scholarly journals A Psychological Portrait of a Teenager in the Posttraumatic Confusional State

2021 ◽  
Vol 3 (1) ◽  
pp. 95-103
Author(s):  
Valentina I Bykova ◽  
Alena I. Tyutyukina ◽  
Yulia G. Sidneva ◽  
Svetlana A. Valiullina
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Social Intelligence ◽  
Brain Injuries ◽  
Psychological Characteristics ◽  
Confusional State ◽  
Russian Science ◽  
Psychological Phenomena ◽  
Gender And Age ◽  
Post Traumatic

The Russian statistics demonstrate that in Russia, brain injuries are increasing every year what is particularly tragic if to speak about children. After traumatic brain injury (TBI), the process of consciousness restoration develops in stages. In Russian science, stages of mental recovery in adults are described by the neuropsychiatric group of researchers from Burdenko Institute of Neurosurgery. The authors have introduced the term amnestic confusion to designate the stage at which there is a possibility to have the verbal contact with amnestic defects and disorders of orientation in time and space. In foreign literature, this stage is defined as post-traumatic state of confused consciousness (PTCS). In children (adolescents), the state of confused consciousness after traumatic brain injury is met in about 80%. The aim of the study was to make a detailed description and phenomenological analysis of some psychological characteristics of the confused state in adolescents after brain injury what will add to the overall picture of medical and neuropsychological examinations. 62 teenagers in the confused consciousness state after TBI were taken into the study. The authors present their observations and analysis of such psychological phenomena as behavioral and emotional characteristics, social intelligence, gender and age identification.

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.

scholarly journals Application of Magnetic Resonance Spectroscopy in Neurocognitive Assessment After Head Injury: A Systematic Review

2021 ◽  
Vol 7 (2) ◽  
pp. 116-129
Author(s):  
Mohammad Haghani Dogahe ◽  
◽  
Alireza Feizkhah ◽  
Sara Seddighi ◽  
Pejman Kiani ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Brain Injuries ◽  
Neurocognitive Disorders ◽  
Systematic Search ◽  
Resonance Spectroscopy ◽  
High Prevalence ◽  
Post Traumatic

Background: Traumatic brain injury is believed to be a public health disorder with some complications. Post Traumatic Neurocognitive Disorders (PTND) received much attention among these complications because of the high prevalence of mild traumatic brain injuries. On the other hand, advanced neuroimaging is increasingly becoming an exciting modality in the field of traumatic brain injury. Magnetic resonance spectroscopy (MRS) provides a new window to understand the detailed biochemistry alterations following traumatic brain injury. Therefore, some researchers have addressed the relations between MRS data and PTND. Objectives: The research aimed to achieve the biochemistry alterations following TBI and find the relations between these alterations and PTND based on published literature in this field. Materials & Methods: With this mind, a systematic search in MEDLINE and EMBASE databases performed to identify relevant published articles without date limitation. The systematic search keyword-targeted all MRS data relevant to the post traumatic neurocognitive disorders. Results: Of the search results, a total of 22 journal articles were reported relations between MRS data and neurocognitive disorders. A variety of questionnaires and computerized tests has been used to detect neurocognitive outcomes. Most studies focused on N-acetyl aspartate (NAA), Choline (Cho), Creatine (Cr), Myo-inositol (MI), and their ratios. As MRI scanners are becoming stranger detecting extra-metabolites such as glutamate, glutamine and glutathione are more reliable. In this regard a few studies reported significant relations between alterations in these metabolites and PTND. Conclusion: MRS is a powerful tool that can provide important data to detect long-term neurocognitive disorders following TBI.

scholarly journals Multifactorial and closed head impact traumatic brain injuries cause distinct tactile hypersensitivity profiles

2020 ◽  
Author(s):  
A-S. Wattiez ◽  
W.C. Castonguay ◽  
O.J. Gaul ◽  
J.S. Waite ◽  
C.M. Schmidt ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Closed Head Injury ◽  
Sensory Profile ◽  
Nitric Oxide Donor ◽  
Relative Risks ◽  
Closed Head ◽  
Post Traumatic

AbstractChronic complications of traumatic brain injury (TBI) represent one of the greatest financial burdens and sources of suffering in society today. A substantial number of these patients suffer from post-traumatic headache (PTH), which is typically associated with tactile allodynia. Unfortunately, this phenomenon has been under-studied, in large part due to the lack of well-characterized laboratory animal models. We have addressed this gap in the field by characterizing the tactile sensory profile of two non-penetrating models of PTH. We show that multifactorial TBI, consisting of aspects of impact, acceleration/deceleration, and blast wave exposure, produces long term tactile hypersensitivity and central sensitization, phenotypes reminiscent of PTH in patients, in both cephalic and extracephalic regions. By contrast, closed head injury induces only transient cephalic tactile hypersensitivity, with no extracephalic consequences. Both models show more severe phenotype with repetitive daily injury for three days, compared to either one or three successive injuries in a single day, providing new insight into patterns of injury that may place patients at greater risk of developing PTH. Importantly, even after recovery from transient cephalic tactile hypersensitivity, mice subjected to closed head injury had persistent hypersensitivity to established migraine triggers, including calcitonin gene-related peptide (CGRP) and sodium nitroprusside, a nitric oxide donor. Our results offer new tools for studying PTH, as well as preclinical support for a pathophysiologic role of CGRP in this condition.SummaryTwo models of post-traumatic headache after traumatic brain injury provide novel laboratory tools and insights in relative risks of injury and therapeutic opportunities.

scholarly journals Doctrine of head injury sequelae

2019 ◽  
Vol 21 (1) ◽  
pp. 83-89 ◽  
Author(s):  
L. B. Likhterman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Skull Defects ◽  
Post Traumatic ◽  
Carotid Cavernous Fistulas ◽  
Radiological Grading ◽  
Diffuse Brain

In this article, we provide the definitions of “sequelae” and “complications” of traumatic brain injury (TBI). We have developed the classification principles for TBI consequences and described their clinical forms and morphological substrates. We also provide a radiological grading for assessing the severity of sequelae of focal and diffuse brain injuries. The article covers conceptual approaches, technologies, and results of their application related to leading surgically significant consequences of TBI, including carotid cavernous fistulas, chronic subdural hematomas, post-traumatic hydrocephalus, long-term basal liquorrhea, and skull defects. We have developed the doctrine of sequelae of TBI.

scholarly journals Galveston Orientation & Amnesia Test (GOAT) Score to Assess Degree of Severity in Mild Brain Injury

2019 ◽  
Vol 2 (1) ◽  
pp. 22-29
Author(s):  
Zieky Yohansyah ◽  
Sahat Edison Sitorus
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Traumatic Amnesia ◽  
Chronic Disorder ◽  
Mild Brain Injury ◽  
Post Traumatic

ABSTRACT Introduction.  Most of the minor brain injuries will heal as usual, but around 10-15% even 58% experience a continuous or chronic disorder known as post-traumatic syndrome. Post traumatic syndrome has manifested in the first 7 days where the quality of life of patients has decreased significantly. This study aimed to assess post traumatic amnesia in minor traumatic brain injuries in Emergency, Inpatient, and Outpatient RSUP. Moh. Hoesin Palembang using GOAT to determine the classification of minor brain injuries based on post traumatic amnesia and determine the prognosis of mild traumatic brain injury according to the presence or absence of post-traumatic syndrome. Methods. This research is an analytic survey with cross sectional approach. The subjects of this study were patients who were admitted and treated at the Emergency Department, Inpatient Installation, and Outpatient Installation (Polyclinic) at the RSUP dr. Mohammad Hoesin Palembang with mild traumatic brain injury and met the inclusion criteria. Inclusion criteria were patients who present with mild brain injury (GCS EMV score 13-15), age ≥ 15 years, the time of the event lasts longer ≤ 24 hours, agreeing and signing informed consent Results. Amnesia assessment uses the GOAT (Galveston Orientation and Amnesia Test) which is divided into three categories, namely PTA free if results> 75, and still in amnesia period if results <66 and 66-75 are doubtful. Based on GOAT assessment the number of Amnesia respondents was 23 people (42.6%) with an average GOAT score or score of 67.6. Conclusion. There is a significant relationship between the incidence of amnesia and post-traumatic syndrome using the GOAT Score assessment.

scholarly journals Traumatic brain injuries induced pituitary dysfunction: a call for algorithms

2020 ◽  
Vol 9 (5) ◽  
pp. R112-R123
Author(s):  
Aleksandra Gilis-Januszewska ◽  
Łukasz Kluczyński ◽  
Alicja Hubalewska-Dydejczyk
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Clinical Manifestations ◽  
Traumatic Brain Injuries ◽  
Standards Of Care ◽  
Pituitary Insufficiency ◽  
Pituitary Dysfunction ◽  
Post Traumatic

Traumatic brain injury affects many people each year, resulting in a serious burden of devastating health consequences. Motor-vehicle and work-related accidents, falls, assaults, as well as sport activities are the most common causes of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome metabolic function, reduced bone density, and a significant decrease in one’s quality of life. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exact mechanisms lying behind it remain unclear. Several probable hypotheses have been suggested. The diagnosis of pituitary dysfunction is very challenging both due to the common occurrence of brain injuries, the subtle character of clinical manifestations, the variable course of the disease, as well as the lack of proper diagnostic algorithms. Insufficiency of somatotropic axis is the most common abnormality, followed by presence of hypogonadism, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this review is to summarize the current state of knowledge about post-traumatic hypopituitarism. Moreover, based on available data and on our own clinical experience, we suggest an algorithm for the evaluation of post-traumatic hypopituitarism. In addition, well-designed studies are needed to further investigate the pathophysiology, epidemiology, and timing of pituitary dysfunction after a traumatic brain injury with the purpose of establishing appropriate standards of care.

MANAGEMENT OF MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Hospital Stay ◽  
Treatment Outcomes ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Diagnostic Approach ◽  
Early Activation ◽  
Intracranial Hematomas

Multiple traumatic hematomas (MG) account for 0.74% of all traumatic brain injuries. A comprehensive diagnostic approach to multiple traumatic intracranial hematomas allows to establish a diagnosis in the early stages of traumatic brain injury and to determine treatment tactics. A differentiated approach to the choice of surgical treatment of multiple hematomas allows to achieve satisfactory results and treatment outcomes, which accordingly contributes to the early activation of the patient, a reduction in hospital stay, a decrease in mortality and disabilityin patients with traumatic brain injury

Time Interval Between Traumatic Brain Injury And Post Traumatic Epilepsy

2013 ◽  
Vol 21 (2) ◽  
pp. 222-228
Author(s):  
Daniel Garbin Di Luca ◽  
Glenda Corrêa Borges de Lacerda
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Year ◽  
Time Interval ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Post Traumatic ◽  
Faster Development ◽  
Post Traumatic Epilepsy ◽  
Traumatic Epilepsy

Introduction. The estimated time interval in which an individual can develop Post Traumatic Epilepsy (PTE) after a traumatic brain injury (TBI) is not clear. Objective. To assess the possible influence of the clinical features in the time interval between TBI and PTE develop­ment. Method. We analyzed retrospectively 400 medical records from a tertiary Brazilian hospital. We selected and reevaluated 50 patients and data was confronted with the time between TBI and PTE devel­opment by a Kaplan-Meier survival analysis. A Cox-hazard regression was also conducted to define the characteristics that could be involved in the latent period of the PTE development. Results. Patients devel­oped PTE especially in the first year (56%). We found a tendency of a faster development of PTE in patients older than 24 years (P<0.0001) and in men (P=0.03). Complex partial seizures evolving to generalized seizures were predominant in patients after moderate (37.7%) and severe (48.8%) TBIs, and simple partial seizures evolving to general­ized seizures in mild TBIs (45.5%). Conclusions. Our data suggest that the first year after a TBI is the most critical period for PTE de­velopment and those males older than 24 years could have a faster development of PTE.

Association of Ventilation during Initial Trauma Resuscitation for Traumatic Brain Injury and Post-Traumatic Outcomes: A Systematic Review

2021 ◽  
pp. 1-6
Author(s):  
Mary Beth Howard ◽  
Nichole McCollum ◽  
Emily C. Alberto ◽  
Hannah Kotler ◽  
Mary E. Mottla ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Trauma Resuscitation ◽  
Cerebral Herniation ◽  
Full Text Review ◽  
Post Traumatic ◽  
Ventilation Strategies ◽  
End Tidal

Abstract Objectives: In the absence of evidence of acute cerebral herniation, normal ventilation is recommended for patients with traumatic brain injury (TBI). Despite this recommendation, ventilation strategies vary during the initial management of patients with TBI and may impact outcome. The goal of this systematic review was to define the best evidence-based practice of ventilation management during the initial resuscitation period. Methods: A literature search of PubMed, CINAHL, and SCOPUS identified studies from 2009 through 2019 addressing the effects of ventilation during the initial post-trauma resuscitation on patient outcomes. Results: The initial search yielded 899 articles, from which 13 were relevant and selected for full-text review. Six of the 13 articles met the inclusion criteria, all of which reported on patients with TBI. Either end-tidal carbon dioxide (ETCO2) or partial pressure carbon dioxide (PCO2) were the independent variables associated with mortality. Decreased rates of mortality were reported in patients with normal PCO2 or ETCO2. Conclusions: Normoventilation, as measured by ETCO2 or PCO2, is associated with decreased mortality in patients with TBI. Preventing hyperventilation or hypoventilation in patients with TBI during the early resuscitation phase could improve outcome after TBI.

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