Brain injury : [BI]
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Brain injury : [BI] · Jan 2017
Preliminary investigation of Brain Network Activation (BNA) and its clinical utility in sport-related concussion.
The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician's decision-making process. ⋯ The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions.
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Conventional neuroimaging is not recommended for the routine diagnosis of concussion, but some patients with concussion undergo computed tomography (CT) or magnetic resonance imaging (MRI). The objective of this study was to explore the clinical factors that predict neuroimaging utilization in concussion. ⋯ Several clinical factors predict neuroimaging utilization in patients with concussion. CT is generally used acutely, while MRI is used in the sub-acute and chronic post-concussion periods. In a sports concussion clinic, delayed neuroimaging has limited clinical yield.
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Brain injury : [BI] · Jan 2017
Temporal profile of care following mild traumatic brain injury: predictors of hospital admission, follow-up referral and six-month outcome.
To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). ⋯ Clinical factors modulate triage to admission, while demographic/socioeconomic elements modulate follow-up care acquisition; six-month functional disability associates with both clinical and demographic/socioeconomic variables. Improving triage to acute and outpatient care requires further investigation to optimize resource allocation and outcome after mTBI. ClinicalTrials.gov registration: NCT01565551.
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Brain injury : [BI] · Jan 2017
Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI).
Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study were to train research assistants (RAs) to rate CDEs and then to evaluate their performance. The aim was to assess inter-rater reliability (IRR) of CDEs between trained RAs and a neurologist and to evaluate applicability of CDEs in acute and sub-acute TBI to test the feasibility of using CDE CT ratings in future trials and ultimately in clinical practice. The second aim was to confirm that the ratings of CDEs reflect pathophysiological events after TBI. ⋯ RA, research assistant; CT, Cranial Tomography; TBI, Traumatic Brain Injury; CDE, Common Data Elements; IRR, inter-rater reliability; PCA, Principal Component Analysis; GCS, Glasgow Coma Scale; R, rater; CI, confidence interval; CCC, Concordance correlation coefficient; IVH, Intraventricular haemorrhage; DCA, Discriminant Component analysis; SAH, Subarachnoid Haemorrhage.
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Brain injury : [BI] · Jan 2017
Highlighting the differences in post-traumatic symptoms between patients with complicated and uncomplicated mild traumatic brain injury and injured controls.
The goal of the current study is to explore the difference in acute post-concussive symptoms (PCS), headaches, sleep and mood complaints between groups of patients with complicated and uncomplicated mild traumatic brain injuries (mTBIs) and a comparable group of injured controls. Interactions among the following four factors were studied: presence of (1) PCS; (2) headaches; (3) sleep disorders; and (4) psychological status. ⋯ The vestibular function should be assessed systematically after a complicated mTBI. Furthermore, the mTBI diagnosis should be based on operational criteria, and not on reported symptoms.