Journal of neurotrauma
-
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.
-
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.
-
Journal of neurotrauma · Dec 2020
Influence of Anxiety on Baseline Cognitive Testing and Symptom Reporting in Adolescent Student Athletes.
Anxiety symptoms are commonly endorsed by student athletes. This study examined the possible influence of anxiety on baseline cognitive testing and symptom reporting in a large sample of adolescent student athletes. Participants were 37,945 adolescent student athletes from the state of Maine who completed baseline testing using ImPACT®. ⋯ More than eight of 10 youth in the high anxiety group (82.7%) met International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10) symptom criteria for at least a mild form of the postconcussional syndrome compared with less than two of 10 (18.4%) in the low anxiety group. Students in the high anxiety group had slightly lower scores on neurocognitive testing, but the differences were not practically meaningful; however, they endorsed dramatically more physical, cognitive, and emotional symptoms. Anxiety can mimic the ICD-10 postconcussional syndrome in adolescent student athletes at baseline, when they have not been injured.
-
Journal of neurotrauma · Dec 2020
Is the fear-avoidance model also relevant for chronic disability after traumatic brain injury?
Previous studies convincingly suggest that the biopsychosocial fear-avoidance model (FAM) may be of added value in understanding chronic disability after traumatic brain injury (TBI). In this model, persistent symptoms occur as a result of catastrophizing and fear-avoidance regarding initial symptoms, leading to depression, reduced mental activity, and greater disability in daily functioning. This study examined the FAM in a large English-speaking TBI sample. ⋯ The separate regression analyses for depression, fewer mental activities, and disability revealed "fear-avoidance thoughts" as the only consistent variable. In conclusion, this study shows the association of the FAM with chronic disability after TBI, which has implications for assessment and future management of the FAM in TBI in English-speaking countries. Longitudinal studies are warranted to further investigate and refine the model.
-
Journal of neurotrauma · Dec 2020
Repetitive mild traumatic brain injuries in mice during adolescence cause sexually dimorphic behavioural deficits and neuroinflammatory dynamics.
Adolescent brain injuries have devastating impacts on lifelong health given that adolescence is a critical period for brain development. Adolescents are susceptible to mild traumatic brain injuries (mTBIs) acquired from collisions in contact sports, which are often sustained in a repetitive nature (repetitive mild traumatic brain injuries; RmTBIs), and cause compounding, sexually dimorphic neurological deficits. Neuroinflammation accompanies RmTBIs and may be a central driving force for chronic neurological decline. ⋯ Flow cytometric quantification of neuroinflammatory responses revealed time- and sex-dependent infiltration of peripheral macrophages and T cells and male-specific decreases in microglia number. Using immunohistochemistry, we report specific microglia density decreases in male mice in the motor cortex and thalamus. We show novel neuroinflammatory responses after adolescent brain injuries that expands the current understanding of RmTBI pathophysiology in this critical neurodevelopmental period.