Journal of neurotrauma
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Journal of neurotrauma · Dec 2020
Comparative StudySensory reweighting for upright stance in soccer players: A comparison of high and low exposure to soccer heading.
The purpose of this study was to compare sensory reweighting for upright stance between soccer players who report higher soccer heading exposure to those who report lower soccer heading exposure. Thirty participants completed a self-reported questionnaire to estimate the number of soccer headers experienced over the previous year and were divided into "low exposure" and "high exposure" groups based on their responses. Sensory reweighting for upright stance was assessed by simultaneously perturbing visual, vestibular, and proprioceptive systems. ⋯ Without vibration, COM 95% area (F = 5.861, p = 0.022*, partial η2 = 0.173), velocity (F = 14.198, p = 0.001, partial η2 = 0.336), and total power (F = 13.491, p = 0.001, partial η2 = 0.325) for the "high exposure" group were higher than for the "low exposure" group, and postural sway lagged the vestibular stimulus in the "high exposure" group rather than leading it as in the "low exposure" group (F = 4.765, p = 0.038, partial η2 = 0.145). There were no differences in sensory reweighting and no differences in COM gain/phase between groups. These findings lend empirical evidence to a detrimental effect of soccer heading exposure on balance control during upright stance.
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Journal of neurotrauma · Dec 2020
ReviewLOW-VALUE CLINICAL PRACTICES IN ADULT TRAUMATIC BRAIN INJURY: AN UMBRELLA REVIEW.
Despite numerous interventions and treatment options, the outcomes of traumatic brain injury (TBI) have improved little over the last 3 decades, which raises concern about the value of care in this patient population. We aimed to synthesize the evidence on 14 potentially low-value clinical practices in TBI care. Using umbrella review methodology, we identified systematic reviews evaluating the effectiveness of 14 potentially low-value practices in adults with acute TBI. ⋯ For the following practices, effect estimates were consistently close to the null: computed tomography (CT) in adults with mild TBI who are low-risk on a validated clinical decision rule; repeat CT in adults with mild TBI on anticoagulant therapy with no clinical deterioration; antibiotic prophylaxis for external ventricular drain placement; and decompressive craniectomy for refractory intracranial hypertension. We identified five clinical practices with evidence of lack of benefit or harm. However, evidence could not be considered to be strong for any clinical practice as effect measures were imprecise and heterogeneous, systematic reviews were often of low quality, and most included studies had a high risk of bias.
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Journal of neurotrauma · Dec 2020
SOCIO-ECONOMIC CONSEQUENCES OF TRAUMATIC BRAIN INJURY: A DANISH NATIONWIDE REGISTER-BASED STUDY.
This study examined if acquiring a traumatic brain injury (TBI) increases utilization of health care costs, increases risk of job loss for the patient and the closest relatives, and increases the risk of divorce 1 to 5 years following the injury. The study was conducted as a Danish national population-based register study with follow-up. Participants included a cohort of patients with TBI (n = 18,328) admitted to a hospital or treated in an emergency room (ER) and a matching control group (n = 89,155). ⋯ The TBI group had a significant increased risk of job loss (odds ratio [OR] = 2.88; confidence interval [CI]: 2.70-3.07) and divorce (OR = 1.44; CI: 1.27-1.64) during the first 3 years following injury. In conclusion, the TBI group had significantly higher utilization of health care costs, both pre-morbidly and post-injury. Further, increased risk of job loss and divorce were found, emphasizing that the socioeconomic consequences of TBI last for years post-injury.
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Journal of neurotrauma · Dec 2020
Larger Middle Meningeal Arteries on Computed Tomography Angiography in Patients with Chronic Subdural Hematomas as Compared to Matched Controls.
Chronic subdural hematomas (CSDHs) are one of the most prevalent head-trauma-related conditions. The middle meningeal artery (MMA) may participate in the pathophysiology of CSDHs. The aim of this study was to determine whether CSDHs are associated with large MMAs. ⋯ The median diameter of 52 MMAs on the side of a unilateral CSDH (1.6 mm; IQR 1.4-1.8) was larger than that of the 52 contralateral MMAs (1.4 mm; IQR 1.25-1.6) (p < 0.001). Among the characteristics of patients with CSDH, multiple surgeries were associated with significantly larger MMAs (>1.7 mm; p = 0.01). MMAs ipsilateral to CSDHs appear to be significantly larger as compared with contralateral MMAs and MMAs in a control population, suggesting the involvement of the MMA in the pathophysiology of CSDH.
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Journal of neurotrauma · Dec 2020
Comparative StudyPrevalence of Lifetime History of Traumatic Brain Injury among Older Male Veterans Compared to Civilians: A Nationally Representative Study.
Traumatic brain injury (TBI) is common among older adults as well as among veterans in the United States and can increase risk for dementia. We compared prevalence of TBI in older male veterans and civilians using a nationally representative sample. We examined data from 599 male respondents to the 2014 wave of the Health and Retirement Study (HRS), a nationally representative survey of older adults, randomly selected to participate in a comprehensive TBI survey. ⋯ In contrast, prevalence estimates for male civilians were 58% for lifetime history of head/neck injury, 4.8% for multiple NTI, and 45% for lifetime history of at least one TBI (all comparisons, p < 0.001). Male civilians have higher self-reported TBI prevalence, whereas male veterans have higher self-reported NTI and multiple-NTI prevalence. Further research on drivers of the unexpectedly higher prevalence of lifetime history of TBI in male civilians, as well as on mechanisms and sequelae of the highly prevalent non-TBI head/neck injuries among older male veterans, is warranted.