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Moderate and Severe Traumatic Brain Injury


Presentation

  • In conclusion, age, education, TAI, and depression appear to elevate risk for poor long-term outcome, emphasising the need for long-term follow-up of patients presenting with risk factors.[ncbi.nlm.nih.gov]
  • Statistical analysis and data synthesis Data will be presented in a descriptive manner.[systematicreviewsjournal.biomedcentral.com]
Pain
  • Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%).[ncbi.nlm.nih.gov]
  • 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]
  • 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]
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]
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]
  • Variables studied included sex, age, time interval (from crash to arrival at the emergency department), alcohol consumption, helmet use, severity of TBI, choice of treatment, and the outcome.[jhu.pure.elsevier.com]

Prognosis

  • […] compared with the group with a favourable prognosis. 36 Analyses were performed with random effects models.[bmj.com]
  • 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 brain injury[ncbi.nlm.nih.gov]
  • The determination of long-term neurological prognosis is thus of importance as it may inform patients or their representatives and better guide critical level of intervention decision-making [ 3 ].[systematicreviewsjournal.biomedcentral.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]

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

  • Suggestions are provided for the way forward, with an emphasis on epidemiological monitoring, trauma organisation, and approaches to management.[ncbi.nlm.nih.gov]
  • There were consistent epidemiological characteristics of severe TBI from both rural and urban regions.[karger.com]
Sex distribution
Age distribution

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]
  • Jorge RE, Starkstein SE (2005) Pathophysiologic aspects of major depression following traumatic brain injury. J Head Trauma Rehabil 20: 475–487.[journals.plos.org]
  • 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]

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]
  • PHASE I: Design/develop an innovative device to prevent or reduce secondary brain injury for use point of injury/Role1.[sbir.gov]
  • Understanding the prevalence and describing the characteristics of TBI are crucial for successful implementation of prevention and treatment efforts to reduce the mortality and morbidity caused by TBIs.[jhu.pure.elsevier.com]

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