508 Narcolepsy Associated With a History of Head Injury: A Retrospective Review

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A200-A200
Author(s):  
Debbie 304-638-6163 ◽  
Savanna Osburn ◽  
Tyler Burns ◽  
Thomas Gills ◽  
Darrell Welch ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Retrospective Review ◽  
Motor Vehicle ◽  
Sports Injuries ◽  
Head Injuries ◽  
Sleep Wake Disorders ◽  
Histaminergic Neurons ◽  
History Of

Abstract Introduction Head injuries are becoming much more prevalent and may be secondary to sports injuries, motor vehicle accidents, falls, domestic violence, assault, and military blast explosions. Sleepiness may occur acutely and/or chronically after a head injury. Chronic hypersomnia may be overlooked or under-reported in those with a history of head injury, and the association may not be made. Hypersomnia can occur in those with mild, moderate, and severe head injuries, with or without loss of consciousness. The pathophysiology/neuropathology of sleep-wake disturbances after Traumatic Brain Injury was discussed by Lim and Baumann 2020 in their Up To Date review entitled “Sleep-wake disorders in patients with traumatic brain injury”. They reported possible abnormalities in orexin/hypocretin, decreased histaminergic neurons, melatonin abnormalities, decreased serotonergic neurons, decreased noradrenergic neurons, and structural brain changes that can play a role. It is also possible that a head injury occurs in someone predisposed to the development of narcolepsy or that the sleepiness of undiagnosed narcolepsy leads to increased injuries. Methods A retrospective review of charts from 2013 to 2020 revealed 176 patients diagnosed with narcolepsy in our psychiatric/sleep outpatient practice. Information on head injuries was obtained by questionnaires completed by the patient and/or interview with staff. Narcolepsy was diagnosed by PSG/MSLT and/or DSM-V criteria of narcolepsy. Results Of the 176 patients diagnosed with narcolepsy, 125 were female (71%) and 51 were male (29%). The age range was 11 to 75 years, with an average age of 39 years old. Cataplexy was present in 117 patients (66.8%). A history of a head injury was reported at intake by 50 patients (28.4%). Of the patients with a history of a head injury, 34 (68%) were female, 16 (32%) were male, and 36 (72 %) had a history of cataplexy. Conclusion This study revealed 28.4% of patients diagnosed with narcolepsy reported a history of a head injury of varying degrees of severity. While direct causation cannot be declared, the association of a head injury and continued hypersomnia suggests further evaluation of narcolepsy may be beneficial. Support (if any) **No support for this study was given.

Head injury

2011 ◽  
Author(s):  
Ian Whittle
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Motor Vehicle ◽  
Seat Belt ◽  
Head Injuries ◽  
Western Society ◽  
Clinical Neuroscience ◽  
Horse Riding ◽  
Craniocerebral Injuries

Head injury or traumatic brain injury is a ubiquitous phenomenon in all societies and affects up to 2 per cent of the population per year (Bullock et al. 2006). Although the causes of head injury and its distribution within populations vary, it can have devastating consequences both for the patient and family (Tagliaferri et al. 2006). In some countries severe traumatic brain injury is the commonest cause of death in people under 40 years (Lee et al. 2006), and it is estimated that the sequelae of head injury cost societies billions of dollars per year. Understanding of the pathophysiology, diagnosis, and management have all improved dramatically in the last few decades (Steudel et al. 2005). However within western society, perhaps one of the greatest benefits has been the reduction in severe craniocerebral injuries following motor vehicle accidents. This has arisen because of increased safety in car design, seat-belt legislation, the introduction of air-bags, enforcement of speed limits, and the societal conformity to drink-driving legislation. For instance, because of these changes, in the last 15 years the number of severe head injuries managed in the Clinical Neuroscience unit in Edinburgh has decreased by around 66 per cent. Unfortunately in some developing countries one legacy of increased traffic, particularly of motor cycles, is an epidemic of head injuries amongst young adults (Lee et al. 2006). With the number of severe head injuries declining in many countries the challenge will be to provide better care for patients with minor head injury, about 10 times more common than severe injury (Steudel et al. 2005).Ageing patients who tend to fall over, falls associated with increased alcohol consumption, and domestic or social assaults probably now contribute to the majority of head injuries (Flanagan et al. 2005; Steudel et al. 2005; Tagliaferri et al. 2006). Sporting injuries are fortunately uncommon as a cause of severe craniocerebral injury, although horse riding accidents can sometimes be devastating particularly in teenage girls. In some countries injuries from hand guns and other missiles are common (Aryan et al. 2005), but in European countries many such injuries are self-inflicted. Prompt management of intracranial haematoma, which occurs in 25–45 per cent of severe head injuries, 3–12 per cent of moderate injuries, and 0.2 per cent of minor injuries, and the rehabilitation of patients with head injury are now important areas in clinical neuroscience (Flanagan et al. 2005; Bullock et al. 2006b, c).

Incidence of head injury and traumatic brain injury among people with Alzheimer’s disease

2019 ◽  
Vol 73 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Sarianna Ilmaniemi ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
Sirpa Hartikainen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Injuries ◽  
Community Dwelling ◽  
University Hospital ◽  
Health Concern ◽  
Increased Risk

BackgroundInjuries caused by falling are a major health concern among older population. For older people, falls are the leading cause of head injuries; especially, persons with cognitive disorders have an increased risk of falling.ObjectiveTo compare the incidence of head injury and traumatic brain injury (TBI) among persons with Alzheimer’s disease (AD) with persons without AD.MethodsThis register-based study was conducted on a nationwide cohort, which includes all community-dwelling persons diagnosed with AD in Finland in 2005–2011. Persons with previous head injuries were excluded, leaving 67 172 persons with AD. For each person with AD, a matching person without AD and previous head injury were identified with respect to age, sex and university hospital district. The Cox proportional hazard model and competing risk analyses were used to estimate HR for head injury and TBI.ResultsPersons with AD had 1.34-fold (95% CI 1.29 to 1.40) risk of head injuries and 1.49-fold (95% CI 1.40 to 1.59) risk of TBIs after accounting for competing risks of death and full adjustment by socioeconomic status, drug use and comorbidities.ConclusionPersons with AD are more likely to have a head injury or TBI incident than persons without AD.

Multidetector Computed Tomography (MDCT) Evaluation of Traumatic Brain Injury in Head Trauma Patients in Tertiary Hospital of Eastern Region of Nepal

2021 ◽  
Vol 6 (1) ◽  
pp. 1352-1357
Author(s):  
Ajay Kumar Yadav ◽  
Binit Dev ◽  
Sushil Taparia ◽  
Parvez Kumar ◽  
Rakesh Mandal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Ct Scan ◽  
Head Trauma ◽  
Road Traffic ◽  
Imaging Findings ◽  
Intracranial Lesions ◽  
History Of

Introduction: Traumatic brain injury (TBI) in patients with head trauma is common cause for emergency visits to hospital affecting all age groups. It is one of important leading cause of death and disability worldwide besides leading to neurological disease burden. Noncontrast enhanced Multidetector computed tomography (MDCT) is imaging modality of choice for detection of various intracranial lesions. Objectives: This study was done to analyse various imaging findings on MDCT in traumatic head injury patients along with association of CT findings with clinical manifestation and mechanism of injury. Methodology: In this ethically approved prospective study, CT scan was done in 224 consecutive patients with head injury from November 2020 to February 2021. The various imaging findings seen in CT scan were documented in proforma. The data collected was analyzed with appropriate statistical test and statistical significance was calculated. Results: Total of 224 patients with diagnosis of head injury were included in the study. The male to female ratio was 2.86 and most common age group involved was between 20-40years (41.1%). The most common mode of injury was road traffic accidents (57.6%) and most of the patients presented with history of altered sensorium (35.7%). About 47.3% patients showed abnormal findings on CT scan with scalp lesion was most common findings (82%) followed by skull fractures (54.7%) and cerebral contusions (43.4%). Patients with history of RTA had more abnormal CT scan (62%) than fall injury and physical assault. Statistically significant association seen between CT scan findings with Glasgow Coma Scale and RTA (P<0.05). Conclusion: The present study showed well documented role of CT scan in diagnosis of TBI besides detection of spectrum of intracranial lesions in patients with head trauma. Road traffic accident is most common mode of head injury with most of the victims are young middle age active male. 

Pediatric Minor Head Injury and Concussion

2018 ◽  
Author(s):  
Chad Scarboro ◽  
Simone Lawson
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Mild Traumatic Brain Injury ◽  
Head Injuries ◽  
Normal Activity ◽  
Secondary Brain Injury ◽  
Wide Range ◽  
Serious Injuries

Head injury is one of the most common reasons children present to the emergency department (ED) and the leading cause of pediatric death and disability. Head injuries can range from having no neurologic deficits to death. Management in the ED centers on determining if there is a serious brain injury and preventing secondary brain injury. In most cases of mild traumatic brain injury, serious injuries can be ruled out based on the history of the injury, associated symptoms, and clinical assessment. Concussion is a common presentation of head injury and encompasses a wide range of symptoms. Computed tomography should be used judiciously, and extensive research has led to algorithms to aid in this decision. Prior to discharge from the ED, parents will often have questions about when their child may resume normal activity. This is a decision that most often will involve the patient’s primary care provider or a concussion specialist as the ED provider is unable to follow progression or resolution of symptoms. However, the ED provider should be able to provide anticipatory guidance.   Key words: computed tomography, concussion, head injury, mild traumatic brain injury, traumatic brain injury

The Elusive Nature of Mild Traumatic Brain Injury

Biofeedback ◽  
2009 ◽  
Vol 37 (3) ◽  
pp. 92-95
Author(s):  
Ronald J. Swatzyna
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Impulse Control ◽  
Head Injuries ◽  
Poor Response ◽  
Clinical History ◽  
Response To Treatment ◽  
Quantitative Electroencephalography ◽  
History Of

Abstract The author discloses a personal history of undiagnosed mild traumatic brain injury (MBTI) and identifies a typical course and progression of this condition. He advocates a careful inquiry for possible head injury whenever the clinical history shows an original period of normal functioning, a progression of disturbance over time, multiple diagnoses, and poor response to treatment with medication. He discusses the use of quantitative electroencephalography (QEEG) in assessing possible mild traumatic brain injury, describes typical features of quantitative electroencephalography in mild traumatic brain injury, and cautions about the frequency of false negatives. He provides two case histories showing the progression of disturbing cognitive, personality, and impulse control problems following early head injuries.

scholarly journals Pediatric Traumatic Brain Injury in the United States: Rural-Urban Disparities and Considerations

2020 ◽  
Vol 10 (3) ◽  
pp. 135 ◽  
Author(s):  
John K. Yue ◽  
Pavan S. Upadhyayula ◽  
Lauro N. Avalos ◽  
Tene A. Cage
Keyword(s):  
Mental Health ◽  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Healthcare Costs ◽  
Motor Vehicle ◽  
The United States ◽  
Pubmed Database ◽  
Pediatric Tbi

Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR “brain/head injury”) AND “rural/underserved” AND “pediatric/child”). All qualifying articles focusing on rural pediatric TBI, including the subtopics epidemiology (N = 3), intervention/healthcare cost (N = 6), and prevention (N = 1), were reviewed. Results: Rural pediatric TBIs were more likely to have increased trauma and head injury severity, with higher-velocity mechanisms (e.g., motor vehicle collisions). Rural patients were at risk of delays in care due to protracted transport times, inclement weather, and mis-triage to non-trauma centers. They were also more likely than urban patients to be unnecessarily transferred to another hospital, incurring greater costs. In general, rural centers had decreased access to mental health and/or specialist care, while the average healthcare costs were greater. Prevention efforts, such as mandating bicycle helmet use through education by the police department, showed improved compliance in children aged 5–12 years. Conclusions: U.S. rural pediatric patients are at higher risk of dangerous injury mechanisms, trauma severity, and TBI severity compared to urban. The barriers to care include protracted transport times, transfer to less-resourced centers, increased healthcare costs, missing data, and decreased access to mental health and/or specialty care during hospitalization and follow-up. Preventative efforts can be successful and will require an improved multidisciplinary awareness and education.

Acquired brain injury and violent offending: prevalence and risk factors

2011 ◽  
Vol 26 (S2) ◽  
pp. 775-775 ◽  
Author(s):  
R. Faruqui
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Mental Disorder ◽  
Acquired Brain Injury ◽  
List Type ◽  
Violent Offending ◽  
History Of ◽  
Associated Risk Factors

IntroductionAcquired brain injury has been reported to be associated with violence.ObjectivesTo determine whether an association exists between acquired brain injury and violent offendingAimsStudy an association between brain injury and crime and identify associated risk factors.MethodsSystematic search of Medline, Embase, PsychInfo, CINAHL, TRIP, using terms, Acquired brain injury, traumatic brain injury (TBI), head injury, frontal lobe, crime, offending, violent offending, sexual offending, prison.ResultsA:Multiple studies reported higher life time history of head injury in prison or offender populations in comparison to control groups. Sampling bias and case definition problems have influenced reported prevalence of head injury in offender population ranging from 3.3% to 82%. Reports from secure psychiatric services identify that patients with history of head injury may be more difficult to discharge. Community based studies report cognitive damage as significant risk factor for domestic violence.B:Large scale population and military cohorts have reported a higher relative risk for criminal conviction in mild traumatic brain injury (TBI) group. TBI increases the risk of mental disorder by two-folds but also that TBI is significantly related to mental disorder with co-existing criminality.C:Childhood conduct problems, loss of a parent, substance misuse, maternal drug use in pregnancy, impaired executive cognitive functioning, structural damage to orbito-frontal and ventromedial areas, amygdala, and hippocampus are reported as risk factors for violent offending in this population group.ConclusionsThe review provides evidence for an association between brain injury and violent offending and also identifies associated risk factors.

scholarly journals Relationship of The Degree of Head Injury Based on Glasgow Coma Scale (GCS) with the Arrival of Acute Post Concussion Syndrome (PCS) Onset in Post-Head Injury Patients in General Hospital Dr.M.Djamil Padang

2021 ◽  
Vol 7 (1) ◽  
pp. 153-169
Author(s):  
Muhammad Reza Azriyantha ◽  
Syaiful Saanin ◽  
Hesty Lidya Ningsih
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Glasgow Coma Scale ◽  
Cause Of Death ◽  
Head Injuries ◽  
Acute Onset ◽  
P Value ◽  
Coma Scale ◽  
Post Concussion Syndrome

A B S T R A C TBackground: Traumatic brain injury is the main cause of death in the populationunder the age of 45 years, and the fourth leading cause of death in the entire ofpopulation. Based on the degree of traumatic brain injury, it is commonly categorizedbased on the Glasgow Coma Scale (GCS). Post-Concussion Syndrome (PCS) is theset of somatic, emotional / behavioral and cognitive symptoms that occur after atraumatic brain injury. The aim of this study was to find out the prevalence andcorrelation of the degree of traumatic brain injury based on the Glasgow Coma Scale(GCS) and the emersion of Post-Concussion Syndrome (PCS) acute onset in patientswith head injuries Method: This study was a cross-sectional analytic study ofpatients who experienced Post-Concussion Syndrome (PCS) after traumatic braininjury at DR. M. Djamil Hospital Padang in 2020 from June to November 2020. Datawere collected by filling in a questionnaire (The Rivermead Post ConcussionSymptoms Questionnaire) and medical record data of neurosurgical patients thatmet the inclusion and exclusion criteria. Result: : It indicated that 70 patients wereincluded in the inclusion criteria of this study. A total of 38 (54.3) respondents didnot undergo the acute onset of PCS, meanwhile respondents who experienced acuteonset of PCS were 32 (45.7) respondents. The results showed that 25 (67.6%)respondents with mild traumatic brain injury had PCS acute onset, while 4 (17.4%)respondents with moderate degree of traumatic brain injury had PCS acute onset,and 4 (17.4%) respondents had PCS acute onset PCS 3 (30%) respondentsexperienced severe traumatic brain injury with acute onset PCS and statistically thedifference in the proportion of data from each of these variables was significant witha p-value of 0.0001. The results of statistical tests showed that p value> 0.05 on thecorrelation between PCS and GCS, thus, it can be concluded that there was nocorrelation between the direction of the relationship between PCS and GCS.Conclusion There was no correlation between the degree of traumatic brain injurybased on GCS and the incidence of PCS acute onset, either it was unidirectional orvice versa in patients with head injuries at RSUP M. Djamil Padang.

The Mild Traumatic Brain Injury Rest and Activity Questionnaire (MTBI-RAQ): A Pilot Study

2018 ◽  
Vol 19 (2) ◽  
pp. 141-152 ◽  
Author(s):  
Karen A. Sullivan ◽  
Rebecca Cox
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Vehicle Accident ◽  
Cut Score ◽  
History Of ◽  
Cognitive Behaviours ◽  
Adult Volunteers

Objective: To develop a tool for assessing intentions to continue or change activities for recovery following mild traumatic brain injury (mTBI) and determine if they are dependent on injury context or activity type. Method: Adult volunteers with no (or no recent) history of mTBI were randomly allocated to one of two vignette conditions, each with a different injury context. The vignette described an mTBI due to a motor vehicle accident (MVA, n = 76) or sport (SPORT, n = 89). Volunteers reported their rest or activity plans for 39 behaviours comprising three behaviour types (cognitive, physical, and restful). Results: Compared to a cut-score representing no change, on average there was a significant (p <= .001) planned decrease in physical and cognitive behaviours (MVAphysicalt(53) = 7.373; SPORTphysicalt(41) = 9.281; MVAcognitivet(41) = 9.367; SPORTcognitivet(51) = −3.521) and a significant planned increase in restful behaviours, such as sleep (MVArestfult(72) = 10.006; SPORTrestfult(86) = 9.566). An overall within-group effect for behaviour-type was not identified and there was no effect of condition (MVA vs. SPORT). Conclusion: The acute rest and activity plans for a simulated mTBI are behaviour specific and not dependent on context. An expectation for blanket-rest was not was observed but rest was planned for specific behaviours. This tool could be used to guide discussions with mTBI patients about their recovery so that their plans align with advice, and it could aid further research into the relation between intended and actual rest and activity and the effect on eventual outcomes.

Strategies for Helping Head-Injured Children Successfully Return to School

1987 ◽  
Vol 18 (4) ◽  
pp. 292-300 ◽  
Author(s):  
Roberta DePompei ◽  
Jean Blosser
Keyword(s):  
Head Injury ◽  
Motor Vehicle ◽  
Sports Injuries ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Return To School ◽  
Educational Setting ◽  
Vehicle Accidents ◽  
Speech Language Pathologist ◽  
Head Injured

Each year approximately 75,000 individuals sustain a closed head injury (CHI). The head injuries may be the result of motor vehicle accidents, falls, sports injuries, or abuse. It is estimated that as many as 18,000 of those injured are children. Often, head-injured children return to the educational setting following physical recuperation. The communication, physical, cognitive, emotional, and/or behavioral changes which have resulted from the head injury may interfere with successful re-entry into school. This article will present information that may be helpful in implementing the CHI student's successful return to school. Specific topics to be discussed include: types of deficits in CHI students, initiating the return to the educational setting, reasons for involvement of the speech-language pathologist in the re-entry process, suggestions for establishing effective networks between the rehabilitation setting (hospital/clinic) and the educational setting; and, specific recommendations for implementing the return.

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