scholarly journals Characterizing traumatic brain injury and its association with homelessness in a community-based sample of precariously housed adults and youth

2019 ◽  
Author(s):  
Jacob L. Stubbs ◽  
Allen E. Thornton ◽  
Kristina M. Gicas ◽  
Tiffany A. O’Connor ◽  
Emily M. Livingston ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Common Mechanism ◽  
Stable Housing ◽  
Related Risk ◽  
Mri Scans ◽  
History Of ◽  
The Impact ◽  
Precarious Housing

ABSTRACTWe characterized the prevalence, mechanisms, and sex difference of lifetime traumatic brain injury (TBI) in a precariously housed sample. We also examined the impact of TBI severity and timing on becoming and staying homeless. 285 precariously housed participants (adults n = 226, youths n = 59) completed the Brain Injury Screening Questionnaire (BISQ) in addition to other health assessments. A history of TBI was reported in 82.1% of the sample, with 64.6% reporting > 1 TBI, and 21.4% reporting a moderate or severe TBI (msTBI). 10.1% of adults had traumatically-induced lesions on MRI scans. Assault was the most common mechanism of injury overall, and females reported significantly more TBIs due to physical abuse than males (adjusted OR = 1.26, 95% CI = 1.14 – 1.39, p = 9.18e-6). The first msTBI was significantly closer to the first experience of homelessness (b = 2.79, p = 0.003) and precarious housing (b = 2.69, p = 7.47e-4) than was the first mild TBI. Traumatic brain injuries more proximal to the initial loss of stable housing were associated with a longer lifetime duration of homelessness (RR = 1.04, 95% CI = 1.02 – 1.06, p = 6.8e-6) and precarious housing (RR = 1.03, 95% CI = 1.01 – 1.04, p = 5.5e-10). These findings demonstrate the high prevalence of TBI in vulnerable persons and the severity- and timing-related risk that TBI may confer for the onset and prolongation of homelessness.

Characterizing Traumatic Brain Injury and Its Association with Losing Stable Housing in a Community-based Sample : Caractérisation d’une lésion cérébrale traumatique et de son association avec la perte d’un logement stable dans un échantillon communautaire

2021 ◽  
pp. 070674372110006
Author(s):  
Jacob L. Stubbs ◽  
Allen E. Thornton ◽  
Kristina M. Gicas ◽  
Tiffany A. O’Connor ◽  
Emily M. Livingston ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Common Mechanism ◽  
Stable Housing ◽  
History Of ◽  
Severe Tbi ◽  
The Impact ◽  
Precarious Housing

Objective: Traumatic brain injury (TBI) is increasingly recognized as a common and impactful health determinant in homeless and precariously housed populations. We sought to describe the history of TBI in a precariously housed sample and evaluate how TBI was associated with the initial loss and lifetime duration of homelessness and precarious housing. Method: We characterized the prevalence, mechanisms, and sex difference of lifetime TBI in a precariously housed sample. We also examined the impact of TBI severity and timing on becoming and staying homeless or precariously housed; 285 precariously housed participants completed the Brain Injury Screening Questionnaire in addition to other health assessments. Results: A history of TBI was reported in 82.1% of the sample, with 64.6% reporting > 1 TBI, and 21.4% reporting a moderate or severe TBI. Assault was the most common mechanism of injury overall, and females reported significantly more traumatic brain injuries due to physical abuse than males (adjusted OR = 1.26, 95% CI = 1.14 to 1.39, P < 0.0001). The first moderate or severe TBI was significantly closer to the first experience of homelessness ( b = 2.79, P = 0.003) and precarious housing ( b = 2.69, P < 0.0001) than was the first mild TBI. In participants who received their first TBI prior to becoming homeless or precariously housed, traumatic brain injuries more proximal to the initial loss of stable housing were associated with a longer lifetime duration of homelessness (RR = 1.04, 95% CI = 1.02 to 1.06, P < 0.0001) and precarious housing (RR = 1.03, 95% CI = 1.01 to 1.04, P < 0.0001). Conclusions: These findings demonstrate the high prevalence of TBI in this vulnerable population, and that aspects of TBI severity and timing are associated with the loss and lifetime duration of stable housing.

The impact of hypopituitarism on function and performance in subjects with recent history of traumatic brain injury and aneurysmal subarachnoid haemorrhage

Brain Injury ◽  
2009 ◽  
Vol 23 (7-8) ◽  
pp. 639-648 ◽  
Author(s):  
Lakshmi Srinivasan ◽  
Brian Roberts ◽  
Tamara Bushnik ◽  
Jeffrey Englander ◽  
David A. Spain ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Subarachnoid Haemorrhage ◽  
Recent History ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
History Of ◽  
And Performance ◽  
The Impact

Bilateral chorea following severe traumatic brain injury treated with risperidone

2021 ◽  
Vol 14 (5) ◽  
pp. e241929
Author(s):  
Daniel Krasna ◽  
Erica Montgomery ◽  
Jacob Koffer ◽  
Miriam Segal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Movement Disorders ◽  
Daily Living ◽  
Brain Injuries ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Burden Of Care ◽  
History Of

A functionally independent man in his 20s with a history of intellectual disability and epilepsy and family history of Huntington’s disease suffered a severe traumatic brain injury. Postinjury, bilateral chorea rendered him dependent for all activities of daily living. Risperidone provided a significant reduction of chorea, decreasing the overall burden of care. Movement disorders are a common sequela of brain injury. Currently, there are no best treatment guidelines for chorea in patients with brain injury. To the authors’ knowledge there have been no case reports describing the effects of brain injury on patients with a primary movement disorder. Risperidone was an effective treatment in this case. Further research is needed to establish guidelines for treatment of movement disorders following brain injury and to better understand the effect of brain injuries on primary movement disorders.

Mild Traumatic Brain Injury and Postconcussive Symptom Endorsement: A Parallel Comparison Between Two Nonclinical Cohorts

2020 ◽  
Author(s):  
R Elisabeth Cornwell ◽  
Jorge I Arango ◽  
C B Eagye ◽  
Candace Hill-Pearson ◽  
Karen Schwab ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Epidemiological Studies ◽  
Emergency Department Visits ◽  
Survey Study ◽  
Military Health ◽  
History Of ◽  
The Military ◽  
The Impact

ABSTRACT Introduction The prevalence of mild traumatic brain injury (mTBI) is commonly estimated based on indirect metrics such as emergency department visits and self-reporting tools. The study of postconcussive symptoms faces similar challenges because of their unspecific character and indistinct causality. In this article, we compare two nonclinical, epidemiological studies that addressed these two elements and were performed within a relatively narrow period in the state of Colorado. Materials and Methods De-identified datasets were obtained from a random digit-dialed survey study conducted by the Craig Hospital and a study surveying soldiers returning from deployment by Defense and Veteran Traumatic Brain Injury Center. Information pertinent to participants’ demographics, a history of mTBI, and symptom endorsement was extracted and homogenized in order to establish a parallel comparison between the populations of the two studies. Results From the 1,558 (Warrior Strong, 679; Craig Hospital, 879) records selected for analysis, 43% reported a history of at least one mTBI. The prevalence was significantly higher among individuals from the Defense and Veteran Traumatic Brain Injury Center study independent of gender or race. Repetitive injuries were reported by 15% of the total combined cohort and were more prevalent among males. Symptom endorsement was significantly higher in individuals with a positive history of mTBI, but over 80% of those with a negative history of mTBI endorsed at least one of the symptoms interrogated. Significant differences were observed between the military and the civilian populations in terms of the types and frequencies of the symptoms endorsed. Conclusions The prevalence of mTBI and associated symptoms identified in the two study populations is higher than that of previously reported. This suggests that not all individuals sustaining concussion seek medical care and highlights the limitations of using clinical reports to assess such estimates. The lack of appropriate mechanisms to determine symptom presence and causality remains a challenge. However, the differences observed in symptom reporting between cohorts raise questions about the nature of the symptoms, the impact on the quality of life for different individuals, and the effects on military health and force readiness.

scholarly journals The Intertwined History of Malingering and Brain Injury: An Argument for Structural Competency in Traumatic Brain Injury

2021 ◽  
Vol 49 (3) ◽  
pp. 365-371
Author(s):  
Stephen T. Casper
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Health Crisis ◽  
Sources Of Uncertainty ◽  
Public Health Crisis ◽  
Structural Competency ◽  
History Of ◽  
The Cost

AbstractEvery year millions of people suffer minor brain injuries, many of which occur in collision sports. While there has been substantial commentary and debate about the nature of this public health crisis, it is clear that the scientific and clinical arguments reflect values preferences and judgments that are often invisible in documents which combine artful language with undue focus paid to sources of uncertainty at the cost of clarity and transparency. This essay gives a brief history of these patterns and proposes a remedy.

scholarly journals Mild traumatic brain injury affects the features of migraine

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ryotaro Ishii ◽  
Todd J. Schwedt ◽  
Meesha Trivedi ◽  
Gina Dumkrieger ◽  
Melissa M. Cortez ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Physical Abuse ◽  
Mild Traumatic Brain Injury ◽  
Clinical Course ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Lack Of Sleep ◽  
History Of ◽  
The Impact

Abstract Background Headache is one of the most common symptoms after concussion, and mild traumatic brain injury (mTBI) is a risk factor for chronic migraine (CM). However, there remains a paucity of data regarding the impact of mTBI on migraine-related symptoms and clinical course. Methods Of 2161 migraine patients who participated in the American Registry for Migraine Research between February 2016 and March 2020, 1098 completed questions assessing history of TBI (50.8%). Forty-four patients reported a history of moderate to severe TBI, 413 patients reported a history of mTBI. Patients’ demographics, headache symptoms and triggers, history of physical abuse, allodynia symptoms (ASC-12), migraine disability (MIDAS), depression (PHQ-2), and anxiety (GAD-7) were compared between migraine groups with (n = 413) and without (n = 641) a history of mTBI. Either the chi-square-test or Fisher’s exact test, as appropriate, was used for the analyses of categorical variables. The Mann-Whitney test was used for the analyses of continuous variables. Logistic regression models were used to compare variables of interest while adjusting for age, gender, and CM. Results A significantly higher proportion of patients with mTBI had CM (74.3% [307/413] vs. 65.8% [422/641], P = 0.004), had never been married or were divorced (36.6% [147/402] vs. 29.4% [187/636], P = 0.007), self-reported a history of physical abuse (24.3% [84/345] vs. 14.3% [70/491], P <  0.001), had mild to severe anxiety (50.5% [205/406] vs. 41.0% [258/630], P = 0.003), had headache-related vertigo (23.0% [95/413] vs. 15.9% [102/640], P = 0.009), and difficulty finding words (43.0% [174/405] vs. 32.9% [208/633], P <  0.001) in more than half their attacks, and headaches triggered by lack of sleep (39.4% [155/393] vs. 32.6% [198/607], P = 0.018) and reading (6.6% [26/393] vs. 3.0% [18/607], P = 0.016), compared to patients without mTBI. Patients with mTBI had significantly greater ASC-12 scores (median [interquartile range]; 5 [1–9] vs. 4 [1–7], P < 0.001), MIDAS scores (42 [18–85] vs. 34.5 [15–72], P = 0.034), and PHQ-2 scores (1 [0–2] vs. 1 [0–2], P = 0.012). Conclusion Patients with a history of mTBI are more likely to have a self-reported a history of physical abuse, vertigo, and allodynia during headache attacks, headaches triggered by lack of sleep and reading, greater headache burden and headache disability, and symptoms of anxiety and depression. This study suggests that a history of mTBI is associated with the phenotype, burden, clinical course, and associated comorbid diseases in patients with migraine, and highlights the importance of inquiring about a lifetime history of mTBI in patients being evaluated for migraine.

scholarly journals A Pro-social Pill? The Potential of Pharmacological Treatments to Improve Social Outcomes After Pediatric Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Bridgette D. Semple ◽  
Ramesh Raghupathi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Social Behavior ◽  
Early Life ◽  
Brain Injuries ◽  
Time Window ◽  
Therapeutic Interventions ◽  
Future Research ◽  
Clinical Literature ◽  
The Impact

Traumatic brain injury (TBI) is a leading cause of injury-induced disability in young children worldwide, and social behavior impairments in this population are a significant challenge for affected patients and their families. The protracted trajectory of secondary injury processes triggered by a TBI during early life—alongside ongoing developmental maturation—offers an extended time window when therapeutic interventions may yield functional benefits. This mini-review explores the scarce but promising pre-clinical literature to date demonstrating that social behavior impairments after early life brain injuries can be modified by drug therapies. Compounds that provide broad neuroprotection, such as those targeting neuroinflammation, oxidative stress, axonal injury and/or myelination, may prevent social behavior impairments by reducing secondary neuropathology. Alternatively, targeted treatments that promote affiliative behaviors, exemplified by the neuropeptide oxytocin, may reduce the impact of social dysfunction after pediatric TBI. Complementary literature from other early life neurodevelopmental conditions such as hypoxic ischemic encephalopathy also provides avenues for future research in neurotrauma. Knowledge gaps in this emerging field are highlighted throughout, toward the goal of accelerating translational research to support optimal social functioning after a TBI during early childhood.

scholarly journals Schizophrenia and Hyperostosis Frontalis Interna with History of Head Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Fatima Elghazouani
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Frontal Bone ◽  
Cranial Computed Tomography ◽  
Schizophrenic Disorder ◽  
History Of ◽  
The Right ◽  
The Impact

Hyperostosis frontalis interna is an irregular thickening of the frontal bone. Its etiology is unknown. It has been rarely linked with schizophrenia and head injury. Case Presentation. We describe an unusual case of a 44-year-old female with schizophrenia and hyperostosis frontalis interna having a history of head trauma. At the age of 3 years, she had a head injury that could be classified as mild traumatic brain injury. She presents a family history of schizophrenia. She was admitted for resistant schizophrenic disorder. The cranial computed tomography showed bilateral and asymmetrical hyperostosis of the frontal bone that was more pronounced on the right side. This corresponds to the impact of the trauma with frontal atrophy without any metabolic or endocrinal abnormalities. Conclusion. We surmise that the long-term pathological effects of traumatic brain injury, including hyperostosis frontalis interna, are likely to interact with genetic vulnerability and may lead to schizophrenic disorder.

scholarly journals Prevention of Dementia Formation in Retired Combat Participants with a History of Traumatic Brain Injuries

2020 ◽  
Vol 15 (2) ◽  
pp. 160-167
Author(s):  
Andrey Soloviev ◽  
Elena Ichitovkina ◽  
Elena Golubeva
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mental Disorders ◽  
Emotional Disorders ◽  
Cognitive Abilities ◽  
Brain Injuries ◽  
Cognitive Disorders ◽  
Stress Disorders ◽  
Intellectual Activity ◽  
History Of

Background: A set of measures to prevent the formation of gross organic mental disorders in combat participants having traumatic brain injury (TBI) is an important public health task. This study aims to conduct a catamnestic survey of retired combat participants who possess a history of TBI to determine the directions of prevention of dementia formation. Methods: Seventy-one retired combatants were surveyed at the time of their retirement and three years after their retirement. Clinical and experimental psychological methods were used. To identify the dynamics of cognitive disorders, the Short Sample Test was used (in the adaptation of Vanderlick), and Kotenev’s Questionnaire of Traumatic Stress was used for post-stress disorders –. The catamnestic method was applied via the study of outpatient cards and using a social survey of retired combatants three years after their dismissal. Results: It was found that 47.8% of participants in combat operations had neurosis-like disorders with impaired emotions, 26.8% – organic emotional-labile disorder, 25.4% – organic personality disorder, 26.7% – alcohol abuse, and 25.4% were disabled due to mental illness. Three years after their dismissal, their cognitive abilities had a significant negative dynamic with a marked decrease in the integral indicator of intellectual activity; emotional disorders, and signs of psychosocial maladaptation were detected. Conclusion: A catamnestic analysis of the mental health of participants in combat operations with traumatic brain injury in their history showed the presence of adverse psychosocial trends, a fact that requires the development of measures to improve the effectiveness of complex inter-professional therapy and rehabilitation. To prevent the formation of deep mental disorders with severe cognitive impairment and dementia, it is necessary to develop and improve the regulatory legal and information base for organizing psychiatric care.

Assessing the Impact of Military Service on Patient Health Literacy in an Otolaryngology Clinic

2021 ◽  
Author(s):  
Danielle A Morrison ◽  
Charles A Riley ◽  
Anthony M Tolisano
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Literacy ◽  
Military Service ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
History Of ◽  
The Impact ◽  
Inadequate Health Literacy

ABSTRACT Objective To examine the impact of military service on health literacy. Study Design Prospective, cross-sectional study. Subjects and Methods The validated Brief Health Literacy Screen (BHLS) with military supplement was administered to sequential adult patients (military and civilian) treated at two outpatient academic military otolaryngology clinics between November and December 2019. Inadequate health literacy, defined by a BHLS score ≤9, was the primary outcome measure. Secondary outcome measures included comparisons of inadequate BHLS scores with patient demographics and history of military service. Results Three hundred and eighty-two patients were evaluated during the study period. The median age was 48-57 years, with a majority being male (230, 60.2%), White (264, 69.1%), married (268, 70.2%), and active duty military (303, 79.3%). A minority reported history of PTSD (39, 13%) or traumatic brain injury (29, 9.6%). Overall, very few subjects (10, 2.6%) demonstrated inadequate health literacy. Patients with prior (1.6% vs 6.3%, P &lt; .05) or current (0% vs 5.0%, P &lt; .05) military service had lower rates of inadequate health literary as compared to civilians. Gender, race, marital status, history of PTSD, and history of traumatic brain injury did not significantly impact health literacy. In a multivariate regression model exploring history of military service, age was not predictive of inadequate health literacy. Conclusions Both history of and current military service predict higher health literacy rates for patients treated at military otolaryngology clinics. Widely accessible health care and mandatory health evaluations for service members to maintain deployment readiness may contribute to this finding but warrant additional study.

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