Articles: traumatic-brain-injuries.
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Brain injury : [BI] · Jan 2015
Community integration 2 years after moderate and severe traumatic brain injury.
The aim of this study was to examine community integration by the Community Integration Questionnaire (CIQ) 2 years after injury in a divided TBI sample of moderately and severely injured patients. The second aim was to identify social-demographic, injury-related and rehabilitation associated predictors of CIQ. ⋯ At 2 years follow-up, there was significant difference between the moderately and severely injured patients in the productivity scores (p < 0.003), while difference in the total CIQ scores approached the significance level (p = 0.074). Significant predictors of a higher CIQ score were living with a spouse, higher Glasgow Coma Scale (GCS) in the acute phase, shorter Post-Traumatic Amnesia (PTA), longer rehabilitation stay (LOS) and use of rehabilitation service. Use of rehabilitation service (B = 7.766) and living with a spouse (B = 4.251) had the largest influence. This means that living with a spouse, better score on the GCS scale, shorter PTA, longer LOS and use of rehabilitation service after discharge equated to better community integration 2 years after TBI Conclusions: Two years after TBI the moderately injured patients have a higher productivity level than the severely injured patients. Marital status, injury severity and rehabilitation after injury were associated with community integration 2 years after TBI.
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Traumatic brain injuries and other blast-related injuries have been identified as the signature injury of the wars in Iraq and Afghanistan. Some operational units in Iraq, especially those responsible for clearing roadways, were exposed to hundreds of blast incidents and thousands of individual doses of concussive energy during their lengthy deployments. Using operational records maintained by a single command element, the researchers conducted a retrospective cohort study evaluating the association between estimated individual exposures to blasts and the risk for postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD). ⋯ This study suggests that estimating the total individual dosage to concussive forces through physical evidence at the scene could be a useful predictor of future brain-disorder diagnoses. Those in vehicles sustaining heavy blast damage are at increased risk of being diagnosed with PTSD with a rate ratio of 2.79 (95% CI, 1.27-6.13) and PTSD in conjunction with PCS with a rate ratio of 4.10 (95% CI, 1.63-10.28). Standardization of the data collection method for blast incidents and additional follow-up studies could lead to the development of better ways of monitoring operational risk factors for negative health outcomes, plans to intervene in order to minimize health risks, and establish customized follow-up protocols based on specific dosage thresholds.
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Journal of neurotrauma · Jan 2015
Noninvasive brain stimulation for persistent postconcussion symptoms in mild traumatic brain injury.
Mild traumatic brain injury (mTBI) is typically followed by various postconcussive symptoms (PCS), including headache, depression, and cognitive deficits. In 15-25% of cases, PCS persists beyond the usual 3-month recovery period, interfering with activities of daily living and responding poorly to pharmacotherapy. We tested the safety, tolerability, and efficacy of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) for alleviating PCS. ⋯ Participants also reported positive outcomes such as less sleep disturbance (n = 3), and better mental focus (n = 3). On average, PCS scores declined by 14.6 points (p = 0.009) and fMRI task-related activation peaks in the DLPFC increased after rTMS. rTMS is safe, tolerated by most patients with mTBI, and associated with both a reduction in severity of PCS and an increase in task-related activations in DLPFC. Assessment of this intervention in a randomized, control trial is warranted.
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Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5-10% of all extradural hematomas. However, higher mortality rates have been reported in previous series. ⋯ The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage.
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Brain injury : [BI] · Jan 2015
Prevalence of mental health conditions after military blast exposure, their co-occurrence, and their relation to mild traumatic brain injury.
To measure common psychiatric conditions after military deployment with blast exposure and test relationships to post-concussion syndrome (PCS) symptoms and mild traumatic brain injury (mTBI) history. ⋯ These findings support that psychiatric conditions beyond PTSD are common after military combat deployment with blast exposure. They also highlight the non-specificity of post-concussion type symptoms. While some researchers have implicated mTBI history as a contributor to post-deployment mental health conditions, no clear association was found. This may partly be due to the more rigorous method of retrospective mTBI diagnosis determination.