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 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.

Eyeball Pressure Stimulation Unveils Subtle Autonomic Cardiovascular Dysfunction in Persons with a History of Mild Traumatic Brain Injury

2015 ◽  
Vol 32 (22) ◽  
pp. 1796-1804 ◽  
Author(s):  
Max J. Hilz ◽  
Felix Aurnhammer ◽  
Steven R. Flanagan ◽  
Tassanai Intravooth ◽  
Ruihao Wang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Cardiovascular Dysfunction ◽  
History Of

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 Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

2018 ◽  
Vol 7 (4) ◽  
pp. 197-203 ◽  
Author(s):  
Roghieh Nazari ◽  
Saeed Pahlevan Sharif ◽  
Kelly A Allen ◽  
Hamid Sharif Nia ◽  
Bit-Lian Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Injury Severity ◽  
Repeated Measure ◽  
Neck Stiffness ◽  
Significant Difference ◽  
Eye Opening ◽  
Different Levels

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.

Pilot investigation of a novel white matter imaging technique in Veterans with and without history of mild traumatic brain injury

Brain Injury ◽  
2018 ◽  
Vol 32 (10) ◽  
pp. 1255-1264 ◽  
Author(s):  
Sarah M. Jurick ◽  
Samantha N. Hoffman ◽  
Scott Sorg ◽  
Amber V. Keller ◽  
Nicole D. Evangelista ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Mild Traumatic Brain Injury ◽  
Imaging Technique ◽  
Pilot Investigation ◽  
History Of

Effects of hypertonic saline on intracranial pressure and cerebral autoregulation in pediatric traumatic brain injury

2021 ◽  
pp. 1-7
Author(s):  
Julian Zipfel ◽  
Juliane Engel ◽  
Konstantin Hockel ◽  
Ellen Heimberg ◽  
Martin U. Schuhmann ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Hypertonic Saline ◽  
Pediatric Patients ◽  
Injury Severity ◽  
Primary Outcome Measure ◽  
Favorable Outcome ◽  
Outcome Group ◽  
Significant Difference

OBJECTIVE Hypertonic saline (HTS) is commonly used in children to lower intracranial pressure (ICP) after severe traumatic brain injury (sTBI). While ICP and cerebral perfusion pressure (CPP) correlate moderately to TBI outcome, indices of cerebrovascular autoregulation enhance the correlation of neuromonitoring data to neurological outcome. In this study, the authors sought to investigate the effect of HTS administration on ICP, CPP, and autoregulation in pediatric patients with sTBI. METHODS Twenty-eight pediatric patients with sTBI who were intubated and sedated were included. Blood pressure and ICP were actively managed according to the autoregulation index PRx (pressure relativity index to determine and maintain an optimal CPP [CPPopt]). In cases in which ICP was continuously > 20 mm Hg despite all other measures to decrease it, an infusion of 3% HTS was administered. The monitoring data of the first 6 hours after HTS administration were analyzed. The Glasgow Outcome Scale (GOS) score at the 3-month follow-up was used as the primary outcome measure, and patients were dichotomized into favorable (GOS score 4 or 5) and unfavorable (GOS score 1–3) groups. RESULTS The mean dose of HTS was 40 ml 3% NaCl. No significant difference in ICP and PRx was seen between groups at the HTS administration. ICP was lowered significantly in all children, with the effect lasting as long as 6 hours. The lowering of ICP was significantly greater and longer in children with a favorable outcome (p < 0.001); only this group showed significant improvement of autoregulatory capacity (p = 0.048). A newly established HTS response index clearly separated the outcome groups. CONCLUSIONS HTS significantly lowered ICP in all children after sTBI. This effect was significantly greater and longer-lasting in children with a favorable outcome. Moreover, HTS administration restored disturbed autoregulation only in the favorable outcome group. This highlights the role of a “rescuable” autoregulation regarding outcome, which might be a possible indicator of injury severity. The effect of HTS on autoregulation and other possible mechanisms should be further investigated.

A-108 Psychological and Sociodemographic Challenges, but Not History of Mild Traumatic Brain Injury, Is Associated with Criminal Justice Involvement among Veterans and Service Members

2021 ◽  
Vol 36 (6) ◽  
pp. 1157-1157
Author(s):  
Becky Gius ◽  
Lauren F Fournier ◽  
Tea Reljic ◽  
Terri Pogoda ◽  
John Corrigan ◽  
...  
Keyword(s):  
Social Support ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Criminal Justice ◽  
Alcohol Consumption ◽  
Mild Traumatic Brain Injury ◽  
Ptsd Symptoms ◽  
Criminal Justice Involvement ◽  
Lifetime History ◽  
History Of

Abstract Objective Examine factors associated with history of arrests and felony incarceration among Veterans and Service Members (V/SM) with combat exposure. Method Participants were V/SM who completed a baseline assessment for the multicenter Chronic Effects of Neurotrauma Consortium study (N = 1555). Most were male (87%), white (72%), with a mean age of 40 years (SD = 9.71). The majority (83%) reported a history of ≥1 mild traumatic brain injury (mTBI), with thirty-five present of those experiencing 3+ mTBIs. Results Three groups were composed based on self-reported level of involvement with the criminal justice system: 1.) No history of arrests or incarcerations (65%), 2.) A lifetime history of arrest but no felony incarceration (32%), and 3.) A lifetime history of felony incarceration (3%). Chi-square and Kruskal-Wallis H tests revealed statistically significant differences between the groups in demographic factors including the incarcerated group having younger age, greater percentage of men, lower education, and greater percentage of never being married, followed by the arrest group and then the no arrest group (all p &lt; 0.05). The incarcerated group also had the highest level of posttraumatic stress disorder (PTSD) symptoms, lowest social support, and greatest percentage of hazardous alcohol consumption, followed by the arrest and then the no arrest groups (all p &lt; 0.05). No differences were found between groups for mTBI history or neuropsychological testing results. Conclusions Correlates of legal involvement among V/SM span demographic and psychological dimensions. Some correlates are modifiable, including social support, PTSD symptoms, and alcohol consumption. Addressing these modifiable risk factors is critical to lower the risk of future criminal justice involvement.

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.

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