Presentation
Three hundred twenty-three moderate to severe TBI survivors received 2 to 16 years post-trauma an aftercare survey with seven questions asking for changes in behavior and affect, presented both to patients and their proxies. [ncbi.nlm.nih.gov]
15 points, nor “independent” even when they presented an ADS score of 25 points. [hsj.gr]
Statistical analysis and data synthesis Data will be presented in a descriptive manner. [systematicreviewsjournal.biomedcentral.com]
The Effect of Moderate-Severe Traumatic Brain Injury and Subarachnoid Haemorrhage on Cortisol Response to ACTH-Stimulation Presentation Number: MON-0666 Date of Presentation: June 23rd, 2014 Anna Tolli * Karolinska Institutet, Stockholm, Sweden Abstract [endocrine.org]
Entire Body System
- Falling
In the platelet inhibitor group 74% and in the warfarin group, 85% were injured by falls. [ncbi.nlm.nih.gov]
Causes and risk factors Preventing traumatic brain injury Falls are the most common cause of traumatic brain injury, and falling poses an especially serious risk for older adults. [alz.org]
Low-energy falls, such as falling from a standing height, are reported to lead to a high proportion of severe TBI among these patients [ 25 ]. [karger.com]
- Pain
The Glasgow Coma Scale Best Visual Response Best Verbal Response Best Motor Response None To pain To speech Spontaneous None Incomprehensible Inappropriate words Confused Oriented None Extends to pain Flexes to pain Withdrawl to pain Localizes to pain [shepherd.org]
If the patient’s eyes open only to someone speaking or only to pain, the score is lower. If the eyes cannot open at all, this indicates a very severe loss of consciousness and, likely, a severe brain injury. [maginnislaw.com]
Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). [ncbi.nlm.nih.gov]
NSAIDs and etidronate can help with pain management. The risks and benefits of these drugs in managing established heterotopic ossification should be assessed. [emedicine.medscape.com]
Abstract Background: Headache symptoms are a major contributor to chronic pain after moderate-to-severe traumatic brain injury (TBI). [digital.lib.washington.edu]
- Military Personnel
According to the Center for Disease Control, these causes include Falls (40.5%) Motor vehicle-traffic crashes (14.3%) Struck by/against (15.5%) Assaults / Abuse (10.7%) Blasts are a leading cause of TBI for active duty military personnel in war zones. [shepherd.org]
Personnel, 2000-2012 Figure 15: The Total Worldwide Number of Combat-Related TBIs Diagnosed in US Military Personnel, 2000-2012 Figure 16: Management Algorithm of TBI According to Glasgow Coma Score Figure 17: NRAP's Approach to Address the Current Unmet [gii.co.jp]
It has been estimated that approximately 22 percent of military personnel in these war zones may sustain a TBI, and that as many as 60 percent of injured soldiers may have a TBI as part of their clinical spectrum (Terrio et al. 2009). [nap.edu]
- Fever
Children in whom vasospasm developed were more likely to have been involved in motor vehicle accidents, had higher Injury Severity Scores, had fever at admission, and had lower Glasgow Coma Score scores. [ncbi.nlm.nih.gov]
It is often associated low-grade fever, peri-articular swelling, peri-articular warmth, and peri-articular erythema. In decreasing order of frequency, heterotopic ossification occurs in the hips, knees, elbows, shoulders, hands, and spine. [emedicine.medscape.com]
- Bullet Wound
In addition, traumatic brain injury can result from bullet wounds or other injuries that penetrate the skull and brain. [alz.org]
Cardiovascular
- Hypotension
Documented hypotension occurred in 118 children (39%). An attempt to treat documented hypotension was made in 48% (57 of 118 children). [pediatrics.aappublications.org]
Acute care focuses on avoiding secondary insults, including hypoxia, hypotension, and hyperthermia. [ncbi.nlm.nih.gov]
Hypotension is even a significant predictor of mortality even after controlling for the presence of multiple severe injuries [ 15 ]. Three-quarters of the patients that arrive both hypotensive and hypoxic to the hospital will die [ 15 ]. [oapublishinglondon.com]
KEYWORDS: Traumatic brain injury, intracranial hypotension, intracranial hypertension, elevated intracranial pressure (ICP), cerebral vasospasm, hypoxemia, respiratory ventilation, device TPOC-1: Dr. Tammy Crowder TPOC-2: Dr. Therese West [sbir.gov]
[…] can further damage the glands. [21], [22] One recent study found 43% showed acute infarcts of varying size and postulated that direct injury through axonal shearing stress can lead to pituitary and hypothalamic damage. [23] Secondary insults such as hypotension [ijem.in]
Jaw & Teeth
- Bad Taste
Anosmia, which is loss of or diminished sense of smell Loss of or diminished sense of taste Bad taste in the mouth Social-emotional or behavioral effects Dependent behaviors Fluctuating emotions Lack of motivation Irritability Aggression Depression Lack [brainline.org]
Ears
- Tinnitus
Partial or total loss of vision Weakness of eye muscles and double vision (diplopia) Blurred vision Problems judging distance Involuntary eye movements (nystagmus) Intolerance of light (photophobia) Hearing Decrease or loss of hearing Ringing in the ears (tinnitus [traumaticbraininjury.com]
[…] vision Diplopia, which is weakness of eye muscles that causes double vision Blurred vision Problems judging distance Involuntary eye movements, called nystagmus Photophobia, which is intolerance of light Effects on hearing Decrease or loss of hearing Tinnitus [brainline.org]
그러나, 일부 연구에서는 이와 상충된 효과를 주장하는데, 전정피질 신경망의 잡음이 더 증폭되어 마치 이명(vestibular tinnitus)과 유사하게 작용한다는 것이다[27]. 이는 어떠한 결정에 소요되는 시간(내가 어느 방향으로 이동하고 있는가?)을 예측하는데 이용하는 Drift Diffusion model을 적용하여 개념화할 수 있다[28,29]. [e-rvs.org]
Eyes
- Blurred Vision
Partial or total loss of vision Weakness of eye muscles and double vision (diplopia) Blurred vision Problems judging distance Involuntary eye movements (nystagmus) Intolerance of light (photophobia) Hearing Decrease or loss of hearing Ringing in the [traumaticbraininjury.com]
If a victim of a severe TBI is conscious after the accident, symptoms can include amnesia, slurred speech, paralysis, severe headache, blurred vision, and difficulty thinking. Severe TBIs typically lead to permanent disability or death. [greylaw.com]
Partial or total loss of vision Diplopia, which is weakness of eye muscles that causes double vision Blurred vision Problems judging distance Involuntary eye movements, called nystagmus Photophobia, which is intolerance of light Effects on hearing Decrease [brainline.org]
Severe TBI Symptoms Headaches Difficulty coordinating balance Blurred vision in one or both eyes Mild vision problems Seizures Changes in sensory perception Trouble speaking and swallowing Changes in sleep patterns Lack of bowel and bladder control Changes [shepherd.org]
Psychiatrical
- Mood Swings
Mild TBI Symptoms Fatigue Headaches Light sensitivity Dizziness and balance problems Irritability Depression and mood swings Nausea General confusion and mental fog Moderate Traumatic Brain Injury Moderate brain injuries score between 8 and 13 on the [shepherd.org]
swings Difficulty speaking If You Feel You Might Have a TBI, Seek Medical Advice If you’ve experienced trauma to the head or body, and are showing any of the symptoms listed above, seek professional medical advice right away. [braininjurylaw.ca]
Symptoms of mild traumatic brain injury include: Headache Dizziness Insomnia, Decreased concentration and attention span Depression Anxiety Mood swings Impaired balance Decreased speed of information processing Decreased ability to learn new things and [paterehab.com]
Neurologic
- Confusion
The Glasgow Coma Scale Best Visual Response Best Verbal Response Best Motor Response None To pain To speech Spontaneous None Incomprehensible Inappropriate words Confused Oriented None Extends to pain Flexes to pain Withdrawl to pain Localizes to pain [shepherd.org]
These brain injuries result in temporary mental changes, such as confusion and memory loss or unconsciousness for less than 30 minutes. [greylaw.com]
Mild traumatic brain injuries result in concussions or feelings of confusion that last 30 minutes or less. Moderate or severe TBIs can be caused by significant falls, car accidents, sports injuries or child abuse. [braininjurylaw.ca]
Assessment of the person's level of consciousness and confusion. Neurological examination to assess memory and thinking, vision, hearing, touch, balance, reflexes, and other indicators of brain function. [alz.org]
Resources available to aid recovery Areas of function not affected by TBI The impact of a moderate to severe brain injury can include cognitive deficits including difficulties with: Attention Concentration Distractibility Memory Speed of Processing Confusion [traumaticbraininjury.com]
- Dizziness
TOOLS PDF Links PubReader ePub Link Full text via DOI Download Citation CrossRef TDM E-Mail Print Share: METRICS 0 Crossref 1,045 View 49 Download Related articles Dizziness after Traumatic Brain Injury: Neurological Aspects 2019 September;18(3) Dizziness [e-rvs.org]
Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). [ncbi.nlm.nih.gov]
Mild TBI Symptoms Fatigue Headaches Light sensitivity Dizziness and balance problems Irritability Depression and mood swings Nausea General confusion and mental fog Moderate Traumatic Brain Injury Moderate brain injuries score between 8 and 13 on the [shepherd.org]
Symptoms of mild traumatic brain injury include: Headache Dizziness Insomnia, Decreased concentration and attention span Depression Anxiety Mood swings Impaired balance Decreased speed of information processing Decreased ability to learn new things and [paterehab.com]
The most commonly reported symptoms include tiredness, headaches and dizziness ( physical effects ) difficulties with thinking, attention, memory planning, organising, concentration and word-finding problems ( cognitive effects ) and irritability (a behavioural [headway.org.uk]
- Slurred Speech
[…] and Language Not understanding the spoken word (receptive aphasia) Difficulty speaking and being understood (expressive aphasia) Slurred speech Speaking very fast or very slow Problems reading Problems writing Sensory Difficulties with interpretation [traumaticbraininjury.com]
If a victim of a severe TBI is conscious after the accident, symptoms can include amnesia, slurred speech, paralysis, severe headache, blurred vision, and difficulty thinking. Severe TBIs typically lead to permanent disability or death. [greylaw.com]
Slurred speech Speaking very fast or very slow Problems with reading comprehension Sensory and perceptual effects Difficulty recognizing and distinguishing between touch and pressure sensations Difficulty perceiving temperature Difficulty perceiving movement [brainline.org]
Symptoms of severe traumatic brain injury can include loss of consciousness, headache, nausea, vomiting, lack of coordination, dizziness, trouble with balance, dilation of one or more pupils, slurred speech, behavioral or mood changes, loss of coordination [paterehab.com]
- Insomnia
MEASURES: Semistructured interviews, Ohio State University TBI-Identification Method, Insomnia Severity Index. RESULTS: Two main dimensions emerged: "Messed up sleep" and Surviving and Managing SWD. [ncbi.nlm.nih.gov]
[…] of depression35–38 and that persons with persistent insomnia were 40 times more likely to develop depression within one year compared with persons with no insomnia. 35 Poor social skills and personal relationship problems, including perceived lack of [touchneurology.com]
Symptoms of mild traumatic brain injury include: Headache Dizziness Insomnia, Decreased concentration and attention span Depression Anxiety Mood swings Impaired balance Decreased speed of information processing Decreased ability to learn new things and [paterehab.com]
Consider using behavioural techniques early in treatment to build confidence and engagement Behavioural techniques (e.g., relaxation, behavioural activation, insomnia treatments, exposure therapies) are a good first-line treatment for anxiety and depression [psychology.org.au]
- Nystagmus
Perceptual Integration or patterning of sensory impressions into psychologically meaningful data Vision Partial or total loss of vision Weakness of eye muscles and double vision (diplopia) Blurred vision Problems judging distance Involuntary eye movements (nystagmus [traumaticbraininjury.com]
[…] the five senses (sight, smell, touch, hearing, and taste) Effects on vision Partial or total loss of vision Diplopia, which is weakness of eye muscles that causes double vision Blurred vision Problems judging distance Involuntary eye movements, called nystagmus [brainline.org]
Workup
An appropriate workup to evaluate GU symptoms and rule out infection is indicated. When the causes of urinary incontinence are impaired communication and mobility, a trial of a timed voiding is indicated to manage overflow incontinence. [emedicine.medscape.com]
Treatment
We examined variation in treatment for traumatic brain injury by assessing factors influencing treatment and the association between treatment and patient outcome. DESIGN: Secondary analysis of prospectively collected data. [ncbi.nlm.nih.gov]
Consider using behavioural techniques early in treatment to build confidence and engagement Behavioural techniques (e.g., relaxation, behavioural activation, insomnia treatments, exposure therapies) are a good first-line treatment for anxiety and depression [psychology.org.au]
We found a low level of evidence that a comprehensive holistic day treatment program resulted in greater productivity, but not improved community integration, than the standard treatment. [effectivehealthcare.ahrq.gov]
EEG-neurobiofeedback treatment of patients with brain injury Part 4: Duration of treatments as a function of both the initial load of clinical symptoms and the rate of rehabilitation. Journal of Neurotherapy, 6(1), 23-38. Byers, A. P. (1995). [hjernetraening.dk]
Prognosis
[…] compared with the group with a favourable prognosis. 36 Analyses were performed with random effects models. [bmj.com]
This paper will focus on classification of traumatic brain injury by severity, outcome, and prognosis. [acnr.co.uk]
Predicting the Prognosis of TBI is Difficult 2.9.1. Glasgow Outcome Scale 2.9.2. Disability Rating Scale 2.9.3. The NIH's International Mission for Prognosis and Clinical Trial (IMPACT) Prognosis Model 2.9.4. [gii.co.jp]
KEYWORDS: AIS = Abbreviated Injury Scale; BAC = blood alcohol concentration; GCS = Glasgow Coma Scale; NMDAR = N-methyl-d-aspartate receptor; TBI = traumatic brain injury; alcohol; ethanol; intoxication; mortality; outcome; prognosis; trauma; traumatic [ncbi.nlm.nih.gov]
Chesnut RM, Ghajar J, Maas AR (2000) Guidelines for the Management and prognosis of severe traumatic brain injury part II: Early indicators of prognosis in severe traumatic brain injury. J Neurotrauma 17: 556-627. [scitechnol.com]
Etiology
CONCLUSION: Given the unique etiological features and treatment challenges associated with managing spasticity after TBI, more TBI-specific spasticity CPGs are required. [ncbi.nlm.nih.gov]
Given the unique etiological features and treatment challenges associated with managing spasticity after TBI, more TBI -specific spasticity CPGs are required. [journals.lww.com]
In severe brain injury, more often than not there is an organic based etiology. Increased rates of personality disorder involving sensitive-compulsive individuals are often times seen. Social isolation is common. [scarlettlawgroup.com]
Risk factors for ischemic stroke in young adults include hypertension, smoking, diabetes mellitus, and obesity. 30 Stroke in young adults also has other etiologies that are not fully understood but may differ from those of ischemic stroke in individuals [stroke.ahajournals.org]
Epidemiology
Yet, this large-scale epidemiological study does not prove that there is a causal relationship between moderate-to-severe TBI and NDD. [ncbi.nlm.nih.gov]
There were consistent epidemiological characteristics of severe TBI from both rural and urban regions. [karger.com]
Pathophysiology
Its pathophysiology is divided into two major phases: the initial neuronal injury (or primary injury) followed by secondary insults (secondary injury). [ncbi.nlm.nih.gov]
Rumination worsens depressive symptoms over time and is a risk factor for developing future major depressive disorders. 44,48–50 Pathophysiology Lesion location may be related to the development of depression following TBI. [touchneurology.com]
The risk of heterotopic ossification is greatest during the first 3-4 months after injury. [32] The pathophysiology of heterotopic ossification remains unclear. [emedicine.medscape.com]
Major Unmet Needs in TBI Figure 3: Finanical Forecast of the Potential TBI Market, in 2014 and 2020 in the US and EU ($ billions) Figure 4: The Anatomy of the Human Brain Figure 5: Cause of all TBIs within the US General Population, 2010 Figure 6: The Pathophysiological [gii.co.jp]
Prevention
This finding demonstrates that therapy directed by PbtO2 monitoring is valuable for the treatment of patients with moderate and severe TBI and that increasing PaO2 to 150 mmHg may be efficacious for preventing cerebral hypoxic events after brain trauma [ncbi.nlm.nih.gov]
Enteral feeding can help prevent gastric stress ulcers [ 9 ]. Patients should also receive medications to prevent stress ulcers [ 9 ]. [oapublishinglondon.com]
PHASE I: Design/develop an innovative device to prevent or reduce secondary brain injury for use point of injury/Role1. [sbir.gov]