A case is described of a policeman who assaulted the man he was arresting after receiving a concussive blow to the head. The defence argued he was suffering from post-traumatic automatism and after juries were unable to agree a verdict in two trials he was acquitted. Aspects of post-traumatic automatism in English law are described and theories of the neurology of concussion and aggressive behaviour are discussed. Guidelines are proposed for the evaluation of cases of post-traumatic automatism.
Get full access to this article
View all access options for this article.
References
1.
AdamsJ. H.GrahamD. I.ScottG.ParkerL. S.DoyleD. (1980) Brain damage in fatal non-missile head injury. J. Clin. Pathol.33, 1132–45.
2.
BakerA. J.MoultonR. J.MacMillanV. H.SheddenP. M. (1993) Excitatory amino acids in cerebrospinal fluid following traumatic brain injury in humans. J. Neurosurg.79, 369–72.
3.
BlairD. (1977) The medicolegal aspects of automatism. Med. Sci. Law17, 167–82.
4.
FenwickP. (1986) Aggression and epilepsy. In: TrimbleM. R.BolwigT. G. (eds.) Aspects of Epilepsy and Psychiatry. Chichester, John Wiley, pp. 31–57.
5.
FenwickP. (1990) Automatism, medicine and the law. Psychol. Med. Monogr.Suppl. 17, 1–27.
6.
HamillR. W.WoolfP. D.McDonaldJ. V.LeeL. A.KellyM. (1987) Catecholamines predict outcome in traumatic brain injury. Ann. Neurol.21, 438–43.
7.
LeDouxJ. E. (1992) Emotion and the amygdala. In: AggletonJ. P. (ed.) The Amygdala: neurobiological aspects of emotion, memory, and mental dysfunction. New York, Wiley-Liss.
8.
LevinH. S.WilliamsD. H.EisenbergH. M.HighW. M.GuintoF. C. (1992) Serial MRI and neurobehavioural findings after mild to moderate closed head injury. J. Neurol. Neurosurg. Psychiat.55, 255–62.
9.
LishmanW. A. (1987) Organic Psychiatry. Oxford, Blackwell Scientific Publications.
10.
McCaldonR. J. (1964) Automatism. Can. Med. Assoc. J.91, 914–20.
11.
McGuireP. K.ShahG. M. S.MurrayR. M. (1993) Increased blood flow in Broca's area during auditory hallucinations in schizophrenia. Lancet342, 703–6.
12.
NilssonP.HilleredL.PontenU.UngerstdetU. (1990) Changes in cortical extracellular levels of energy-related metabolites and amino acids following concussive brain injury in rats. J. Cereb. Blood Flow Metab.10, 631–7.
13.
OmmayaA. K.GennarelliT. A. (1975) Experimental head injury. In: VinkenP. J.BruynG. W. (eds.) Handbook of Clinical Neurology, Vol. 23. Amsterdam, North Holland Publishing Company, pp. 67–90.
14.
ParkinsonD. (1992) Concussion is completely reversible; an hypothesis. Med. Hypotheses37, 379.
15.
Ritchie RussellW. (1932) Cerebral involvement in head injury. Brain55, 549–603.
16.
RosnerM. J.NewsomeH. H.BeckerD. P. (1984) Mechanical brain injury: the sympathoadrenal response. J. Neurosurg.61, 76–84.
17.
SchwartzM. L.HudsonA. R.FernieG. R.HayashiK.ColecloughA. A. (1986) Biomechanical study of full-contact karate contrasted with boxing. J. Neurosurg.64, 248–52.
18.
SiegelAShaikhM. B. (1992) Neurotransmitters and aggressive behavior: some new perspectives. In: StrongmannK. T. (ed.) International Review of Studies on Emotion, Vol 2.
19.
UnterharnscheidtF. J. (1975) Injuries due to boxing and other sports. In: VinkenP. J.BruynG. W. (eds.) Handbook of Clinical Neurology, Vol. 23. Amsterdam, North Holland Publishing Company, pp. 527–93.