Project BRAIN: Working Together to Improve Educational Outcomes for Students With Traumatic Brain Injury

Children and youth who sustain traumatic brain injury (TBI) are at risk for being unidentified or misidentified and, even if appropriately identified, are at risk of encountering professionals who are ill-equipped to address their unique needs. A comparison of the number of people in Tennessee ages 3–21 years incurring brain injury compared to the number of students ages 3–21 years being categorized and served as TBI by the Department of Education (DOE) motivated us to create this program. Identified needs addressed by the program include the following: (a) accurate identification of students with TBI; (b) training of school personnel; (c) development of linkages and training of hospital personnel; and (d) hospital-school transition intervention. Funded by Health Services and Resources Administration (HRSA) grants with support from the Tennessee DOE, Project BRAIN focuses on improving educational outcomes for students with TBI through the provision of specialized group training and ongoing education for educators, families, and health professionals who support students with TBI. The program seeks to link families, hospitals, and community health providers with school professionals such as speech-language pathologists (SLPs) to identify and address the needs of students with brain injury.

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Transcranial Doppler to Screen on Admission Patients With Mild to Moderate Traumatic Brain Injury

Neurosurgery ◽

10.1227/neu.0b013e31820cd43e ◽

2011 ◽

Vol 68 (6) ◽

pp. 1603-1610 ◽

Cited By ~ 50

Author(s):

Pierre Bouzat ◽

Gilles Francony ◽

Philippe Declety ◽

Céline Genty ◽

Affif Kaddour ◽

...

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Brain Injury ◽

Glasgow Coma Scale ◽

Pulsatility Index ◽

Area Under Curve ◽

Moderate Traumatic Brain Injury ◽

Patients At Risk

Abstract BACKGROUND: Detecting patients at risk for secondary neurological deterioration (SND) after mild to moderate traumatic brain injury is challenging. OBJECTIVE: To assess the diagnostic accuracy of transcranial Doppler (TCD) on admission in screening these patients. METHODS: This prospective, observational cohort study enrolled 98 traumatic brain injury patients with an initial Glasgow Coma Scale score of 9 to 15 whose initial computed tomography (CT) scan showed either absent or mild lesions according to the Trauma Coma Data Bank (TCDB) classification, ie, TCDB I and TCDB II, respectively. TCD measurements of the 2 middle cerebral arteries were obtained on admission under stable conditions in all patients. Neurological outcome was reassessed on day 7. RESULTS: Of the 98 patients, 21 showed SND, ie, a decrease of ≥ 2 points from the initial Glasgow Coma Scale or requiring any treatment for neurological deterioration. Diastolic cerebral blood flow velocities and pulsatility index measurements were different between patients with SND and patients with no SND. Using receiver-operating characteristic analysis, we found the best threshold limits to be 25 cm/s (sensitivity, 92%; specificity, 76%; area under curve, 0.93) for diastolic cerebral blood flow velocity and 1.25 (sensitivity, 90%; specificity, 91%; area under curve, 0.95) for pulsatility index. According to a recursive-partitioning analysis, TCDB classification and TCD measurements were the most discriminative among variables to detect patients at risk for SND. CONCLUSION: In patients with no severe brain lesions on CT after mild to moderate traumatic brain injury, TCD on admission, in complement with brain CT scan, could accurately screen patients at risk for SND.

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Mild Traumatic Brain Injury: Are ED Providers Identifying Which Patients Are at Risk?

Journal of Emergency Nursing ◽

10.1016/j.jen.2011.04.006 ◽

2012 ◽

Vol 38 (5) ◽

pp. 435-442 ◽

Cited By ~ 15

Author(s):

Barbara Stuart ◽

Barbara Mandleco ◽

Russell Wilshaw ◽

Renea L. Beckstrand ◽

Sondra Heaston

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Brain Injury ◽

Mild Traumatic Brain Injury

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Mood disorders following traumatic brain injury: identifying the extent of the problem and the people at risk

Brain Injury ◽

10.1080/026990598122656 ◽

1998 ◽

Vol 12 (3) ◽

pp. 177-190 ◽

Cited By ~ 64

Author(s):

AUDREY BOWEN ◽

VERA NEUMANN ◽

MARK CONNER ◽

ALAN TENNANT ◽

M. ANNE CHAMBERLAIN

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Brain Injury ◽

Mood Disorders ◽

The People

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Injury Prevention Implications in an Ethnically Mixed Population: A Study of 764 Patients with Traumatic Brain Injury

Panamerican Journal of Trauma, Critical Care & Emergency Surgery ◽

10.5005/jp-journals-10030-1007 ◽

2012 ◽

Vol 1 (1) ◽

pp. 27-32 ◽

Cited By ~ 1

Author(s):

Ashok Parchani ◽

Kimball I Maull ◽

Nissar Sheikh ◽

Mark Sebastian

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Brain Injury ◽

Injury Prevention ◽

Motor Vehicle ◽

Demographic Data ◽

Prevention Programs ◽

Mixed Population ◽

Injury Mechanism ◽

Populations At Risk

ABSTRACT Objective We hypothesized that an analysis of the demographic profile of patients who suffered moderate and severe traumatic brain injury (TBI) would identify wide variation in injury mechanism by age and ethnicity. The objective is to utilize this data to target injury prevention programs for specific population. Methods All head injured patients admitted to the trauma ICU were studied (N = 764). Standard demographic data, nationality, and mechanism of injury were determined. All patients had moderate to severe TBI. Demographics were cross referenced with injury mechanism, nationality and age of exposure. Results Head injuries were more common in males, the expatriate population, and the age group from 21 to 40 years. Motor vehicle collision (MVC) was the most common injury mechanism followed by fall from height (FFH) with profound ethnic differences in both ages affected and populations at risk. Struck by falling objects (SFO) was the third most common injury mechanism. TBI mortality improved over the period of study, declining from 21 to 17%. Conclusion Prevention or reduction in TBI severity has profound implications for improving public health and reducing TBI-related health care costs. The defining of populations at risk by nationality, injury mechanism and peak age of exposure can provide a model for coordinated regional or national injury prevention programs. How to cite this article Parchani A, Maull KI, Sheikh N, Sebastian M. Injury Prevention Implications in an Ethnically Mixed Population: A Study of 764 Patients with Traumatic Brain Injury. Panam J Trauma Critical Care Emerg Surg 2012; 1(1):27-32.

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