Brain injury : [BI]
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Brain injury : [BI] · Jan 2015
Multicenter Study Comparative StudyPrescribing practice and off-label use of psychotropic medications in post-acute brain injury rehabilitation centres: a cross-sectional survey.
Guidance on pharmacotherapy of neurobehavioural sequelae post-acquired brain injury (ABI) is limited. Clinicians face the choice of prescribing off-label. This survey assesses prescribing practice and off-label use of psychotropic medications in Italian brain injury rehabilitation centres and factors associated with atypical antipsychotics use. ⋯ In clinical practice, the effectiveness and safety of medications, in particular off-label, should be systematically monitored. Studies are needed to improve the quality of evidence guiding pharmacotherapy and to evaluate effectiveness and safety of off-label prescribing.
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Sports concussion headache (SCH) is common; yet poorly researched and understood. Somatic complaints including headache are frequently reported by both amateur and professional athletes. Although the literature is replete with reports of a high incidence of headache following sports concussive injuries, there is a dearth of evidence-based medicine to provide practitioners with an understanding of sports concussion headache risk factors, epidemiology, biomechanical risk factors and/or injury thresholds, aetiology, assessment, treatment or prognosis. ⋯ This article will provide readers with an overview of SCH based on the available literature (which as noted is limited); and, where evidence is lacking, information will be provided from the more general post-traumatic headache (PTHA) literature, the author's extensive clinical experience and literature from parallel primary headache disorders. Incidence, pathoanatomy, neurobiology, classification, natural history and prognosis of sports concussion headache will be reviewed. Common, as well as less common, sports concussion headache sub-types will be discussed. General approaches to evaluation (including history taking and physical examination), as well as treatment approaches will also be addressed for specific headache subtypes. Lastly, directions for future research will be explored.
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Brain injury : [BI] · Jan 2015
ReviewExposure to sub-concussive head injury in boxing and other sports.
Current characterizations of chronic traumatic brain injury (CTBI) in boxing, football and other sports are reviewed in the context of the history of research on sub-concussive brain trauma in athletes. ⋯ Recommendations for development of exposure models for sport-specific phenotypic characterizations of CTBI are presented.
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Brain injury : [BI] · Jan 2015
Subdural hygroma following decompressive craniectomy or non-decompressive craniectomy in patients with traumatic brain injury: Clinical features and risk factors.
Subdural hygroma (SDG) is a common complication that can occur after head trauma or secondary to decompressive craniectomy (DC). SDGs can be located not only ipsilateral or contralateral to the side of the DC, but also bilateral or unilateral in patients without DC. This study investigated the incidence and risk factors for different types of SDG in a large cohort of patients with traumatic brain injury (TBI). ⋯ This study suggested that the incidence of SDG in patients who have and have not undergone DC was identical; however, the patients' characteristics and risk factors differed. Therefore, the management and prediction of SDG should be performed according to SDG type.
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Brain injury : [BI] · Jan 2015
A longitudinal evaluation of diffusion kurtosis imaging in patients with mild traumatic brain injury.
To investigate longitudinal diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) changes in white and grey matter in patients with mild traumatic brain injury (mTBI). ⋯ These data demonstrate that DKI may be sensitive in tracking pathophysiological changes associated with mTBI and may provide additional information to conventional DTI parameters in evaluating longitudinal changes following TBI.