Fifteen years after sustaining a traumatic brain injury (TBI) with three-week loss of consciousness while serving in the military, a 38-year-old male presenting as a female entered a hospital emergency department exhibiting self-inflicted injuries. The wounds were consistent with the literature on vampirism and autovampirism, and brain imaging showed focal damage to the patient’s bilateral frontal lobes.

A report on the case, lead-authored by William M. Hervey, MD, a psychiatrist at the James A. Haley Veterans Hospital in Tampa and an assistant professor of behavioral sciences at the University of South Florida, was published online June 16 in World Journal of Clinical Cases.

“The patient reported that she began chewing the inside of her mouth to ingest blood after sustaining the TBI at age 23,” write Hervey and colleagues. “She reported the self-laceration beginning after her discharge from the military at age 27. She noted that her desire for blood progressively increased from age 23 to approximately age 33 when it reached its current level.”

The authors report that, after the patient was referred for outpatient psychiatric treatment following treatment in the emergency room, a CT scan revealed extra-axial cerebrospinal fluid bilaterally over her frontal lobes, indicating a focal loss of cortical volume.

A follow-up MRI confirmed the focal loss of cortical volume, although it produced no pertinent additional findings.

In their discussion, the authors note that the patient had a long history of pre-injury vampiristic thoughts and interests but never acted on these thoughts until after sustaining the TBI.

“It is possible that the TBI decreased our patient’s inhibitions regarding the vampiristic actions, allowing her to initiate these behaviors,” they conclude. “While TBI has not previously been associated with vampirism, it has been associated with disinhibition. As TBIs are becoming increasingly common worldwide, it is possible that we will see an increase in behavioral disinhibition in those patients who have had such an injury.”

This possibility “underlines the importance of spending time with our patients who have suffered a TBI,” the authors write, “to discover and better understand the behavioral changes associated with their injury and initiate needed treatments as early as possible.”

To read the full case report, click here.