Traumatic brain injury

Author(s):  
Manoj Sivan ◽  
Margaret Phillips ◽  
Ian Baguley ◽  
Melissa Nott

Traumatic brain injury (TBI) is a subset of acquired brain injuries, a larger grouping that includes acute-onset diseases such as stroke as well as degenerative conditions such as the dementing illnesses. TBI is often considered separately to other acquired brain injuries due to differences in its presentation and how treatment is approached. TBI occurs over an extremely broad range of severities, from concussion through to profound and life-threatening damage. As the injury becomes more severe, the affected individual has an increasing risk of experiencing lifelong and complex physical, behavioural, emotional, cognitive and social problems. This chapter describes mechanisms, severity, consequences, related conditions, and stages of rehabilitation.

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  

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


2020 ◽  
pp. 000313482097335
Author(s):  
Isaac W. Howley ◽  
Jonathan D. Bennett ◽  
Deborah M. Stein

Moderate and severe traumatic brain injuries (TBI) are a major cause of severe morbidity and mortality; rapid diagnosis and management allow secondary injury to be minimized. Traumatic brain injury is only one of many potential causes of altered mental status; head computed tomography (HCT) is used to definitively diagnose TBI. Despite its widespread use and obvious importance, interpretation of HCT images is rarely covered by formal didactics during general surgery or even acute care surgery training. The schema illustrated here may be applied in a rapid and reliable fashion to HCT images, expediting the diagnosis of clinically significant traumatic brain injury that warrants emergent medical and surgical therapies to reduce intracranial pressure. It consists of 7 normal anatomic structures (cerebrospinal fluid around the brain stem, open fourth ventricle, “baby’s butt,” “Mickey Mouse ears,” absence of midline shift, sulci and gyri, and gray-white differentiation). These 7 features can be seen even as the CT scanner obtains images, allowing the trauma team to expedite medical management of intracranial hypertension and pursue neurosurgical consultation prior to radiologic interpretation if the features are abnormal.


Author(s):  
Yu-Chin Tsai ◽  
Shao-Chun Wu ◽  
Ting-Min Hsieh ◽  
Hang-Tsung Liu ◽  
Chun-Ying Huang ◽  
...  

Thank you for Eduardo Mekitarian Filho’s appreciation of our work on the study of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) in patients with traumatic brain injuries [...]


2016 ◽  
Vol 12 (2) ◽  
pp. 63-66
Author(s):  
Bal G Karmacharya ◽  
Brijesh Sathian

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015


2021 ◽  
Vol 14 (5) ◽  
pp. e241929
Author(s):  
Daniel Krasna ◽  
Erica Montgomery ◽  
Jacob Koffer ◽  
Miriam Segal

A functionally independent man in his 20s with a history of intellectual disability and epilepsy and family history of Huntington’s disease suffered a severe traumatic brain injury. Postinjury, bilateral chorea rendered him dependent for all activities of daily living. Risperidone provided a significant reduction of chorea, decreasing the overall burden of care. Movement disorders are a common sequela of brain injury. Currently, there are no best treatment guidelines for chorea in patients with brain injury. To the authors’ knowledge there have been no case reports describing the effects of brain injury on patients with a primary movement disorder. Risperidone was an effective treatment in this case. Further research is needed to establish guidelines for treatment of movement disorders following brain injury and to better understand the effect of brain injuries on primary movement disorders.


2002 ◽  
Vol 181 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Richard F. Mollica ◽  
David C. Henderson ◽  
Svang Tor

BackgroundThe prevalence of brain injury and its effects in populations exposed to war violence has not been studied in recent years.AimsTo examine the association between traumatic brain injury events and psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in Cambodian survivors of mass violence.MethodThe population comprised a multi-stage random sample of Cambodian refugees livingin a Thai refugee camp. The main results analysed the relationship between six categories of trauma events and psychiatric symptoms of depression and PTSD during two time periods.ResultsAlmost 15 000 trauma events were reported (n=13481, Pol Pot period; n=1249, past year). Traumatic brain injury was most common in the highly educated and in individuals with the highest levels of cumulative trauma. Of all trauma categories, traumatic brain injury revealed the strongest association with symptoms of depression, and a weaker association with PTSD. Brain injury represented 4% of the total number of traumatic events for both time periods, contributing 20% of the total symptom score for depression and 8% of that for PTSD.ConclusionsClinical identification and treatment of traumatic brain injuries in highly traumatised populations must be maintained in order to develop a new public health model for their treatment.


2021 ◽  
Author(s):  
Sahra Kim ◽  
Alyssa Currao ◽  
Jennifer R. Fonda ◽  
Brigitta Beck ◽  
Alexandra Kenna ◽  
...  

Abstract Background: Since 2006, efforts have been made to increase the identification of traumatic brain injuries (TBIs) in post-9/11 military personnel. The BAT-L is the first validated instrument to diagnose TBIs throughout the lifespan in post-9/11 Veterans. The objective is to investigate the correspondence of the Boston Assessment of TBI-Lifetime (BAT-L) diagnostic prevalence and injury severity of traumatic brain injury with in-theater medical records from Department of Defense (DoD). Methods: A convenience sample of 153 Veterans deployed in 2011 enrolled in the TRACTS longitudinal cohort study was examined. Retrospective review of DoD online medical records to determine diagnostic prevalence and injury severity for all head injury cases during deployment were compared with diagnostic prevalence and injury severity from the BAT-L clinical interview using Chi-square analyses.Results: There was moderate correspondence for TBI diagnosis between the BAT-L and DoD records (κ = 0.42). Sensitivity was 72.7% and specificity was 82.8%. Comparison of injury severity also had moderate correspondence (κ = 0.41). Missing TBI diagnostic data from DoD records was frequent; 43% percent of TBIs reported on the BAT-L did not have any documentation of mTBI assessment or diagnosis in DoD records while 83% did not have in-theater documentation.Conclusions: Diagnosis of TBI via the BAT-L retrospective interview was both sensitive and specific when compared to DoD medical records. However, diagnostic correspondence was only moderate. This lack of diagnostic agreement was related to multiple factors including lack of documentation of injury, differences in assessment tools and goals, and other combat-related motivational factors associated with failure to report injuries while deployed. Several policies were implemented to address underreporting and under-documentation of TBI, yet challenges remain. Findings suggest changes at both individual-level (e.g. service members) and system-level (e.g. DoD/military branches) are needed to adequately diagnose and document all TBI during deployment.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jason H. Boulter ◽  
Margaret M. Shields ◽  
Melissa R. Meister ◽  
Gregory Murtha ◽  
Brian P. Curry ◽  
...  

Traumatic brain injury is a rapidly increasing source of morbidity and mortality across the world. As such, the evaluation and management of traumatic brain injuries ranging from mild to severe are under active investigation. Over the last two decades, quantitative pupillometry has been increasingly found to be useful in both the immediate evaluation and ongoing management of traumatic brain injured patients. Given these findings and the portability and ease of use of modern pupillometers, further adoption and deployment of quantitative pupillometers into the preclinical and hospital settings of both resource rich and medically austere environments.


Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Alexandrina Nikova ◽  
Ivaylo Dimitrov ◽  
Theodossios Birbilis ◽  
Lora Zaharieva

Objective: Traumatic brain injury (TBI) due to transport accidents is a serious cause of death and disability. In every case, however, quick response and a proper health care are required.   Materials and methods: We collected 10-year data retrospectively from the laboratory of forensic science and toxicology in Montana, Bulgaria with the intention to show the importance of neurosurgical care in the traumatology and its connection to mortality rate.   Results: 124 cadavers were included with significant male predominance. The data analysis shows that the mortality rate at the hospitals without neurosurgical facilities and the mortality at the scene of the accident is the same for traffic brain injuries. Furthermore, we found that the age has no correlation with the mortality rate.   Conclusion: Road injuries are the most common type of brain injury. We believe that the outcome of these TBIs depends on the availability of a neurosurgical unit.


2021 ◽  
Vol 105 (1) ◽  
pp. 56-60
Author(s):  
E. Shuminsky ◽  
◽  
A. Kopchak ◽  

Summary. Craniofacial trauma is one of the most difficult types of injuries. There is disagreement among various authors about the relationship between maxillofacial trauma (MFT) and traumatic brain injury (TBI). Purpose. Retrospectively evaluate the epidemiology of traumatic injuries of the craniomaxillofacial area and determine whether there is a relationship between different isolated or combined fractures of the facial bones and brain damage. Materials and methods. The case histories of three groups of patients with isolated fractures of the mandible (I group), isolated fractures of the midface zone (II group) and combined fractures of all areas of the face (III group), who were hospitalized in the period from 2012 to 2017, were analyzed. The main epidemiological indicators were determined. The analysis of indicators of severity of MFT and TBI is carried out. Correlation analysis of indicators, analysis using the Kruskal- Wallis test and Steel-Dwass test for pairwise comparisons was performed. Results. Were treated519 patients. 457 men (88 %) and 62 women (12 %). The main causes of injuries were assaults (40 %). Correlation analysis did not reveal the dependence of MFT and TBI. The difference in severity of isolated fractures of the mandible and midface bones was statistically significant, and there is a statistical significance between the severity of TBI in case of isolated fractures of midface bones and panfacial fractures (p < 0.05). Conclusions. The severity of maxillofacial trauma in the case of panfacial fractures is on average 3 times higher than in the case of isolated fractures of the lower jaw or midface bones. The severity of TBI is largely consistent with concussion in all groups, but in the group with panfacial fractures, the median rate is lower comparing to other groups. Key words: Glasgow coma scale, fracture, Le Fort, traumatic brain injury


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