Severe Traumatic Brain Injury: Some Effects on Family Caregivers

2002 ◽  
Vol 90 (2) ◽  
pp. 415-425 ◽  
Author(s):  
Gregory J. Boyle ◽  
Sandra Haines
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Member ◽  
Family Environment ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Comparison Group ◽  
Brain Injured ◽  
The Family ◽  
Time And Energy

This study assesses the effects of severe traumatic brain injuries on family members and functioning—a topic of interest for those working with survivors and their families. This issue is receiving increased attention as recent findings suggest that family adjustment influences outcome for brain-injured persons. The Family Environment Scale and the Profile of Mood States were completed by 25 individuals who had a family member with a severe traumatic brain injury. These scales were also completed by a comparison group of 32 individuals who had no brain-injured family member. In terms of family functioning, the findings suggest that, when a family member suffers a severe traumatic brain injury, depression may be elevated, along with a decreased ability to express feelings, decreased time and energy for social and recreational activities, and increased control in comparison to families without a brain-injured member. While this might contribute to family isolation which could last for many years, the overall finding of the present study was that caregiver families were coping adequately.

scholarly journals Family System Functioning in Caring for Thai Survivors with Severe Traumatic Brain Injury

2020 ◽  
Author(s):  
Sumamita Sawasdinaruenart ◽  
Warunee Fongkaew ◽  
Praneed Songwathana ◽  
Hilaire J. Thompson ◽  
Nuttamon Vuttanon ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Member ◽  
Severe Traumatic Brain Injury ◽  
Family System ◽  
Moderate Level ◽  
Self Report ◽  
Qualitative Approaches ◽  
The Family ◽  
System Functioning

Objective: This study aimed to describe family system functioning, in providing care for a family member, after surviving a severe traumatic brain injury (TBI).Material and Methods: A cross sectional survey, using a self-report questionnaire, was conducted with 77 family members; from 32 families, caring for survivors from one province in southern Thailand. Family system functioning was measured using the Family Assessment Measure III (FAM-III) General Scale, Thai version as well as a demographic questionnaire. Descriptive statistics were applied to analyze family functioning including means, standard deviation, percentage and T-scores.Results: The findings showed that the overall family system functioning existed within the moderate level (M=49.94, S.D. =8.99). The finding also indicated moderate levels of functioning within the FAM III subscales.Conclusion: The present findings provide evidence that family systems functioning was at a moderate level in those providing care for a family member who had sustained a severe TBI. This level of function might pose difficulty regarding ability of the family towards a variety of basic, developmental and crisis tasks. The investigation suggests a future study, complementing quantitative methods with qualitative approaches.

The Effect of Severe Traumatic Brain Injury on the Family

2002 ◽  
Vol 52 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
Vicki Montgomery ◽  
Ronald Oliver ◽  
Andrew Reisner ◽  
Mary E. Fallat
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
The Family

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.

scholarly journals The Expanding Role of Quantitative Pupillometry in the Evaluation and Management of Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Jason H. Boulter ◽  
Margaret M. Shields ◽  
Melissa R. Meister ◽  
Gregory Murtha ◽  
Brian P. Curry ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Ease Of Use ◽  
Brain Injured ◽  
The World ◽  
Injured Patients ◽  
Austere Environments ◽  
Active Investigation

Traumatic brain injury is a rapidly increasing source of morbidity and mortality across the world. As such, the evaluation and management of traumatic brain injuries ranging from mild to severe are under active investigation. Over the last two decades, quantitative pupillometry has been increasingly found to be useful in both the immediate evaluation and ongoing management of traumatic brain injured patients. Given these findings and the portability and ease of use of modern pupillometers, further adoption and deployment of quantitative pupillometers into the preclinical and hospital settings of both resource rich and medically austere environments.

Traumatic Brain and Spinal Cord Injuries

2020 ◽  
Author(s):  
Geoffrey S.F. Ling ◽  
Mohit Datta
Keyword(s):  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Gunshot Wound ◽  
Brain Injuries ◽  
Spinal Cord Injuries ◽  
Cord Injury ◽  
Brain And Spinal Cord

Traumatic brain and spinal cord injuries are significant causes of permanent disability and death. In 2010, 823,000 traumatic brain injuries were reported in the United States alone; in fact, the actual number is likely considerably higher because mild traumatic brain injuries and concussions are underreported. The number of new traumatic spinal cord injuries has been estimated at 12,000 annually. Survival from these injuries has increased due to improvements in medical care. This review covers mild traumatic brain injury and concussion, moderate to severe traumatic brain injury, and traumatic spinal cord injury. Figures include computed tomography scans showing a frontal contusion, diffuse cerebral edema and intracranial air from a gunshot wound, a subdural hematoma, an epidural hematoma, a skull fracture with epidural hematoma, and a spinal fracture from a gunshot wound. Tables list requirements for players with concussion, key guidelines for prehospital management of moderate to severe traumatic brain injury, key guidelines for management of moderate to severe traumatic brain injury, brain herniation brain code, key clinical practice guidelines for managing cervical spine and spinal cord injury, and the American Spinal Injury Association’s neurologic classification of spinal cord injury. This review contains 6 highly rendered figures, 12 tables, and 55 references.

Trauma

2020 ◽  
pp. 131-170
Keyword(s):  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Cervical Spinal Cord ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Cord Injury

This chapter discusses traumatic spinal cord and brain injuries. The first three studies review the background and key findings of the third National Acute Spinal Cord Injury Study (NASCIS) trial, examine the efficacy of the Canadian C-Spine Rule in the evaluation of cervical spine injuries in alert and stable trauma patients; and describe the development of the Thoracolumbar Injury Classification and Severity Score (TLICS) classification system. The next two studies assess the effect of early surgical decompression in patients with traumatic cervical spinal cord injury and delineate the role of secondary brain injury in determining patient outcome in severe traumatic brain injury. The following set of four studies evaluates the efficacy of phenytoin in preventing posttraumatic seizures, as well as the efficacy of intracranial pressure monitoring, induction of hypothermia, and decompressive craniectomy for severe traumatic brain injury. The last study, which is of historical value, identifies predictors of outcome in comatose patients with traumatic acute subdural hematoma.

Emotion Perception and Alexithymia in People With Severe Traumatic Brain Injury: One Disorder or Two? A Preliminary Investigation

2011 ◽  
Vol 12 (3) ◽  
pp. 165-178 ◽  
Author(s):  
Skye McDonald ◽  
Julia Rosenfeld ◽  
Julie D. Henry ◽  
Leanne Togher ◽  
Robyn Tate ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Preliminary Investigation ◽  
Emotion Perception ◽  
Poor Performance ◽  
Cross Sectional Study ◽  
Primary Objective ◽  
Cross Sectional

AbstractPrimary objective:Recent research studies attest to the presence of deficits in emotion perception following severe traumatic brain injury (TBI). Additionally, a growing number of studies report significant levels of alexithymia (disorder of emotional cognition) following TBI. This research aimed to examine the relation between the two, while assessing the influence of posttraumatic stress disorder (PTSD).Design:Cross-sectional study examining levels of alexithymia, emotion perception disorders and PTSD and their association, in 20 people with severe, chronic TBI and 20 adults without brain injuries.Methods:Participants were assessed on the Toronto Alexithymia — 20 Scale, the Posttraumatic Diagnostic Scale and on two emotion perception tasks: matching and labelling of photos depicting the 6 basic emotions.Results:The group with TBI were impaired relative to controls when matching facial expressions. Their performance on ‘fear’ was especially poor. Performance on labelling was similar in pattern, although failed to reach significance. There was no association between poor performance on fear, or other negative expressions, and either PTSD or alexithymia symptoms in the TBI group.Conclusions:Alexithymia, as assessed by the TAS-20, taps a constellation of difficulties that do not appear to include difficulties with emotion perception in people with traumatic brain injuries.

scholarly journals Mannitol cannot reduce the mortality on acute severe traumatic brain injury (TBI) patients: a meta–analyses and systematic review

2015 ◽  
Vol 3 ◽  
pp. 1-8 ◽  
Author(s):  
Kai Wang ◽  
Mingwei Sun ◽  
Hua Jiang ◽  
Xiao-ping Cao ◽  
Jun Zeng
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Meta Analysis ◽  
Outcome Data ◽  
Control Treatment ◽  
Current Evidence ◽  
Cochrane Library

Abstract Background We aimed to systematically review the efficacy of mannitol (MTL) on patients with acute severe traumatic brain injury (TBI). Methods Databases such as PubMed (US National Library of Medicine), CENTRAL (The Cochrane Library 2014, Issue 3), ISI (Web of Science: Science Citation Index Expanded), Chinese Biomedicine Database (CBM), and China Knowledge Resource Integrated Database (CNKI) have been searched for relevant studies published between 1 January 2003 and 1 October 2014. We have established inclusion and exclusion criteria to identify RCTs, which were suitable to be enrolled in the systematic review. The comparison group could be hypertonic saline (HS), hydroxyethyl starch, or others. The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and modified Jadad score scale. The major outcome was mortality, followed by the secondary outcomes such as neurological outcome, days on intensive care unit (ICU), and ventilator day. In addition, intracranial pressure (ICP), cerebral perfusion pressure (CPP), and mean arterial pressure (MAP) were used as the surrogate endpoints. Data synthesis and meta-analysis was conducted by using R (version 3.7-0.). Results When 176 potential relevant literatures and abstracts have been screened, four RCTs met all the inclusion criteria and were enrolled for the meta-analysis. Amongst all the enrolled studies, two trials have provided the primary outcome data. There was no heterogeneity between two studies (I2 = 0 %) and a fixed model was used for meta-analysis (n = 53), pooled result indicated that the mortality was similar in mannitol intervention and control treatment, OR = 0.80, 95 % CI [0.27, 2.37], P = 0.38. We found that both mannitol and HS were efficient in decreasing the ICP. Furthermore, the effect of the HS on the ICP appeared to be more effective in the patients with diffuse brain injuries than mannitol did. Conclusions As a conclusion, the mannitol therapy cannot reduce the mortality risk of acute severe traumatic brain injury. Current evidence does not support the mannitol as an effective treatment of acute severe traumatic brain injury. The well-designed randomized controlled trials are in urgent need to demonstrate the adoption of mannitol to acute severe traumatic brain injury.

scholarly journals When Basic Research Doesn't Translate to the Bedside—Lessons from the Magnesium Brain Trauma Study

2007 ◽  
Vol 7 (5) ◽  
pp. 133-135 ◽  
Author(s):  
John W. Miller ◽  
Raimondo D'Ambrosio
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Primary Outcome ◽  
Brain Injuries ◽  
Controlled Trial ◽  
Serum Magnesium ◽  
Trauma Centre ◽  
Double Blind ◽  
Positive Effect

Magnesium Sulfate for Neuroprotection After Traumatic Brain Injury: A Randomised Controlled Trial. Temkin NR, Anderson GD, Winn HR, Ellenbogen RG, Britz GW, Schuster J, Lucas T, Newell DW, Mansfield PN, Machamer JE, Barber J, Dikmen SS. Lancet Neurol 2007;6(1):29–38. BACKGROUND: Traumatic brain injuries represent an important and costly health problem. Supplemental magnesium positively affects many of the processes involved in secondary injury after traumatic brain injury and consistently improves outcome in animal models. We aimed to test whether treatment with magnesium favourably affects outcome in head-injured patients. METHODS: In a double-blind trial, 499 patients aged 14 years or older admitted to a level 1 regional trauma centre between August, 1998, and October, 2004, with moderate or severe traumatic brain injury were randomly assigned one of two doses of magnesium or placebo within 8 h of injury and continuing for 5 days. Magnesium doses were targeted to achieve serum magnesium ranges of 1 0–1·85 mmol/L or 1·25–2·5 mmol/L. The primary outcome was a composite of mortality, seizures, functional measures, and neuropsychological tests assessed up to 6 months after injury. Analyses were done according to the intention-to-treat principle. This trial is registered with Clinicaltrials.gov, number NCT00004730. FINDINGS: Magnesium showed no significant positive effect on the composite primary outcome measure at the higher dose (mean = 55 average percentile ranking on magnesium vs. 52 on placebo, 95% CI for difference – 7 to 14; p = 0·70). Those randomly assigned magnesium at the lower dose did significantly worse than those assigned placebo (48 vs. 54, 95% CI −10·5 to −2; p = 0007). Furthermore, there was higher mortality with the higher magnesium dose than with placebo. Other major medical complications were similar between groups, except for a slight excess of pulmonary oedema and respiratory failure in the lower magnesium target group. No subgroups were identified in which magnesium had a significantly positive effect. INTERPRETATION: Continuous infusions of magnesium for 5 days given to patients within 8 h of moderate or severe traumatic brain injury were not neuroprotective and might even have a negative effect in the treatment of significant head injury.

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