NeuroRehabilitation
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NeuroRehabilitation · Jan 2012
ReviewCentral sensitization as a component of post-deployment syndrome.
Many service members and veterans report chronic unexplained symptoms such as pain, fatigue and memory complaints, which have most recently been characterized as post-deployment syndrome (PDS). Chronic widespread pain is a component of this syndrome, producing significant disability and considerable health care costs. ⋯ Here, we provide support for PDS as a consequence of pain and sensory amplification secondary to neuroplastic changes within the central nervous system, a phenomenon often termed central sensitization. We also discuss how factors such as stress and genetics may promote chronic widespread pain in veterans and service members who develop PDS.
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NeuroRehabilitation · Jan 2012
ReviewPediatric traumatic brain injury: neuroimaging and neurorehabilitation outcome.
Brain injury in the pediatric patient not only occurs in an immature brain, but potentially influences all subsequent brain and neurodevelopmental maturation. This presents unique challenges in neuroimaging the developing central nervous system, which is reviewed herein. ⋯ Pediatric neuroimaging findings of TBI are discussed in terms of techniques that can assess underlying neural networks and provide information about neuroplasticity of recovery. Neuroimaging methods also provide insights into the complexities of brain injury, cognitive and neurobehavioral recovery, and how multimodality contemporary neuroimaging methods best demonstrate underlying neuropathology that affects outcome.
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NeuroRehabilitation · Jan 2012
ReviewDecompressive craniectomy in pediatric traumatic brain injury: a review of the literature.
Pediatric traumatic brain injury accounts for approximately 37,000 hospitalizations and 2,685 deaths in the United State annually. The 2003 guidelines consolidated and summarized the body of literature on this subject. Among the material covered was the role of surgical management of elevated intracranial pressure. Here we review the guideline recommendations, recent literature on the topic, and important recent results in the adult population. ⋯ Based on the only randomized trial in children and the abundance of smaller studies, it is our belief that decompressive craniectomy does provide a benefit in terms of the management of intracranial hypertension and overall outcome in children.
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NeuroRehabilitation · Jan 2012
ReviewNeuroimaging after critical illness: implications for neurorehabilitation outcome.
Survivors of critical illness frequently have severe and long-lasting cognitive impairments and psychiatric disorders, which adversely affect functional outcomes including return to work, and quality of life. While data regarding cognitive outcomes has increased over the last 15 years, neuroimaging data in medical and surgical critical populations is extremely limited. ⋯ Patients admitted to neurorehabilitation who received critical care related to their primary diagnosis may have sustained neurological injury from the nonspecific effects of their critical illness and as demonstrated in this review, generalized, non-specific neuroimaging findings may be observed and quantified. Given the high prevalence rate of cognitive impairments in this population, neuroimaging is important to help elucidate neuropathology of critical illness acquired brain injury and may be beneficial in guiding rehabilitation outcomes in this population.
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NeuroRehabilitation · Jan 2012
Feasibility and consumer satisfaction ratings following an intervention for families who have a child with acquired brain injury.
Our objective was to ascertain the feasibility and consumer satisfaction ratings of families who received an adapted pediatric acquired brain injury (ABI) 'Signposts for Building Better Behavior' program in either group- or telephone-support delivery formats. ⋯ The current research has provided preliminary evidence for the feasibility and satisfaction of a family-centered parent-based behavioral intervention program called Signposts to be used with a pediatric ABI population. It also provides evidence for a less costly option of intervention delivery via telephone-support.