scholarly journals Post-traumatic Headache After Pediatric Traumatic Brain Injury: Prevalence, Risk Factors, and Association With Neurocognitive Outcomes

2019 ◽  
Vol 35 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Blake McConnell ◽  
Tyler Duffield ◽  
Trevor Hall ◽  
Juan Piantino ◽  
Dylan Seitz ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Assessment Tool ◽  
Color Naming ◽  
Pediatric Traumatic Brain Injury ◽  
Symptom Domains ◽  
Post Traumatic ◽  
Matrix Reasoning ◽  
Neurocognitive Measures

Post-traumatic headache is common after pediatric traumatic brain injury and affects thousands of children every year, but little is known about how headache affects recovery after traumatic brain injury in other symptom domains. We aimed to determine the association between headache and other common symptoms after pediatric traumatic brain injury and explore whether subjective complaints of headache are associated with objective deficits on specialized neurocognitive testing. We conducted a retrospective cohort study of children ages 3-19 years following traumatic brain injury with a completed Sports Concussion Assessment Tool (SCAT) questionnaire. Post-traumatic headache was defined by a score more than 2 on the SCAT question for headache and define headache groups for comparison. In our cohort, we analyzed data from the Delis-Kaplan Executive Function System and the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II). Headache was reported in 40 (33%) patients presenting for post-traumatic brain injury care among 121 pediatric traumatic brain injury patients and did not differ by injury severity. Median total SCAT symptom score in the headache group was 5-fold higher compared to patients without headache (median 45.5 vs 9; P < .001). Significantly lower-scaled scores in color naming, matrix reasoning, letter sequencing, and letter switching were also found in the headache group (all P ≤ .03). Our study shows that headache, as reported by patients on the SCAT, is associated with higher symptom scores in all other symptom domains, including sleep, mood, sensory, and cognitive. Headache was also associated with worse objective neurocognitive measures and may identify patients who could benefit from specialized follow-up care and management.

scholarly journals Introduction of the Abbreviated Westmead Post-Traumatic Amnesia Scale and Impact on Length of Stay

2017 ◽  
Vol 106 (4) ◽  
pp. 356-360 ◽  
Author(s):  
C. E. Watson ◽  
E. A. Clous ◽  
M. Jaeger ◽  
S. K. D’Amours
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Hospital Admissions ◽  
Assessment Tool ◽  
Hospital Length Of Stay ◽  
Traumatic Amnesia ◽  
Post Traumatic

Background and Aims: Mild traumatic brain injury is a common presentation to Emergency Departments. Early identification of patients with cognitive deficits and provision of discharge advice are important. The Abbreviated Westmead Post-traumatic Amnesia Scale provides an early and efficient assessment of post-traumatic amnesia for patients with mild traumatic brain injuries, compared with the previously used assessment, the Modified Oxford Post-traumatic Scale. Material and Methods: This retrospective cohort study reviewed 270 patients with mild traumatic brain injury assessed for post-traumatic amnesia over a 2-year period between February 2011 and February 2013. It identified those assessed with Abbreviated Westmead Post-traumatic Amnesia Scale versus Modified Oxford Post-traumatic Scale, the outcomes of these post-traumatic amnesia assessments, the hospital length of stay for patients, and their readmission rates. Results: The Abbreviated Westmead Post-traumatic Amnesia Scale was used in 91% of patient cases (and the Modified Oxford Post-traumatic Scale in 7%), and of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 94% cleared post-traumatic amnesia testing within 4 h. Of those assessed with the Abbreviated Westmead Post-traumatic Amnesia Scale, 56% had a shorter length of stay than had they been assessed with the Modified Oxford Post-traumatic Scale, resulting in 295 bed-days saved. Verbal and written discharge advice was provided to those assessed for post-traumatic amnesia to assist their recovery. In all, 1% of patients were readmitted for monitoring of mild post-concussion symptoms. Conclusion: The Abbreviated Westmead Post-traumatic Amnesia Scale provides an effective and timely assessment of post-traumatic amnesia for patients presenting to the Emergency Department with mild traumatic brain injury compared with the previously used assessment tool. It helps identify patients with cognitive impairment and the need for admission and further investigation, resulting in appropriate access to care. It also results in a decreased length of stay and decreased hospital admissions, with subsequent cost savings to the hospital.

Early Post-Traumatic Seizures in Moderate to Severe Pediatric Traumatic Brain Injury: Rates, Risk Factors, and Clinical Features

2011 ◽  
Vol 28 (5) ◽  
pp. 755-762 ◽  
Author(s):  
Kate Liesemer ◽  
Susan L. Bratton ◽  
C. Michelle Zebrack ◽  
Douglas Brockmeyer ◽  
Kimberly D. Statler
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Clinical Features ◽  
Pediatric Traumatic Brain Injury ◽  
Injury Rates ◽  
Post Traumatic

scholarly journals Plasma Levels, Temporal Trends and Clinical Associations between Biomarkers of Inflammation and Vascular Homeostasis after Pediatric Traumatic Brain Injury

2019 ◽  
Vol 41 (3-4) ◽  
pp. 177-192
Author(s):  
Abhijit V. Lele ◽  
Bhunyawee Alunpipatthanachai ◽  
Qian Qiu ◽  
Crystalyn Clark-Bell ◽  
Arraya Watanitanon ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cerebral Autoregulation ◽  
Inverse Relationship ◽  
Direct Relationship ◽  
Injury Severity ◽  
Plasma Concentrations ◽  
Temporal Trends ◽  
Pediatric Traumatic Brain Injury ◽  
Vascular Homeostasis

Expression of inflammatory (interleukin-6 [IL-6]) and vascular homeostatic (angiopoietin-2 [AP-2], endothelin-1 [ET-1], endocan-2 [EC-2]) biomarkers in pediatric traumatic brain injury (TBI) was examined in this prospective, observational cohort study of 28 children hospitalized with mild, moderate, and severe TBI by clinical measures (age, sex, Glasgow Coma Scale score [GCS], Injury Severity Score [ISS], and cerebral autoregulation status). Biomarker patterns suggest an inverse relationship between GCS and AP-2, GCS and IL-6, ISS and ET-1, but a direct relationship between GCS and ET-1 and ISS and AP-2. Biomarker patterns suggest an inverse relationship between AP-2 and ET-1, AP-2 and EC-2, but a direct relationship between AP-2 and IL-6, IL-6 and EC-2, and IL-6 and ET-1. Plasma concentrations of inflammatory and vascular homeostatic biomarkers suggest a role for inflammation and disruption of vascular homeostasis during the first 10 days across the severity spectrum of pediatric TBI. Although not statistically significant, without impact on cerebral autoregulation, biomarker patterns suggest a relationship between inflammation and alterations in vascular homeostasis. The large variation in biomarker levels within TBI severity and age groups, and by sex suggests other contributory factors to biomarker expression.

Cognitive Deficits Post-Traumatic Brain Injury and Their Association with Injury Severity and Gray Matter Volumes

2017 ◽  
Vol 34 (7) ◽  
pp. 1466-1472 ◽  
Author(s):  
Abigail Livny ◽  
Anat Biegon ◽  
Tammar Kushnir ◽  
Sagi Harnof ◽  
Chen Hoffmann ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Gray Matter ◽  
Cognitive Deficits ◽  
Injury Severity ◽  
Post Traumatic ◽  
Gray Matter Volumes

Rates of symptom reporting following traumatic brain injury

2010 ◽  
Vol 16 (3) ◽  
pp. 401-411 ◽  
Author(s):  
SUREYYA DIKMEN ◽  
JOAN MACHAMER ◽  
JESSE R. FANN ◽  
NANCY R. TEMKIN
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Symptom Reporting ◽  
Psychiatric History ◽  
Post Injury ◽  
Post Traumatic ◽  
Severity Levels ◽  
Traumatic Symptoms

AbstractThis study examines rates of reporting of new or worse post-traumatic symptoms for patients with a broad range of injury severity at 1 month and 1 year after traumatic brain injury (TBI), as compared with those whose injury spared the head, and assesses variables related to symptom reporting at 1 year post-injury. Seven hundred thirty two TBI subjects and 120 general trauma comparison (TC) subjects provided new or worse symptom information at 1 month and/or 1 year post-injury. Symptom reporting at 1 year post-injury was compared in subgroups based on basic demographics, preexisting conditions, and severity of brain injury. The TBI group reported significantly more symptoms at 1 month and 1 year after injury than TCs (each p < .001). Although symptom endorsement declined from 1 month to 1 year, 53% of people with TBI and 24% of TC continued to report 3 or more symptoms at 1 year post-injury. Symptom reporting in the TBI group was significantly related to age, gender, preinjury alcohol abuse, pre-injury psychiatric history, and severity of TBI. Symptom reporting is common following a traumatic injury and continues to be experienced by a substantial number of TBI subjects of all severity levels at 1 year post-injury. (JINS, 2010, 16, 401–411.)

Post-traumatic seizures following pediatric traumatic brain injury

2021 ◽  
Vol 203 ◽  
pp. 106556
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Wyatt B. David ◽  
Victor Lee ◽  
Cheryl K. Zogg ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pediatric Traumatic Brain Injury ◽  
Post Traumatic

scholarly journals Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Pilakimwe Egbohou ◽  
Tabana Mouzou ◽  
Pikabalo Tchetike ◽  
Hamza Doles Sama ◽  
Sarakawabalo Assenouwe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Brain Injuries ◽  
Injury Severity ◽  
Road Traffic ◽  
Skull Fracture ◽  
University Hospital ◽  
Pediatric Traumatic Brain Injury ◽  
The Mean

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.

scholarly journals Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury

2009 ◽  
Vol 15 (6) ◽  
pp. 862-867 ◽  
Author(s):  
RICHARD A. BRYANT ◽  
MARK CREAMER ◽  
MEAGHAN O’DONNELL ◽  
DERRICK SILOVE ◽  
C. RICHARD CLARK ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Injury Severity ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Traumatic Amnesia ◽  
Post Traumatic

AbstractThe prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later (N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78–2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms. (JINS, 2009, 15, 862–867.)

scholarly journals Post-traumatic stress disorder in UK civilians with traumatic brain injury: an observational study of TBI clinic attendees to estimate PTSD prevalence and its relationship with radiological markers of brain injury severity

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e021675 ◽  
Author(s):  
Kasim L Qureshi ◽  
Rachel Upthegrove ◽  
Emma Toman ◽  
Vijay Sawlani ◽  
David James Davies ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Injury Severity ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Prevalence

ObjectivesTo estimate the prevalence of post-traumatic stress disorder (PTSD) in a large civilian population with traumatic brain injury (TBI), and to assess whether brain injury severity is correlated with PTSD symptoms.DesignObservational, cross-sectional study.Setting and participantsOutpatient clinic in a major UK trauma centre and secondary care hospital. Estimates of PTSD prevalence are based on 171 sampled individuals attending TBI clinic within an 18-month period. Analysis of the relationship between TBI severity and PTSD was performed on the subset of 127 patients for whom injury severity data were also available.MethodsCivilian TBI clinic attendees completed validated self-report questionnaires assessing PTSD (PTSD Checklist Civilian Version (PCL-C)) and other psychiatric symptoms. From this, the prevalence of PTSD was estimated in our cohort. Postresuscitation Glasgow Coma Score and Marshall grade on CT brain scan were recorded as indicators of brain injury severity. A hierarchical regression explored whether TBI severity may predict PTSD scores.ResultsA high prevalence of PTSD was estimated (21% with PCL-C score >50). Higher Marshall grading displayed a slight negative correlation with PTSD symptoms. This statistically significant relationship persisted after confounding factors such as depression and postconcussion symptoms were controlled for.ConclusionsPTSD and TBI frequently coexist, share antecedents and overlap in their resultant symptoms. This complexity has given rise to conflicting hypotheses about relationships between the two. This research reveals that PTSD is common in civilians with TBI (adding to evidence drawn from military populations). The analysis indicated that more severe brain injury may exert a slight protective influence against the development of PTSD—potentially by disrupting implicit access to traumatic memories, or via overlapping neuropsychiatric symptoms that impede diagnosis. The association suggests that further research is warranted to explore the reuse of routine clinical and neuroimaging data—investigating its potential to predict risk of psychiatric morbidity.

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