Brain injury : [BI]
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Brain injury : [BI] · Jan 2019
Opioids and cerebral physiology in the acute management of traumatic brain injury: a systematic review.
Following traumatic brain injury (TBI), optimization of cerebral physiology is recommended to promote more favourable patient outcomes. Accompanying pain and agitation are commonly treated with sedative and analgesic agents, such as opioids. However, the impact of opioids on certain aspects of cerebral physiology is not well established. ⋯ CPP: Cerebral Perfusion Pressure, GCS: Glasgow Coma Scale, ICP: Intracranial Pressure, MAP: Mean Arterial Pressure, PEDro: Physiotherapy Evidence Database, RCT: Randomized Controlled Trial, TBI: Traumatic Brain Injury.
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Brain injury : [BI] · Jan 2019
Service and support needs following pediatric brain injury: perspectives of children with mild traumatic brain injury and their parents.
To provide a qualitative examination of the service and support needs of children who have had a mild traumatic brain injury (mTBI), and their parents, in order to improve clinical services. ⋯ Dedicated pediatric mTBI follow-up services that build on family's resources and meet their individual needs for information, emotional support, and referral may assist in optimizing post-injury outcomes.
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Brain injury : [BI] · Jan 2019
Length of post-traumatic amnesia and its prediction of neuropsychological outcome following severe to extremely severe traumatic brain injury in a litigating sample.
Primary Objective: The aim of the current study was to examine the relationship between duration of post-traumatic amnesia (PTA) and neuropsychological outcome at one or more years following severe to extremely severe traumatic brain injury (TBI) in a litigating sample. Research Design: Retrospective study design, using data collected from 2010 to 2017. Methods and Procedures: Data from 41 cases obtained from a private medicolegal neuropsychological database was examined. ⋯ Main Outcomes and Results: Continuous PTA duration was not found to be a significant predictor of cognitive impairment across domains of verbal intellect, non-verbal intellect, working memory, information processing speed, immediate memory, delayed memory, and executive functioning. Conclusions: The predictive relationship between duration of PTA and cognitive impairment that has been reported in non-litigating populations did not exist in a litigating TBI sample. Findings illustrate the importance of investigating the relationships between injury variables and cognitive outcome in a population undergoing litigation, to provide better understanding of outcome in this subgroup of patients with TBI.
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Drawing upon sources in neuroethics, civil rights, and disability rights law, we argue for the reintegration of people with severe brain injury back into the nexus of their families and communities consistent with the Americans with Disabilities Act (ADA) and the UN Convention on the Rights of Persons with Disabilities, both of which call for the maximal integration of people with disability into society. To this end, we offer a rights-based argument to address the care of people with severe brain injury. Instead of viewing the provision of rehabilitation as a reimbursement issue, which it surely is, we argue that it can be productively understood as a question of civil rights for a population generally segregated from the medical mainstream and from society itself. Their segregation in the chronic care sector constitutes disrespect for persons, made all the more consequential because recent advances in brain injury rehabilitation make reintegration into civil society an aspirational, if not achievable goal.
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Brain injury : [BI] · Jan 2018
Helmet use in preventing acute concussive symptoms in recreational vehicle related head trauma.
Helmets use has proved effective in reducing head trauma (HT) severity in children riding non-motorised recreational vehicles. Scant data are available on their role in reducing concussive symptoms in children with HT while riding non-motorised recreational vehicles such as bicycles, push scooters and skateboards (BSS). We aimed to investigate whether helmet use is associated with a reduction in acute concussive symptoms in children with BSS-related-HT. ⋯ aOR, adjusted odds ratio; APHIRST, Australasian Paediatric Head Injury Rules Study; BSS, bicycles, push scooters and skateboards; CI, confidence interval; CT, computed tomography; ED, emergency department; HT, head trauma; IQR, interquartile range; OR, odds ratio; RCH, Royal Children's Hospital; RV, recreational vehicle.