care outpatient clinic. Results: Of 513 patients reviewed in a 1 year period, four subjects with a diagnosis of Ganser syndrome, with the hallmark syndrome of approximate ans wers ('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. Conclusions: While no epidemiologic conclusions can be drawn from the data, clinicians should, nevertheless, be alert to the possibility of patients p resenting 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.