Psychiatric sequelae of traumatic brain injury (TBI)

2020 ◽  
Vol 11 (5) ◽  
pp. 77-82
Author(s):  
Ambarish Ghosh ◽  
Birva Desai ◽  
Arghya Halder ◽  
Aniruddha Ghosh ◽  
Priyanka Das ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
P Value ◽  
Medical College ◽  
Increased Risk ◽  
Psychiatric Sequelae ◽  
One Year ◽  
First Interview ◽  
Severe Anxiety

Background: Traumatic brain injury (TBI), a leading cause of morbidity and mortality worldwide, is an alteration in brain function, caused by an external force. With rapid surge in urbanization, motorization and economic liberalization in India, risk of TBI is increased, raising a cause for concern about its neurological as well as psychiatric sequelae. Aims and Objectives: This study was planned to understand the magnitude of the problem which could give us insights to manage/ rehabilitate it in a more comprehensive manner. Materials and Methods: The current study included 50 patients aged 18-60 years at DY Patil Medical College, Pune. GCS scores were noted for severity of TBI. Patients were assessed through MMSE, BCRS, HAM-A & BDI. Results: On GCS, 20% cases had severe head injury; 22% moderate and 58% had mild. On MMSE initially, at six months and one year; 26.19%, 21.88% & 11.1% cases had cognitive impairment respectively. On BCRS, 38.10%, 34.4% & 37.10% cases had cognitive deterioration initially, at six month & at one year respectively. On HAM-A, mild & moderate to severe anxiety was found in 64.3% & 35.7% cases respectively. On BDI, initially 7.14% cases had depression, 25% at six months and 37.05% after one year. No statistically significant change was seen in BCRS score during follow up. Comparison of the mean scores at first interview and at six months demonstrated statistically significant (P-value p<0.005) differences in MMSE as well as BDI. Conclusion: TBI is associated with n increased risk of psychiatric disorders and may need psychiatric interventions later.

scholarly journals Study of Patients with First unprovoked Seizure in the Eastern Part of Nepal

2019 ◽  
Vol 8 (1) ◽  
pp. 22-26
Author(s):  
Dilli Ram Kafle ◽  
Surendra Sah ◽  
Miluna Bhusal
Keyword(s):  
Recurrence Risk ◽  
Cross Sectional Study ◽  
P Value ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Neuro Imaging

Background: About 5-10% of the population get at least one seizure in their lifetime. Treatment is started in patients with first unprovoked seizure if the risk of seizure recurrence is predicted to be high. If patients with first seizure are not treated 40-50% of patients develop recurrence within 2 years of the initial seizure. Starting treatment may cause reduction in the risk of recurrence by almost one half. The aim of the study was to identify the factors causing recurrence in patients with first unprovoked seizure. Materials and Methods: It is a prospective cross-sectional study conducted at Nobel Medical College from March 2015 to March 2019. Patients who presented to Nobel Medical College with first unprovoked seizure were enrolled in the study with follow up during the hospital visit. Results: Eighty six patients participated in our study. Recurrence of seizure occurred in 21(24.4%) patients within the study period of 4 years. Abnormal Electroencephalography was significantly associated with recurrence of seizure in patients with first seizure. (P value<0.001) Neuro imaging abnormality was also associated with increased risk of seizure recurrence (Pvalue<0.001) .Starting an antiepileptic after first seizure reduced the risk of further seizure. Conclusion: Recurrence of seizure was observed in almost a quarter of patients within the study period of four years. Recurrence risk was higher in those patients with abnormal Electro encephalography and in those patients with identified cause than those patients whose seizure was assumed to be idiopathic.

scholarly journals Post-Traumatic Headache After Mild Traumatic Brain Injury In A One-Year Follow Up Study – Risk Factors And Return To Work

2021 ◽  
Author(s):  
Yvonn Kraemer ◽  
Kaisa Mäki ◽  
Ivan Marinkovic ◽  
Taina Nybo ◽  
Harri Isokuortti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Outpatient Clinic ◽  
Post Traumatic ◽  
One Year

Abstract Background: Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods: This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results: At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions: Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.

scholarly journals Increased Risk of Graves´ophthalmopathy in Patients With Increasing TRAb After Radioiodine Treatment and the Impact of CTLA4 on TRAb Titres

2021 ◽  
Author(s):  
Bushra Shahida ◽  
Kleoniki Tsoumani ◽  
Tereza Planck ◽  
Vijayachitra Modhukur ◽  
Pernilla Asp ◽  
...  
Keyword(s):  
Previous Treatment ◽  
University Hospital ◽  
P Value ◽  
Graves Ophthalmopathy ◽  
Increased Risk ◽  
Orbital Tissue ◽  
One Year ◽  
The Impact ◽  
The Relationship

Abstract Introduction. Treatment of Graves´ disease (GD) with radioiodine increases the risk of developing Graves´ ophthalmopathy (GO) but the link between thyroid and orbital tissue remains undefined.The aim was to investigate the relationship between GO and TRAb after treatment with radioiodine and to define the impact of risk genes.Methods. GD patients without ophthalmopathy or previous treatment with radioiodine were prospectively included at treatment with radioiodine for hyperthyroidism. A follow-up was performed one year later for registration of GO development. The study was performed at a University Hospital Clinic; referral center of all patients treated with radioiodine in the south of Sweden. The main outcome measures were development of TRAb, anti-TPO, anti-TG after three months and GO after 12 months and relationship to the genetic background (HLA, CTLA-4, CYR61).Results. Three months of radioiodine TRAb increased in two thirds of patients (p<0.0005) but not in the other third. Anti-TPO was associated with TRAb (R=0.362, p <0.0001) but not anti-TG. At follow-up one year later (n=204) 32 patients developed GO with a proportion of 70% in the group increasing in TRAb and 30 % in the group with unchanged or lower TRAb (p-value <0.0005). Patients with GO had higher levels of TRAb than patients without GO. CTLA-4 (rs231775 SNP) was significantly (p<0.005) associated with TRAb levels above the median three months after radioiodine.Conclusions. The increase in TRAb after treatment with radioiodine is associated with GO and a genetic variation in CTLA-4 is associated with higher levels of TRAb.

Risk factors for myocardial dysfunction after traumatic brain injury: A one-year follow-up study

Injury ◽  
2017 ◽  
Vol 48 (8) ◽  
pp. 1794-1800 ◽  
Author(s):  
Kang Lu ◽  
Cheng-Loong Liang ◽  
Ping-Chia Li ◽  
Po-Chou Liliang ◽  
Chih-Yuan Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Myocardial Dysfunction ◽  
Follow Up Study ◽  
One Year

Return to work after severe traumatic brain injury: a national study with a one-year follow-up of neurocognitive and behavioural outcomes

2018 ◽  
Vol 30 (2) ◽  
pp. 281-297 ◽  
Author(s):  
Solrun Sigurdardottir ◽  
Nada Andelic ◽  
Eike Wehling ◽  
Audny Anke ◽  
Toril Skandsen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Severe Traumatic Brain Injury ◽  
National Study ◽  
One Year

scholarly journals Traumatic brain injury as a risk factor for dementia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Mezzalira ◽  
B Stopa ◽  
A Khawaja ◽  
S Izzy ◽  
W Gormley
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Risk Factor ◽  
Brain Injury ◽  
The United States ◽  
Age Group ◽  
Global Public Health ◽  
Public Health Burden ◽  
Increased Risk

Abstract Introduction The Centers for Disease Control and Prevention (CDC) reports that there were 2.87 million cases of traumatic brain injury (TBI) in the United States in 2014, 69 million worldwide. Some studies suggest a connection between TBI and increased risk of dementia, but it remains unclear whether the risk increases with age and TBI severity. Given our aging population, it is essential to better characterize the link between TBI and dementia. Methods We conducted a retrospective cohort study of two major academic medical centers for years 2000-2015. We identified all patients with TBI, aged 45 and older. Variables included age, TBI severity, pre-existing dementia, dementia diagnosed after TBI, years to dementia, and follow-up time. TBI severity was determined by head/neck AIS score, using ICD-PIC software. Mild TBI was defined as AIS 0-2, and Moderate/Severe as AIS 3-6. Analysis was done in R.v.3.0.1 software. Results Overall, there were 14,199 patients with TBI, of which 9,938 (70%) were mild and 4,261 (30%) were moderate/severe. Mean age was 70.5 (±14.0). There were 1,422 cases (10%) of pre-existing dementia, and 850 (6%) cases of dementia diagnosed after TBI. The mean follow-up time was 1,129 (±1,474) days. The 75-84 age group had the highest incidence of TBI (28%). When compared by age group and TBI severity, the proportion of moderate/severe TBI increased with increasing age. The proportion of pre-existing dementia increased with age, as expected. Notably, there is increased incidence of dementia after TBI in patients aged 65 and older (7-10%, p &lt; 0.001). There was no observed effect of TBI severity on the risk of dementia after TBI. Conclusions Our results indicate that TBI is a risk factor for the development of dementia, especially in patients aged 65 and older. Given the global public health burden of these two diseases it is critical to develop effective TBI primary prevention strategies. Key messages TBI is a risk factor for the development of dementia. Need for public health measures to mitigate the risk of TBI in the patient population 65 and older.

scholarly journals Correlation between neutrophil lymphocyte count ratio and outcomes of severe traumatic head injury

2021 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Tamajyoti Ghosh ◽  
Subir Dey
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Severe Traumatic Brain Injury ◽  
Univariate Analysis ◽  
P Value ◽  
Traumatic Head Injury ◽  
Neutrophil Lymphocyte Ratio ◽  
Traumatic Head

Background: Raised peripheral neutrophil lymphocyte ratio is associated with poorer outcomes in conditions such as severe brain injury, ICH, cardiovascular conditions, cancer.Methods: Retrospective analysis of 96 severe Traumatic Brain injury data treated at our institute over a period of 1 year. The patients were followed up for a period of at least 1 month. The primary outcome of the study was 1 month GOS and the various variables which may be associated with the poor GOS at 1 month follow up. Model based analysis was done for NLCR <24 hrs at 48 hrs and GCS at the time of presentation and discriminative ability of the models were studied by the Area under the curve.Results: Univariate analysis were done of 96 patients of severe traumatic brain injury for various variables such as age, sex, mode of head injury, type of head injury, presenting GCS and NLCR at 24 hrs and 48 hrs to that of GOS at 1 month follow up. Initial GCS <7 (p=0.0138) with AUC=0.6689 and peak NLCR (<24 hr) of > 9.6 (AUC=0.931) with a p value of <0.001 with sensitivity of 100% and specificity of 79.27% and peak NLCR (48 hrs) of >12.4 (AUC= 0.973) with a p value of <0.001 with sensitivity of 100% and specificity of 89.02% were associated with unfavourable outcome.Conclusions: High NLCR and initial poor GCS are independent unfavourable prognostic factors in 1 month GOS following severe traumatic head injury.

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