scholarly journals Prevalence of Post Traumatic Amnesia after Mild Closed Traumatic Brain Injury by Galveston Orientation and Amnesia Test

2019 ◽  
Vol 23 (3) ◽  
pp. 157-162
Author(s):  
SYED SHAHZAD HUSSAIN ◽  
USMAN AHMAD KAMBOH ◽  
MUHAMMAD ASIF RAZA ◽  
MUHAMMAD SHAHZAD ◽  
SAMAN SHAHID ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Loss Of Consciousness ◽  
Mild Tbi ◽  
Male And Female ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Male Patients ◽  
The Mean ◽  
Time Since Injury

Objective: We evaluated the frequency of post traumatic amnesia (PTA) in close mild traumatic brain injury (TBI) via. Galveston Orientation and Amnesia Test (GOAT).Materials & Methods: A total of 115 patients with mild TBI, both male and female, aged between 14 to 60 years and presenting within the first 6 hours were included. Assessment with the GOAT was performed within 6 hours of admission. Post traumatic amnesia was recorded.Results: Patients’ mean age was 39.21 years. Majority of the patients (64.34%) were between 36- 60 years of age. Prevalence of post traumatic amnesia (PTA) in closed mild TBI was found in 27.83% patients, whereas, there was no post traumatic amnesia in 72.17% patients. Mean admission GCS was 14.54 and the mean GOAT score was 83.89 in all patients GCS 14/15. There was more prevalence of PTA in age 36-60 years, in male patients and “time since injury” in >3 hours. Mean GOAT was 68.3 in patients (30.19%) with PTA with GCS 14, whereas, mean GOAT was 74.8 in patients (25.80%) with PTA with GCS 15.Conclusion: 30.19% patients with GCS 14, were positive for PTA (GOAT: 68.3). Overall, 28% patients were positive for PTA. This study concluded that prevalence of post traumatic amnesia in mild TBI is relatively high in our study as compared to other recent reports.Abbreviations: TBI: Traumatic Brain Injury. PTA: Post Traumatic Amnesia. GOAT: Galveston Orientation and Amnesia Test. GCS: Glaucoma Outcome Scale. LOC: Loss of Consciousness. CT: Computed Tomography.

scholarly journals Factors predicting post-traumatic seizure and epilepsy after traumatic brain injury- A retrospective study in tertiary care center of western Nepal

2020 ◽  
Vol 1 (1) ◽  
pp. 5-10
Author(s):  
Aabishkar Bhattarai ◽  
Bikash Jang Kshetri ◽  
Bijaya Karki ◽  
Naresh Poudel ◽  
Suman Adhikari ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Logistic Regression ◽  
Brain Injury ◽  
Head Injury ◽  
Binary Logistic Regression ◽  
Loss Of Consciousness ◽  
Skull Fractures ◽  
Factors Associated ◽  
Traumatic Amnesia ◽  
Post Traumatic

Introduction: Posttraumatic seizures are the seizures that arise from traumatic brain injury and brain harm due to physical trauma. This study aims to study various clinic-demographic factors associated with post traumatic seizure in Western Nepal. Methods: A retrospective analytical study was carried out in a tertiary hospital of Nepal to determine factors associated with post traumatic seizures. Various parameters were tested for association with post traumatic seizure using student’s t test for quantitative and chi square or Fischer Exact test for categorical variables. All the variables showing significant association were subjected to binary logistic regression. P-value ≤0.05 was considered statistically significant. Results: There were 66 (21.02%) cases with post traumatic seizure in our study. Univariate analysis showed significant association of fall injury (p=0.004), loss of consciousness (p=0.001), post traumatic amnesia (p=0.012), severity of head injury (Glasgow coma scale) (p=0.011) and depressed fractures (p<0.001). A binary logistic regression was done amongst parameters with significant association with post traumatic seizure which showed patients with fall injury (OR 3.150, P=0.003, CI= 1.473-6.734) and depressed skull fractures (OR 26.278, p<0.001, CI= 12.155-56.809) had statistical significant association. Conclusion: Injuries secondary to fall, post traumatic amnesia, loss of consciousness, severity of head injury in terms of GCS and depressed skull fractures were significantly associated with post traumatic seizures in our study. On multiple regression model with adjusted odds of 3.15 (1.473-6.734) and depressed skull fractures with an adjusted odds of 26.278 (12.155-56.809) were significantly associated with post traumatic seizure.

Neutrophil to lymphocyte ratio as a predictive biomarker for computed tomography scan use in mild traumatic brain injury

2020 ◽  
Vol 14 (12) ◽  
pp. 1085-1090
Author(s):  
George A Alexiou ◽  
Georgios D Lianos ◽  
Aggeliki Tzima ◽  
Athanasios Sotiropoulos ◽  
Anastasios Nasios ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Characteristic Curve ◽  
Predictive Biomarker ◽  
Health Concern ◽  
Mild Tbi ◽  
Ct Findings ◽  
The Mean

Aim: Traumatic brain injury (TBI) is a serious health concern. We set out to investigate the role of neutrophil-to-lymphocytes ratio (NLR) at admission for predicting the need for computed tomography (CT) in mild-TBI. Materials & methods: A retrospective study of adult patients who presented with mild-TBI Results: One hundred and thirty patients met the inclusion criteria. Seventy-four patients had positive CT-findings. The mean NLR-levels at presentations were 5.6 ± 4.8. Patients with positive CT-findings had significant higher NLR-levels. Receiver operating characteristic curve analysis was conducted and the threshold of NLR-levels for detecting the cases with positive CT-findings was 2.5, with 78.1% sensitivity and 63% specificity Conclusion: To the best of our knowledge no previous study has assessed the value of NLR-levels for predicting the need for CT in mild-TBI.

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 The role of deficient pain modulatory systems in the development of persistent post-traumatic headaches following mild traumatic brain injury: an exploratory longitudinal study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kelly M. Naugle ◽  
Christopher Carey ◽  
Eric Evans ◽  
Jonathan Saxe ◽  
Ryan Overman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Pain Catastrophizing ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Mild Tbi ◽  
Inhibitory Capacity ◽  
Pressure Pain Thresholds ◽  
Post Traumatic

Abstract Background Post-traumatic headache (PTH) is one of the most common and long-lasting symptoms following mild traumatic brain injury (TBI). However, the pathological mechanisms underlying the development of persistent PTH remain poorly understood. The primary purpose of this prospective pilot study was to evaluate whether early pain modulatory profiles (sensitization and endogenous pain inhibitory capacity) and psychological factors after mild TBI predict the development of persistent PTH in mild TBI patients. Methods Adult mild TBI patients recruited from Level I Emergency Department Trauma Centers completed study sessions at 1–2 weeks, 1-month, and 4-months post mild TBI. Participants completed the following outcome measures during each session: conditioned pain modulation to measure endogenous pain inhibitory capacity, temporal summation of pain and pressure pain thresholds of the head to measure sensitization of the head, Pain Catastrophizing Scale, Center for Epidemiological Studies – Depression Scale, and a standardized headache survey. Participants were classified into persistent PTH (PPTH) and no-PPTH groups based on the 4-month data. Results The results revealed that mild TBI patients developing persistent PTH exhibited significantly diminished pain inhibitory capacity, and greater depression and pain catastrophizing following injury compared to those who do not develop persistent PTH. Furthermore, logistic regression indicated that headache pain intensity at 1–2 weeks and pain inhibitory capacity on the conditioned pain modulation test at 1–2 weeks predicted persistent PTH classification at 4 months post injury. Conclusions Overall, the results suggested that persistent PTH is characterized by dysfunctional alterations in endogenous pain modulatory function and psychological processes in the early stages following mild TBI, which likely exacerbate risk for the maintenance of PTH.

scholarly journals Loss of Consciousness is Associated with Increased Neurocognitive Intra-Individual Variability Following Sports-Related Concussion

2019 ◽  
Vol 34 (5) ◽  
pp. 734-734
Author(s):  
V C Merritt ◽  
L S Greenberg ◽  
J E Meyer ◽  
P A Arnett
Keyword(s):  
Cognitive Functioning ◽  
Individual Variability ◽  
Clinical Samples ◽  
Loss Of Consciousness ◽  
Neurocognitive Performance ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Two Measures ◽  
Time Since Injury ◽  
Relevant Consideration

Abstract Purpose Traditional markers of concussion severity, including loss of consciousness (LOC), retrograde amnesia (RA), and post-traumatic amnesia (PTA), have been inconsistently associated with neurocognitive performance following sports-related concussion. The purpose of this study was to evaluate whether LOC, RA, and PTA influence a particular aspect of post-concussion cognitive functioning—across-test intra-individual variability (IIV). Methods Concussed athletes (N=119; 77.3% male) were evaluated, on average, 8.55 days post-concussion (SD=11.27; Mdn=4 days) via clinical interview and neuropsychological assessment. Primary outcomes of interest included two measures of IIV-an average standard deviation (ASD) score and a maximum discrepancy (MD) score-computed from 18 norm-referenced variables. Results A one-way ANCOVA adjusting for time since injury revealed a significant effect of LOC on the ASD (F(1, 116)=6.78, p=.010, ηp2=.055) and MD (F(1, 116)=5.65, p=.019, ηp2=.046) scores, such that athletes with LOC displayed significantly greater IIV than athletes without LOC. In contrast, measures of IIV did not significantly differ between athletes who did and did not experience RA or PTA (all p>.05). Conclusion LOC, but not RA or PTA, was associated with greater variability, or inconsistencies, in cognitive performance following concussion. This suggests that LOC may be a relevant consideration when evaluating post-concussion cognitive dysfunction. IIV has recently been established as a sensitive measure of cognitive functioning in a variety of clinical samples and has been associated with underlying neurobiological integrity. Taken together, our results implicate LOC as a possible contributing factor of less efficient cognitive functioning following concussion and may help detect athletes at risk for poor clinical outcomes.

scholarly journals Overview of Traumatic Brain Injury Patients at a Tertiary Trauma Centre

2005 ◽  
Vol 32 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Elaine de Guise ◽  
Mitra Feyz ◽  
Joanne LeBlanc ◽  
Sylvain-Luc Richard ◽  
Julie Lamoureux
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Scale Score ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Term Care ◽  
Traumatic Amnesia ◽  
Post Traumatic

ABSTRACT:Objective:The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay.Material and methods:Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score.Results:The clinical profile of the population revealed a mean age of 40.2 (±18.7) and a mean of 11.5 (±3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities.Conclusion:Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.

Is Post Traumatic Amnesia any Different from Delirium?

2012 ◽  
Vol 2 (2) ◽  
pp. 82-85
Author(s):  
Samit Roy
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Changes ◽  
Traumatic Amnesia ◽  
Post Traumatic ◽  
Narrative Account

This invited commentary discusses David W. Smith’s narrative account of his experiences during recovery from his traumatic brain injury (Smith, 2012). The author discusses the available literature around recovery from an ‘injured cognition state’ with particular reference to post traumatic amnesia, delirium, and other behavioral changes associated with recovery from traumatic brain injury.

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