13 Management of Concurrent Traumatic Brain Injury and Spinal Injury

2018 ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Spinal Injury

scholarly journals NEW MECHANICS OF SPINAL INJURY

2009 ◽  
Vol 01 (02) ◽  
pp. 387-401 ◽  
Author(s):  
VLADIMIR G. IVANCEVIC
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tissue Injury ◽  
Spinal Injury ◽  
Medical Science ◽  
Soft Tissue Injury ◽  
Intervertebral Discs ◽  
Hard Tissue ◽  
Skeletal Injury ◽  
Prediction And Prevention

The prediction and prevention of spinal injury is an important aspect of preventive medical science. The spine, or vertebral column, represents a chain of 26 movable vertebral bodies, joint together by transversal viscoelastic intervertebral discs and longitudinal elastic tendons. This paper proposes a new locally–coupled loading–rate hypothesis, which states that the main cause of both soft- and hard-tissue spinal injury is a localized Euclidean jolt, or SE(3)-jolt, an impulsive loading that strikes a localized spinal section in several coupled degrees-of-freedom simultaneously. To show this, based on the previously defined covariant force law, we formulate the coupled Newton–Euler dynamics of the local spinal motions and derive from it the corresponding coupled SE(3)-jolt dynamics (see our recent papers on new mechanics of traumatic brain injury [V. G. Ivancevic, New mechanics of traumatic brain injury, Cogn. Neurodyn. Springer (Online)]. and generic musculo-skeletal injury [V. G. Ivancevic, New mechanics of generic musculo-skeletal injury, Biophys. Rev. Let. (2009) (in press)]). The SE(3)-jolt is the main cause of two basic forms of spinal injury: (i) hard-tissue injury of local translational dislocations; and (ii) soft-tissue injury of local rotational disclinations. Both the spinal dislocations and disclinations, as caused by the SE(3)-jolt, are described using the Cosserat multipolar viscoelastic continuum model.

scholarly journals Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures

2020 ◽  
Author(s):  
David Häske ◽  
◽  
Rolf Lefering ◽  
Jan-Philipp Stock ◽  
Michael Kreinest
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Clinical Symptoms ◽  
Spinal Injury ◽  
Spinal Injuries ◽  
Spine Injury ◽  
Emergency Procedures ◽  
The Mean ◽  
Injured Patients

Abstract Purpose This study aimed to identify the prevalence and predictors of spinal injuries that are suitable for immobilization. Methods Retrospective cohort study drawing from the multi-center database of the TraumaRegister DGU®, spinal injury patients ≥ 16 years of age who scored ≥ 3 on the Abbreviated Injury Scale (AIS) between 2009 and 2016 were enrolled. Results The mean age of the 145,833 patients enrolled was 52.7 ± 21.1 years. The hospital mortality rate was 13.9%, and the mean injury severity score (ISS) was 21.8 ± 11.8. Seventy percent of patients had no spine injury, 25.9% scored 2–3 on the AIS, and 4.1% scored 4–6 on the AIS. Among patients with isolated traumatic brain injury (TBI), 26.8% had spinal injuries with an AIS score of 4–6. Among patients with multi-system trauma and TBI, 44.7% had spinal injuries that scored 4–6 on the AIS. Regression analysis predicted a serious spine injury (SI; AIS 3–6) with a prevalence of 10.6% and cervical spine injury (CSI; AIS 3–6) with a prevalence of 5.1%. Blunt trauma was a predictor for SI and CSI (OR 4.066 and OR 3.640, respectively; both p < 0.001) and fall > 3 m for SI (OR 2.243; p < 0.001) but not CSI (OR 0.636; p < 0.001). Pre-hospital shock was predictive for SI and CSI (OR 1.87 and OR 2.342, respectively; both p < 0.001), and diminished or absent motor response was also predictive for SI (OR 3.171) and CSI (OR 7.462; both p < 0.001). Patients over 65 years of age were more frequently affected by CSI. Conclusions In addition to the clinical symptoms of pain, we identify ‘4S’ [spill (fall) > 3 m, seniority (age > 65 years), seriously injured, skull/traumatic brain injury] as an indication for increased attention for CSIs or indication for spinal motion restriction.

Special considerations in paediatric head and spinal trauma

2019 ◽  
pp. 999-1008
Author(s):  
Andrew Kay ◽  
Desiderio Rodrigues ◽  
Melanie Sharp ◽  
Guirish Solanki
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Spinal Injury ◽  
Paediatric Population ◽  
Spinal Trauma ◽  
Unique Pattern ◽  
Injury Management ◽  
Ping Pong

This chapter focuses on the special considerations in paediatric head and spinal trauma. Anatomical, physiological, and mechanical differences in the developing paediatric brain create a unique pattern and epidemiology of traumatic brain injury and spinal injury. Management needs to be adapted to allow for such differences. Traumatic brain injury management tailored to the paediatric population will be covered. In this chapter, injuries unique to the paediatric population will be outlined including non-accidental injuries, growing fractures, and ping pong fractures. Spinal injury considerations including craniocervical and axial trauma, as well as SCIWORA in the paediatric population will also be covered here.

Venous Thromboembolism Risk and Thromboprophylaxis in Pediatric Neurosurgery and Spinal Injury: Current Trends and Literature Review

2021 ◽  
Author(s):  
Dimitrios Panagopoulos ◽  
Ploutarchos Karydakis ◽  
Georgios Noutsos ◽  
Marios Themistocleous
Keyword(s):  
Traumatic Brain Injury ◽  
Venous Thromboembolism ◽  
Brain Injury ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Patient Population ◽  
Pediatric Patients ◽  
Spinal Injury ◽  
Neurosurgical Procedures ◽  
Number Of Patients

AbstractAlthough the entities of venous thromboembolism (VTE), deep venous thrombosis, pulmonary embolus, and thromboprophylaxis in adult patients undergoing brain tumor and spine surgery, traumatic brain injury and elective neurosurgical procedures are widely elucidated, the same is not valid when pediatric patients are under consideration. An attempt to review the peculiarities of these patients through a comprehensive bibliographic review is undertaken. We performed a narrative summary of the relevant literature dedicated to pediatric patients, centered on traumatic brain injury, the general incidence of thromboembolic disease in this patient population, the role of low molecular weight heparin (LMWH) in the treatment and prophylaxis of VTE, and its role in elective neurosurgical procedures, including spinal operations. Additionally, the risk of deep venous thrombosis in elective neurosurgical procedures is reviewed. Due to inherent limitations of the current studies, particularly a restricted number of patients, our data are underpowered to give a definitive protocol and guidelines for all the affected patients. Our current conclusions, based only on pediatric patients, argue that there is limited risk of VTE in pediatric patients suffering from brain tumors and that the possibility of VTE is very low in children undergoing elective neurosurgical procedures. There is no consensus regarding the exact incidence of VTE in traumatic brain injury patients. LMWH seems to be a safe and effective choice for the “at risk” pediatric patient population defined as being older than 15 years, venous catheterization, nonaccidental trauma, increased length of hospital stays, orthopaedic (including spinal) surgery, and cranial surgery.

Neurological rehabilitation

2017 ◽  
pp. 933-940
Author(s):  
Joseph S. K. Kwan ◽  
Mona M. Y. Tse ◽  
Leonard S. W. Li
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Spinal Injury ◽  
Brain Activity ◽  
Activity Patterns ◽  
Intensive Therapy ◽  
Functional Independence ◽  
Neurological Rehabilitation ◽  
Neurocognitive Dysfunction ◽  
Neurological Injuries

Neurological rehabilitation aims to help people regain functional independence from physical and cognitive disabilities caused by neurological injuries or diseases, improving their participation in the society and quality of life. Among older patients, the more common need for neurological rehabilitation arises from acute stroke, traumatic brain injury, or spinal cord damage. There has been a recent paradigm shift in the approach of neurological rehabilitation towards promoting neural reorganization, restructure and modification of brain activity patterns (neuroplasticity). Stroke patients benefit from organized interdisciplinary care within a comprehensive stroke unit, followed by early supported discharge in the community. Early intensive therapy and prevention of complications such as infections are the key components of acute neurological rehabilitation. In the post-acute period, a problem-oriented approach using evidence-based strategies can enhance neuroplasticity and patient outcome. Special attention is needed for traumatic brain injury and spinal injury, younger patients, and those with neurocognitive dysfunction.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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