Traumatic Head Injury: Implications for Rehabilitation Counseling

Traumatic head injury is a topic of growing concern for rehabilitation professionals. Between 30,000 and 50,000 individuals each year are left with disabilities severe enough to preclude a return to normal life following traumatic head injury. Approximately one-half of the head injuries are caused by motor vehicle accidents, the incidence among males is almost twice that among females, and males fifteen to twenty-four years of age incur more head injuries than any other age group. Brain damage following traumatic injury is typically diffuse. Therefore, a unique set of temporary or permanent limitations may be evident, encompassing physical, cognitive-intellectual, and/or personality-emotional functioning. Flexibility in rehabilitation planning is of key importance in considering the complexity of potential limitations and their changeable nature. Professional awareness and training, specialized services and programs, advocacy for program eligibility in established agencies and programs, and individualized assessment and counseling are part of the exciting rehabilitation challenge in returning the head injured to productive lives.

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An Overview of Rehabilitation Considerations for Persons with Head Injuries

Journal of Applied Rehabilitation Counseling ◽

10.1891/0047-2220.20.4.22 ◽

1989 ◽

Vol 20 (4) ◽

pp. 22-26 ◽

Cited By ~ 1

Author(s):

Steven W. Ostwald

Keyword(s):

Head Injury ◽

Head Injuries ◽

Basic Knowledge ◽

Traumatic Head Injury ◽

Rehabilitation Professionals ◽

Visuospatial Deficits ◽

Head Injured ◽

Traumatic Head ◽

Left And Right

Each year, 400,000 to 600,000 individuals suffer traumatic head injury. Of these, approximately 30,000 to 50,000 will encounter long-term disability. The prevalence of head injury and the myriad of problems associated with it, make it critical that rehabilitation professionals possess basic knowledge of the problems and deficits encountered by head injured clients. This article addresses those aspects of head injury which are felt to be pertinent to the rehabilitation of the head injured client. Common deficits, resulting behavior, and suggestions are discussed as they relate to left and right cerebral damage. Communication and visuospatial deficits are important considerations when serving a head injured client. The head injured client's fatigability, memory deficits, loss of competence, increased anxiety, and motivation are examined from the rehabilitative perspective. Successful rehabilitation of the head injured client, although possible, is complicated by numerous factors not always encountered with other disabling conditions.

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Strategies for Helping Head-Injured Children Successfully Return to School

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1804.292 ◽

1987 ◽

Vol 18 (4) ◽

pp. 292-300 ◽

Cited By ~ 6

Author(s):

Roberta DePompei ◽

Jean Blosser

Keyword(s):

Head Injury ◽

Motor Vehicle ◽

Sports Injuries ◽

Head Injuries ◽

Closed Head Injury ◽

Return To School ◽

Educational Setting ◽

Vehicle Accidents ◽

Speech Language Pathologist ◽

Head Injured

Each year approximately 75,000 individuals sustain a closed head injury (CHI). The head injuries may be the result of motor vehicle accidents, falls, sports injuries, or abuse. It is estimated that as many as 18,000 of those injured are children. Often, head-injured children return to the educational setting following physical recuperation. The communication, physical, cognitive, emotional, and/or behavioral changes which have resulted from the head injury may interfere with successful re-entry into school. This article will present information that may be helpful in implementing the CHI student's successful return to school. Specific topics to be discussed include: types of deficits in CHI students, initiating the return to the educational setting, reasons for involvement of the speech-language pathologist in the re-entry process, suggestions for establishing effective networks between the rehabilitation setting (hospital/clinic) and the educational setting; and, specific recommendations for implementing the return.

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The role of vagal insulin signaling and enteric hormones in acute stomach and duodenal erosions and ulcers associated with severe concomitant traumatic head injuries

Kazan medical journal ◽

10.17750/kmj2015-485 ◽

2015 ◽

Vol 96 (4) ◽

pp. 485-488

Author(s):

F I Alyev

Keyword(s):

Head Injury ◽

Insulin Signaling ◽

Vagal Stimulation ◽

Head Injuries ◽

Traumatic Injury ◽

Serum Levels ◽

Traumatic Head Injury ◽

Abdominal Organs ◽

History Of ◽

Traumatic Head

Aim. Clinical and experimental study of vagal insulin signaling and enteric hormones in occurrence of acute stomach and duodenal erosions and ulcers complicated by bleeding and associated with severe concomitant traumatic head injuries. Methods. Data of 347 patients with severe concomitant traumatic head injuries for 2011-2012 were used for clinical part of the study. Serum levels of insulin, gastrin, C-peptide, histamine, growth hormone, α-amylase were determined. In the experimental part, the model of acute stomach and duodenal erosions and ulcers associated with traumatic head injury were modeled. The first group consisted of 5 intact rats, the second group included 45 rats with modeled isolated traumatic head injury, the third group included 45 rats with modeled traumatic head injury associated with traumatic lung and chest injury, the fourth group included 45 rats with modeled traumatic head injury associated with abdominal organs traumatic injury, the fifth group included 45 rats with modeled traumatic head injury associated with limb and pelvic fractures. Results. Acute stomach and duodenal erosions and ulcers were found in 21 (6.1%) of 347 patients at endoscopy, mainly in those with the highest parameters of vagal insulin signaling and enteric hormones. At the experiment, all types of combined traumatic head injury increased the incidence of erosions as compared to the second group, with the highest incidence in the group of associated abdominal injury. Vagal stimulation and stimulation of enteric hormones secretion in animals of groups 2-5 was associated with higher incidence of erosions. In contrast, decreased vagal stimulation and enteric hormones secretion leaded to statistically significant reduction of erosions incidence in animals of groups 2-5 as compared both to the natural history of the process (first subgroup), and to animals which were administered 5% dextrose (glucose) and 0.1% histamine solutions (second subgroup). Conclusion. The incidence of erosions and ulcers, as well as the indicators of vagal stimulation and enteric hormones secretion depend on the nature of the accompanying injury that may be taken into account in the prevention and treatment of such complications.

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Famous head injuries of the first aerial war: deaths of the “Knights of the Air”

Neurosurgical FOCUS ◽

10.3171/2015.4.focus15109 ◽

2015 ◽

Vol 39 (1) ◽

pp. E5

Author(s):

Prateeka Koul ◽

Christine Mau ◽

Victor M. Sabourin ◽

Chirag D. Gandhi ◽

Charles J. Prestigiacomo

Keyword(s):

Head Injury ◽

World War I ◽

Head Injuries ◽

World War ◽

Traumatic Head Injury ◽

The Public ◽

Time Period ◽

Traumatic Head ◽

The Media

World War I advanced the development of aviation from the concept of flight to the use of aircraft on the battlefield. Fighter planes advanced technologically as the war progressed. Fighter pilot aces Francesco Baracca and Manfred von Richthofen (the Red Baron) were two of the most famous pilots of this time period. These courageous fighter aces skillfully maneuvered their SPAD and Albatros planes, respectively, while battling enemies and scoring aerial victories that contributed to the course of the war. The media thrilled the public with their depictions of the heroic feats of fighter pilots such as Baracca and the Red Baron. Despite their aerial prowess, both pilots would eventually be shot down in combat. Although the accounts of their deaths are debated, it is undeniable that both were victims of traumatic head injury.

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Pediatric Head Injury Caused by Off-Road Vehicle Accidents

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100029188 ◽

1989 ◽

Vol 16 (3) ◽

pp. 336-339 ◽

Cited By ~ 8

Author(s):

E.R. Cardoso ◽

Alexander Pyper

Keyword(s):

Head Injury ◽

Spinal Injury ◽

Head Injuries ◽

Rural Setting ◽

Road Vehicles ◽

Urban Centers ◽

Average Hospital ◽

Vehicle Accidents ◽

Pediatric Head Injury ◽

Head Injured

ABSTRACT:Morbidity and mortality from pediatric head injuries associated with the use of off-road vehicles are increasing. We reviewed all such injuries admitted to acute care hospitals in the two largest urban centers in Manitoba between April 1979 and August 1986. Of 375 injured children, 83 suffered head injury, 70 boys and 13 girls. Ages ranged from 2 to 15 years, with a mean of 10.4 years. Head injury was defined as any injury involving face, scalp or nervous system. Dirtbikes were implicated in 34 accidents, snowmobiles in 28, 3-wheel ATV's in 19, and 4-wheel ATV's in 2. About 85% of accidents occurred in a rural setting. Loss of vehicle control was the most common cause of injury. Alcohol or drug abuse were not factors. Fifty (60.2%) patients suffered loss of consciousness, prolonged in 6 (7.2%). All head-injured children also suffered at least one associated injury, mainly involving the musculoskeletal system. Associated spinal injury occurred in 18%. The average hospital stay was 13 days. Three (3.6%) patients died as a result of head injury.

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Head Injury in Very Young Children: Mechanisms, Injury Types, and Ophthalmologic Findings in 100 Hospitalized Patients Younger Than 2 Years of Age

PEDIATRICS ◽

10.1542/peds.90.2.179 ◽

1992 ◽

Vol 90 (2) ◽

pp. 179-185 ◽

Cited By ~ 1

Author(s):

A. C. Duhaime ◽

A. J. Alario ◽

W. J. Lewander ◽

L. Schut ◽

L. N. Sutton ◽

...

Keyword(s):

Head Injury ◽

Young Children ◽

Motor Vehicle ◽

Head Injuries ◽

Older Children ◽

Retinal Hemorrhages ◽

Injury Type ◽

Vehicle Accidents ◽

Very Young Children ◽

Injured Patients

Head injury in the youngest age group is distinct from that occurring in older children or adults because of differences in mechanisms, injury thresholds, and the frequency with which the question of child abuse is encountered. To analyze some of these characteristics in very young children, the authors prospectively studied 100 consecutively admitted head-injured patients 24 months of age or younger who were drawn from three institutions. Mechanism of injury, injury type, and associated injuries were recorded. All patients underwent ophthalmologic examination to document the presence of retinal hemorrhages. An algorithm incorporating injury type, best history, and associated findings was used to classify each injury as inflicted or accidental. The results confirmed that most head injuries in children younger than 2 years of age occurred from falls, and while different fall heights were associated with different injury types, most household falls were neurologically benign. Using strict criteria, 24% of injuries were presumed inflicted, and an additional 32% were suspicious for abuse, neglect, or social or family problems. Intradural hemorrhage was much more likely to occur from motor vehicle accidents and inflicted injury than from any other mechanism, with the latter being the most common cause of mortality. Retinal hemorrhages were seen in serious accidental head injury but were most commonly encountered in inflicted injury. The presence of more serious injuries associated with particular mechanisms may be related to a predominance of rotational rather than translational forces acting on the head.

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Head Trauma in Children

Pediatrics in Review ◽

10.1542/pir.15.6.213 ◽

1994 ◽

Vol 15 (6) ◽

pp. 213-219

Author(s):

Brahm Goldstein ◽

Karen S. Powers

Keyword(s):

Head Injury ◽

Hospital Admissions ◽

Motor Vehicle ◽

Pediatric Population ◽

Head Injuries ◽

Motor Vehicle Accidents ◽

Initial Assessment ◽

Severe Injuries ◽

Vehicle Accidents ◽

Pediatric Head Injury

Head injury, either alone or in association with multiple other injuries, is extremely common. The initial assessment and management of children who have a head injury is an important topic for all pediatricians. Epidemiology Table 1 lists definitions of minor, moderate, and severe head injuries as determined by the initial neurologic presentation. The most common method to assess a child's neurologic status initially is to assign a score based on the Glasgow Coma Scale (GCS). The GCS is determined by eye opening and best verbal and motor responses (Tables 2 and 3). Mild-to-moderate head injuries are far more common than severe injuries in the pediatric population. More than 90% of children requiring admission to a hospital following head injury have a GCS score of 13 to 15; severe head injury (GCS≤ 8) accounts for approximately 5% of admissions. Motor vehicle accidents, bicycle accidents, falls, sporting accidents, assaults, and child abuse are the most common causes of pediatric head injury. Despite a significant reduction in the number of pediatric fatalities due to implementation of the 55 mile/hour speed limit, motor vehicle accidents still result in a large number of hospital admissions and deaths each year. Many of these accidents are associated with drug or alcohol abuse.

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Mode of occurrence of traumatic head injuries in male patients with cluster headache or migraine: Is there a connection with lifestyle?

Cephalalgia ◽

10.1177/0333102409359710 ◽

2010 ◽

Vol 30 (12) ◽

pp. 1502-1508 ◽

Cited By ~ 12

Author(s):

Giorgio Lambru ◽

Paola Castellini ◽

Gian Camillo Manzoni ◽

Paola Torelli

Keyword(s):

Head Injury ◽

Cluster Headache ◽

Head Injuries ◽

Traumatic Head Injury ◽

Study Objective ◽

Episodic Cluster Headache ◽

Mode Of Occurrence ◽

Traumatic Head ◽

Male Patients ◽

Headache Patients

Introduction: Our study objective was to investigate the mode of occurrence of traumatic head injury in episodic cluster headache and migraine patients. Methods: We conducted a retrospective study on 400 male patients, 200 with cluster headache (cases) and 200 with migraine (controls). We investigated the frequency and mode of occurrence of traumatic head injury and some lifestyle habits. Results: The number of traumatic head injuries was significantly higher in cases than in controls (adjusted odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.5–2.8). Cases were more often responsible for the head traumas (adjusted OR = 2.6; 95% CI = 1.3–4.9) and reported a significantly higher proportion of injuries during scuffles or brawls (OR = 6.5; 95% CI = 2.9–14.8). Compared with other cluster headache patients, cases responsible for traumatic head injuries were more frequently heavy alcohol ( p = .000), heavy tobacco ( p = .03) and heavy coffee consumers ( p = .003). Conclusions: Cluster headache patients (a) had traumatic head injuries more frequently than migraineurs; and (b) were more often responsible for them, perhaps due to particular behaviours related to their lifestyles.

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Intentional Head Injury: Survivor Victim's Profile, Gender Differences and Role of Alcohol Use at Manipal Teaching Hospital, Pokhara, Nepal

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i1.17284 ◽

2017 ◽

Vol 2 (1) ◽

pp. 102-105

Author(s):

Alok Atreya ◽

T Kanchan ◽

BG Karmacharya

Keyword(s):

Head Injury ◽

Alcohol Use ◽

Teaching Hospital ◽

Head Injuries ◽

Radiological Finding ◽

Physical Assault ◽

Traumatic Head Injury ◽

Minimum Age ◽

Traumatic Head

IntroductionHead is a vulnerable area in human body and also a favorable site for assaults which is easily accessible by assailant's raised arms. ObjectiveThe objective of this study was to evaluate the socio demographic spectrum, severity, radiological findings and outcome of victims assaulted to the head. Furthermore, the study aims to correlate such findings to the role of alcohol use in Nepalese context. MethodologyThis longitudinal prospective study includes victims of traumatic head injury as a result of physical assault who were admitted in the Neurosurgery Unit of Manipal Teaching Hospital Pokhara, Nepal from 1st January to 31st December 2015. ResultsIntentional head injury accounted to 17.40% of all head injury cases admitted during the study period. Among them 48 (76.19%) were males and 15 (23.81%) were females. The minimum age of the patient was 15 years and maximum was 84 years with a mean age of 33.89±14.67 years. Most of the victims of physical assault belonged to the age group of 21 to 30 years. Blunt object was the most commonly used for assault. Loss of consciousness was associated only with 49.21% of cases and 14.29% cases had bleeding from ear and/or nose. More than 75% of the cases had significant radiological finding in the form of fracture and/or intracranial lesion. Majority of the victims during the study were treated conservatively and were discharged with advice. Alcohol use was involved in 36.51% cases of intentional head injuries. ConclusionIntentional injuries under the influence of alcohol use are totally preventable public health concerns. It can be ascertained that reducing availability and improving the environment in which alcohol is sold and consumed can result in a dramatic reduction in violent crimes.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 102-105

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