Brain injury : [BI]
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Brain injury : [BI] · Feb 2020
Acute cognitive postconcussive symptoms follow longer recovery trajectories than somatic postconcussive symptoms in young children.
Objective: To investigate somatic and cognitive postconcussive symptoms (PCS) using the symptom evaluation subtest (cSCAT3-SE) of the Child Sports Concussion Assessment Tool 3 (Child SCAT) in tracking PCS up to 2 weeks postinjury. Methods: A total of 96 participants aged 5 to 12 years (Mage = 9.55, SD = 2.20) completed three assessment time points: 48 h postinjury (T0), 2 to 4 days postinjury (T1), and 2 weeks postinjury (T2). ⋯ Discussion: Differences between cognitive and somatic PCS emerge as early as a few days postinjury, with cognitive PCS being more persistent than somatic PCS across 2 weeks. Research in symptom-specific interventions may be of benefit in helping young children manage severe PCS as early as 2 weeks postinjury.
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Brain injury : [BI] · Jan 2020
The Rivermead Post-Concussion Questionnaire score is associated with disability and self-reported recovery six months after mild traumatic brain injury in older adults.
Background/Objectives: Post-concussion syndrome refers to the adverse group of symptoms following a mild traumatic brain injury (mTBI). The Rivermead post-concussion syndrome questionnaire (RPQ) is a common clinical tool for assessing baseline post-concussion syndrome symptomology; however, it is unknown if scores on this questionnaire are associated with future disability. Therefore, the goal of this study was to determine the association between baseline RPQ scores and future disability in older adults with mTBI. ⋯ Individuals with higher levels of baseline symptomatology were more likely to have poor GOSE scores (RR = 2.13, 95% CI [1.51, 2.31]) and self-reported recovery (RR = 2.64, 95% CI [1.31, 8.98]) 6 months later. Conclusions: High levels of baseline symptomatology may be associated with overall disability and individual perceptions of recovery 6 months post-MTBI. While the RPQ is valid in assessing a patient's post-concussive symptoms following mTBI, it may not predict long-term physical or mental health in older adults.
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Brain injury : [BI] · Jan 2020
Complicated mild traumatic brain injury in older adults: Post-concussion symptoms and functional outcome at one week post injury.
Primary Objective: Mild Traumatic Brain Injury (MTBI) is commonly categorized as complicated when injury severity criteria are mild, but an intracranial abnormality is present on acute neuroimaging. The current study examined whether functional outcomes differed at one week post injury among older adult patients based on injury severity and acute computed tomography (CT) findings. Research Design: Participants (≥55 years-old; n = 173) presenting sequentially to the emergency department with a head injury were divided into three groups: complicated MTBI (positive CT; n = 22), uncomplicated MTBI (negative CT; n = 68), and mild head injury (unperformed CT, no documented loss of consciousness or post-traumatic amnesia; n = 83). ⋯ Main Outcomes and Results: Participants differed on the ∆MRS and GOS-E, but not the RPQ. The complicated MTBI group had worse GOS-E ratings than the uncomplicated MTBI and mild head injury groups and worse ∆MRS than the mild head injury group, but the uncomplicated MTBI and mild head injury groups did not differ on either outcome. Conclusions: Macrostructural abnormality on CT was associated with worse functional outcome at one week post MTBI.
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Brain injury : [BI] · Jan 2019
Diagnostic accuracy of the CRS-R index in patients with disorders of consciousness.
Objective: To obtain a CRS-R index suitable for diagnosis of patients with disorders of consciousness (DOC) and compare it to other CRS-R based scores to evaluate its potential for clinics and research. Design: We evaluated the diagnostic accuracy of several CRS-R-based scores in 124 patients with DOC. ROC analysis of the CRS-R total score, the Rasch-based CRS-R score, CRS-R-MS and the CRS-R index evaluated the diagnostic accuracy for patients with the Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS). ⋯ Conclusion: The CRS-R index is reliable to diagnose patients with UWS and MCS and can be used in compliance with the CRS-R scoring guidelines. The obtained index offers the opportunity to improve the interpretation of clinical assessment and can be used in (longitudinal) research protocols. Abbreviations: CRS-R: Coma Recovery Scale-Revised; CRS-R-MS: Coma Recovery Scale-Revised Modified Score; DOC: Disorders of Consciousness; MCS: Minimally Conscious State; UWS: Unresponsive Wakefulness Syndrome; ROC: Receiver Operating Characteristic; AUC: Area Under the Curve; IRT: Item Response Theory.
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Brain injury : [BI] · Jan 2019
Cerebral blood flow in children and adolescents several years after concussion.
The long-term effects of concussion in youth remain poorly understood. The objective of this study was to determine the association between history of concussion and cerebral blood flow (CBF) in youth. ⋯ Youth with a history of concussion demonstrate differences in regional CBF (not global CBF), but without clear clinical expression.