Articles: traumatic-brain-injuries.
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Journal of neurotrauma · Jan 2016
Modelling of community integration trajectories in the first 5 years after traumatic brain injury.
The aims of this study were to assess the trajectories of community integration in individuals with traumatic brain injury (TBI) through one, two, and five years post-injury and to examine whether those trajectories could be predicted by demographic and injury characteristics. A longitudinal cohort study was conducted with 105 individuals with moderate-to-severe TBI admitted to a trauma referral center in 2005-2007. Demographics and injury-related factors were extracted from medical records. ⋯ Additionally, higher trajectories of community integration were predicted by being single at the time of injury (p<.001), higher level of education (p=0.006), employment (p<0.001), and a shorter length of PTA (p<0.001). In a follow-up HLM with interaction terms, time*PTA was statistically significant (p<0.001), suggesting that participants with longer PTA increased in community integration more rapidly than those with shorter PTA. The longitudinal course of community integration described in this study may help rehabilitation professionals to plan more extensive follow-ups and targeted rehabilitation programs in the early stage of recovery for patients with specific demographic and injury characteristics.
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Comparative Study
Glasgow Coma Scale Versus Full Outline of UnResponsiveness Scale for Prediction of Outcomes in Patients with Traumatic Brain Injury in the Intensive Care Unit.
Glasgow Coma Scale (GCS) is the most applied tool for classifying intensity of coma and predicting patient outcomes with traumatic brain injuries. The present study was conducted with the aim of comparing two criteria of Full Outline of UnResponsiveness (FOUR) scale and GCS in predicting prognosis in patients with traumatic brain injuries. ⋯ FOUR score is a valuable, sensitive and specific diagnostic criterion for predicting outcomes in patients with traumatic brain injuries.
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Brain injury : [BI] · Jan 2016
Case ReportsDegeneration of an injured spinothalamic tract in a patient with mild traumatic brain injury.
This study reports on a patient who developed degeneration of an injured spinothalamic tract (STT) detected on diffusion tensor tractography (DTT) following mild traumatic brain injury (TBI). ⋯ This study recommends further studies conducted on the prognosis (regeneration or degeneration) of injured STTs and on the effect of change of an injured STT on central pain.
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Journal of neurotrauma · Jan 2016
Early CT frontal abnormalities predict long term neurobehavioral problems but not affective problems after moderate to severe TBI.
Behavioral problems are serious consequences of moderate to severe traumatic brain injury (TBI) and have a negative impact on outcome. There may be two types: neurobehavioral problems, manifesting as inadequate social behavior resulting from prefrontal system damage, and affective behavioral problems, resulting from emotional distress as a reaction to the brain injury. In the present study we investigated whether these two types of behavioral problems, as indicated by proxies, could be distinguished in a group of chronic TBI patients and whether early indicators of prefrontal damage on imaging could predict long-term neurobehavioral problems. ⋯ Long-term neurobehavioral problems were significantly correlated to one-year outcome and return to work in the long term. We conclude that in patients with moderate to severe TBI neurobehavioral and affective problems can be distinguished. Early CT frontal abnormalities predict long-term neurobehavioral problems, but not affective problems.
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J Neurosurg Pediatr · Jan 2016
Standardizing ICU management of pediatric traumatic brain injury is associated with improved outcomes at discharge.
OBJECT The goal of critical care in treating traumatic brain injury (TBI) is to reduce secondary brain injury by limiting cerebral ischemia and optimizing cerebral blood flow. The authors compared short-term outcomes as defined by discharge disposition and Glasgow Outcome Scale scores in children with TBI before and after the implementation of a protocol that standardized decision-making and interventions among neurosurgeons and pediatric intensivists. METHODS The authors performed a retrospective pre- and postprotocol study of 128 pediatric patients with severe TBI, as defined by Glasgow Coma Scale (GCS) scores < 8, admitted to a tertiary care center pediatric critical care unit between April 1, 2008, and May 31, 2014. ⋯ After protocol implementation, 9 patients (31%) had unfavorable disposition, while 20 patients (69%) had favorable disposition (p = 0.002). In the preprotocol group, 31 patients (31%) died while 6 patients (21%) died after protocol implementation (p = 0.04). CONCLUSIONS Discharge disposition and mortality rates in pediatric patients with severe TBI improved after implementation of a standardized protocol among caregivers based on best-practice guidelines.