Brain injury : [BI]
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Brain injury : [BI] · Jan 2015
Mild traumatic brain injury defined by Glasgow Coma Scale: Is it really mild?
Conventionally, a Glasgow Coma Scale (GCS) score of 13-15 defines mild traumatic brain injury (mTBI). The aim of this study was to identify the factors that predict progression on repeat head computed tomography (RHCT) and neurosurgical intervention (NSI) in patients categorized as mild TBI with intracranial injury (intracranial haemorrhage and/or skull fracture). ⋯ In patients with intracranial injury, a mild GCS score (GCS 13-15) in patients with an intracranial injury does not preclude progression on repeat head CT and the need for a neurosurgical intervention. Base deficit greater than four and displaced skull fracture are the greatest predictors for neurosurgical intervention in patients with mild TBI and an intracranial injury.
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Brain injury : [BI] · Jan 2015
Neuropsychological outcome and its correlates in the first year after adult mild traumatic brain injury: A population-based New Zealand study.
The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury. ⋯ Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods.
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Brain injury : [BI] · Jan 2015
Case ReportsSyria civil war: Outcomes of humanitarian neurosurgical care provided to Syrian wounded refugees in Israel.
As an expected consequence of the civil war in Syria, emergent neurosurgical care for battlefield trauma has been provided for severely head-injured Syrians transferred to Northern Israel. ⋯ The present findings suggest that aggressive surgery and neuro-intensive care measures may lead to good functional results, even in the presence of seemingly devastating injuries in some selected patients.
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Brain injury : [BI] · Jan 2015
Case ReportsKnee pain relief with genicular nerve blockage in two brain injured patients with heterotopic ossification.
Heterotopic ossification (HO) is the ectopic bone formation in non-osseous tissues. This study aimed to present two patients with traumatic brain injury (TBI) who had HO in knee joint and pain relief after genicular nerve blockage. Case 1: A 14-year-old patient with TBI was admitted with bilateral knee pain and limited range of motion. Physical examination and x-ray graphics revealed calcification which was diagnosed as HO. Ultrasonography (US) guided genicular nerve blockage was performed to both knees with 2 ml lidocaine and 1 ml betamethasone. VAS of pain was decreased to 30 mm from 80 mm. At 6-month follow-up, VAS of pain was still 30 mm. Case 2: A 29-year-old patient with TBI was admitted for rehabilitation. He had right knee pain and his pain was 80 mm according to VAS. Investigation revealed HO. US guided genicular nerve blockage was performed to the right knee and pain was decreased to 20 mm. ⋯ US guided genicular nerve blockage can provide pain relief in HO and this technique may be effective and alternative for pain relief in patients with neurogenic knee HO to increase patient's compliance.
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Brain injury : [BI] · Jan 2015
Case ReportsInfluence of intrathecal baclofen on the level of consciousness and mental functions after extremely severe traumatic brain injury: brief report.
Whenever oral treatment or botulinum toxin injections fail to control severe spasticity, a trial with intrathecal baclofen is recommended no earlier than 1 year after brain injury. When irreversible contractures are to be avoided, such a trial might be done earlier. Some have briefly reported cognitive modifications with this treatment. ⋯ Intrathecal baclofen should be considered within the first year after brain injury whenever spasticity does not respond to medication. ITB lessens the degree of spasticity which in turn facilitates care and, thus, has the potential to limit contractures. After severe brain injury, this treatment might trigger recovery from altered states of consciousness, improve cognition and facilitate rehabilitation.