scholarly journals Hemorrhages Seen on Brain Images After Mild Traumatic Brain Injury May Increase the Risk of Post-concussion Syndrome

2020 ◽  
Vol 6 (2) ◽  
pp. 73-82
Author(s):  
Seddigheh Eslamparast ◽  
◽  
Zoheir Rehianian ◽  
Sara Ramezani ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
General Physician ◽  
Cross Sectional ◽  
Post Concussion Syndrome ◽  
Significant Difference ◽  
Brain Scan ◽  
Temporal Lesion

Background and Aim: Mild Traumatic Brain Injury (mTBI) mostly develops the symptoms that may persist for over three months known as Post-Concussion Syndrome (PCS). However, the PCS potential risk for mTBI victims is not well-identified. Here, we investigated the putative risk factors of PCS. Methods and Materials/Patients: In a cross-sectional study, we collected (HIS) the demographic, clinical, and radiological data using the hospital information system in 388 mTBI patients who passed at least 3 months since the onset of their injury and referred to Poursina hospital from March 2017 to December 2018. The patients were examined to diagnose PCS by a general physician using the phone interview via the Rivermead Post-concussion Symptoms Questionnaire (RPQ). The subjects were separated into groups with and without PCS. Data were analyzed by parametric t-test, Chi-square test and multiple logistic regression. Results: One-hundred ninety one out of 388 mTBI patients consented to complete the RPQ and around 59% of cases experienced PCS. There was no significant difference in the demographic variables and past medical history between groups. However, the previous psychological disease was particularly associated with PCS (P>0.043). Length of hospitalization, functional outcome during discharge, and post-resuscitation consciousness did not show any significant association with PCS (P<0.05). Interestingly, initial abnormal brain scan, fronto-temporal lesion, and accompanied hematoma (hemorrhages) were identified as risk factors of mTBI-induced PCS. The risk of PCS was found to increase by 7.2 times in mTBI patients demonstrated as an abnormality in their initial brain scans (P<0.001). A directly proportional relationship was found between the occurrence of the syndrome and the fronto-temporal lesion (P<0.017). Accompanied hematoma enhanced the risk of PCS by 2.6 times (P<0.04). Conclusion: This study emphasized the significance of early brain scan data for the prediction of PCS and the necessity of proper follow-up care for the at-risk population. The reported data from this study might be applied as an objective trajectory to measure PCS in those who simulated PCS for the litigation.

scholarly journals Divergent Classification Methods of Post-Concussion Syndrome after Mild Traumatic Brain Injury: Prevalence Rates, Risk Factors, and Functional Outcome

2018 ◽  
Vol 35 (11) ◽  
pp. 1233-1241 ◽  
Author(s):  
Daphne C. Voormolen ◽  
Maryse C. Cnossen ◽  
Suzanne Polinder ◽  
Nicole von Steinbuechel ◽  
Pieter E. Vos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Mild Traumatic Brain Injury ◽  
Classification Methods ◽  
Prevalence Rates ◽  
Post Concussion Syndrome

scholarly journals Analysis of the Symptoms and Functional Outcome of Mild Traumatic Brain Injury

2021 ◽  
Vol 7 (6) ◽  
Author(s):  
K. Yrysov ◽  
G. Faizullaeva
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Injury Severity ◽  
Clear Understanding ◽  
Satisfaction Scale ◽  
Post Concussion Syndrome ◽  
Negative Results ◽  
Significant Difference ◽  
History Of

The consequences of TBI are most often grouped into the so-called Post-concussion Syndrome (PCS). At present, there is no clear understanding of the evolution, duration, or resolution of the symptoms of PCS after mild traumatic brain injury (mTBI). Aim of the study. A prospective characterization of the frequency and evolution of PCS symptoms and outcomes of patients after mTBI for 3, 6, and 12 months in a large prospective cohort of patients in the emergency department. Material and methods. A total of 375 patients met the inclusion criteria. Patients were evaluated using the PCS checklist, as well as the Extended Glasgow Outcome Scale (EGOS), the Short List of Symptoms-18 (SLS-18), the Rivermead Post-Concussion Questionnaire (RPCQ), and the Life Satisfaction Scale (LSS). Results. The population was 70.1% male, with a median age of 44 years. Approximately 44% of the population were considered to have complicated mTBI, having positive results of computed tomography (CT). The average injury severity score (ISS), calculated only for patients admitted to the hospital, was 9.37±9.72 (279 in total). ISS was significantly higher in patients with positive CT (16.5±8.39) compared to patients with negative CT (3.8±6.6). Conclusion. Patients with negative CT scans had significantly increased rates of neurological problems, prior TBI, and alcohol use, which may contribute to increased symptoms and a deterioration in BSI-18 scores. After examining only those patients with a negative history of the disease, there was no significant difference between the groups with positive and negative results for any indicator of outcome.

scholarly journals Serum S100B Determination in the Management of Pediatric Mild Traumatic Brain Injury

2012 ◽  
Vol 58 (7) ◽  
pp. 1116-1122 ◽  
Author(s):  
Damien Bouvier ◽  
Mathilde Fournier ◽  
Jean-Benoît Dauphin ◽  
Flore Amat ◽  
Sylvie Ughetto ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Reference Interval ◽  
Pediatric Emergency ◽  
Cranial Computed Tomography ◽  
Serum S100b ◽  
Significant Difference ◽  
Hospitalization Costs ◽  
Group 2

Abstract BACKGROUND The place of serum S100B measurement in mild traumatic brain injury (mTBI) management is still controversial. Our prospective study aimed to evaluate its utility in the largest child cohort described to date. METHODS Children younger than 16 years presenting at a pediatric emergency department within 3 h after TBI were enrolled prospectively for blood sampling to determine serum S100B concentrations. The following information was collected: TBI severity determined by using the Masters classification [1: minimal or Glasgow Coma Scale (GCS) 15, 2: mild or GCS 13–15, and 3: severe or GCS &lt;13]; whether hospitalized or not; good or bad clinical evolution (CE); whether cranial computed tomography (CCT) was prescribed; and related presence (CCT+) or absence (CCT−) of lesions. RESULTS For the 446 children enrolled, the median concentrations of S100B were 0.21, 0.31, and 0.44 μg/L in Masters groups 1, 2, and 3, respectively, with a statistically significant difference between these groups (P &lt; 0.05). In Masters group 2, 65 CCT scans were carried out. Measurement of S100B identified patients as CCT+ with 100% (95% CI 85–100) sensitivity and 33% (95% CI 20–50) specificity. Of the 424 children scored Masters 1 or 2, 21 presented “bad CE.” S100B identified bad CE patients with 100% (95% CI 84–100) sensitivity and 36% (95% CI 31–41) specificity. Of the 242 children hospitalized, 81 presented an S100B concentration within the reference interval. CONCLUSIONS Serum S100B determination during the first 3 h of management of children with mTBI has the potential to reduce the number of CCT scans, thereby avoiding unnecessary irradiation, and to save hospitalization costs.

scholarly journals Cognitive function and other risk factors for mild traumatic brain injury in young men: nationwide cohort study

BMJ ◽  
2013 ◽  
Vol 346 (mar11 1) ◽  
pp. f723-f723 ◽  
Author(s):  
A. Nordstrom ◽  
B. B. Edin ◽  
S. Lindstrom ◽  
P. Nordstrom
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Cognitive Function ◽  
Mild Traumatic Brain Injury ◽  
Young Men

Analysis of Discourse Production to Assess Cognitive Communication Deficits Following Mild Traumatic Brain Injury With and Without Posttraumatic Stress

2021 ◽  
pp. 1-15
Author(s):  
Jennifer Rae Myers ◽  
Nancy Pearl Solomon ◽  
Rael T. Lange ◽  
Louis M. French ◽  
Sara M. Lippa ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Posttraumatic Stress ◽  
Mild Traumatic Brain Injury ◽  
Negative Emotion ◽  
Word Count ◽  
Discourse Production ◽  
Communication Deficits ◽  
Global Coherence ◽  
Significant Difference

Purpose: Cognitive communication deficits can be difficult to assess in individuals with mild traumatic brain injury (mTBI). However, the use of discourse analysis as a direct and sensitive metric of cognitive communication skills has shown promising clinical utility for other TBI severity levels. This exploratory study investigated discourse production in service members and veterans (SMVs) with uncomplicated mTBI with and without posttraumatic stress disorder (PTSD) and SMVs with neither mTBI or PTSD. Method: Fifteen SMVs with mTBI and PTSD, 26 with mTBI, and 25 controls with no brain injury (NBI) and without PTSD were given a wordless picture story to elicit spontaneous discourse. Discourse samples were analyzed for global coherence, word count, the use of negative emotion words, cognitive process words, nonfluencies, and story completeness. Results: Results revealed a significant difference between the mTBI ( Mdn = 3.33) and NBI ( Mdn = 3.50) groups, χ 2 (3) = 6.044, p = .017, ε 2 = .03, for global coherence. Word count differed significantly between the mTBI + PTSD ( Mdn = 135) and NBI ( Mdn = 195) groups, χ 2 (3) = 7.968, p = .006, ε 2 = .06. No other group differences were observed. Discussion: Structural features of discourse production may serve as potential markers of cognitive communication deficits in mTBI. Furthermore, PTSD may contribute to verbal fluency deficits in individuals with mTBI. Additional research is needed to develop discourse-related measures that are more sensitive to the effects of mTBI and PTSD.

scholarly journals Head CT overuse in children with a mild traumatic brain injury within two Canadian emergency departments

2019 ◽  
Vol 25 (1) ◽  
pp. 26-32
Author(s):  
Martin Gariepy ◽  
Jocelyn Gravel ◽  
France Légaré ◽  
Edward R Melnick ◽  
Erik P Hess ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Emergency Departments ◽  
Retrospective Chart Review ◽  
Trauma Centre ◽  
Diagnostic Tools ◽  
General Level ◽  
Head Ct ◽  
Significant Difference

Abstract Background The validated Pediatric Emergency Care Applied Network (PECARN) rule helps determine the relevance of a head computerized tomography (CT) for children with mild traumatic brain injury (mTBI). We sought to estimate the potential overuse of head CT within two Canadian emergency departments (EDs). Methods We conducted a retrospective chart review of children seen in 2016 in a paediatric Level I (site 1) and a general Level II (site 2) trauma centre. We reviewed charts to determine the appropriateness of head CT use according to the PECARN rule in a random subset of children presenting with head trauma. Simple descriptive statistics were applied. Results One thousand five hundred and forty-six eligible patients younger than 17 years consulted during the study period. Of the 203 randomly selected cases per setting, 16 (7.9%) and 24 (12%), respectively from sites 1 and 2 had a head CT performed. Based on the PECARN rule, we estimated the overuse for the younger group (&lt;2 years) to be below 3% for both hospitals without significant difference between them. For the older group (≥2 years), the overuse rate was higher at site 2 (9.3%, 95% confidence interval [CI]: 4.8 to 17% versus 1.2%, 95% CI: 0.2 to 6.5%, P=0.03). Conclusion Both EDs demonstrated overuse rates below 10% although it was higher for the older group at site 2. Such low rates can potentially be explained by the university affiliation of both hospitals and by two Canadian organizations working to raise awareness among physicians about the overuse of diagnostic tools and dangers inherent to radiation.

Symptoms of post-concussional syndrome are non-specifically related to mild traumatic brain injury in UK Armed Forces personnel on return from deployment in Iraq: an analysis of self-reported data

2008 ◽  
Vol 39 (8) ◽  
pp. 1379-1387 ◽  
Author(s):  
N. T. Fear ◽  
E. Jones ◽  
M. Groom ◽  
N. Greenberg ◽  
L. Hull ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Military Personnel ◽  
Symptom Severity ◽  
General Health Questionnaire ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Reported Data

BackgroundMild traumatic brain injury (mTBI) is being claimed as the ‘signature’ injury of the Iraq war, and is believed to be the cause of long-term symptomatic ill health (post-concussional syndrome; PCS) in an unknown proportion of military personnel.MethodWe analysed cross-sectional data from a large, randomly selected cohort of UK military personnel deployed to Iraq (n=5869). Two markers of PCS were generated: ‘PCS symptoms’ (indicating the presence of mTBI-related symptoms: none, 1–2, 3+) and ‘PCS symptom severity’ (indicating the presence of mTBI-related symptoms at either a moderate or severe level of severity: none, 1–2, 3+).ResultsPCS symptoms and PCS symptom severity were associated with self-reported exposure to blast whilst in a combat zone. However, the same symptoms were also associated with other in-theatre exposures such as potential exposure to depleted uranium and aiding the wounded. Strong associations were apparent between having PCS symptoms and other health outcomes, in particular being a post-traumatic stress disorder or General Health Questionnaire case.ConclusionsPCS symptoms are common and some are related to exposures such as blast injury. However, this association is not specific, and the same symptom complex is also related to numerous other risk factors and exposures. Post-deployment screening for PCS and/or mTBI in the absence of contemporaneous recording of exposure is likely to be fraught with hazards.

Factors Associated With Degree and Length of Recovery in Children With Mild and Complicated Mild Traumatic Brain Injury

Neurosurgery ◽  
2019 ◽  
Vol 85 (5) ◽  
pp. E842-E850 ◽  
Author(s):  
James E Gardner ◽  
Masaru Teramoto ◽  
Colby Hansen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Activity Patterns ◽  
Skull Fracture ◽  
Complete Recovery ◽  
Study Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potential Risk Factors

Abstract BACKGROUND A complicated mild traumatic brain injury (C-mTBI) is an mTBI with some form of intracranial abnormality identified radiographically. The lack of knowledge in recovery patterns and no clear guidelines on return to activity in children with C-mTBI provide unique challenges to physicians. OBJECTIVE To examine recovery patterns among three cohorts: mTBI, mTBI with skull fracture only (mTBI-SF), and C-mTBI via a cross-sectional survey. METHODS Caregivers of children with mTBI (from hospital database queries 2010–2013) were mailed a questionnaire on preinjury health, postinjury recovery, and activity patterns before and after injury. We examined degree (0-10 with 10 being complete recovery) and length (in months) of recovery in children with mTBI, and associations of potential risk factors to these variables. RESULTS Of the 1777 surveyed, a total of 285 complete responses were analyzed for this study. Data included 175 (61.4%) children with mTBI, 33 (11.6%) children with mTBI-SF, and 77 (27.0%) children with C-mTBI. Older age and C-mTBI (vs mTBI) were significantly associated with a lower degree and longer period of recovery (P < .05). Predicted probabilities of complete recovery for children with mTBI, those with mTBI-SF, and those with C-mTBI were 65.5%, 52.7%, and 40.0%, respectively. Predicted probabilities of not yet completely recovered after more than a year since injury for these groups were 11.3%, 24.4%, and 37.6%, respectively. CONCLUSION These results demonstrate significant differences in children with different forms of mTBI, and argue for further investigation of treatment plans individualized for each form of mTBI.

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