Articles: traumatic-brain-injuries.
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Cerebral vasospasm is a preventable cause of death and disability in patients who experience aneurysmal subarachnoid hemorrhage (SAH). The aim of this study is to investigate the incidence of cerebral vasospasm following traumatic SAH and its relationship with different brain injuries and severity of trauma. ⋯ Traumatic SAH is associated with a high incidence of cerebral vasospasm with a higher probability in patients with severe TBI.
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Curr Treat Option Ne · Sep 2009
Current treatment options for depression after mild traumatic brain injury.
Mild traumatic brain injury (MTBI) is the most common neurologic condition in the United States; about 503 of every 100,000 persons visiting the emergency department have this diagnosis. A complex cluster of neurologic signs and symptoms are associated with an acceleration-deceleration mechanism of injury. Unfortunately, many persons do not seek treatment for MTBI. ⋯ Thus, evidence-based treatment of post-MTBI depression is quite limited. Because depressive symptoms can develop as early as 1 week after injury and can be exacerbated by stress, pain, and comorbidities, it seems prudent to begin early interventions focused on managing pain and stress, along with providing psychoeducational and problem-solving therapies. Efficacy studies are needed to determine whether telemedicine approaches, group interventions, or peer counseling may be helpful methods of delivering such interventions during the early months as ways to attenuate the development of a major depressive disorder.
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J Pediatr Rehabil Med · Jan 2009
Injury severity variables as predictors of WeeFIM scores in pediatric TBI: Time to follow commands is best.
After pediatric traumatic brain injury (TBI), early prognosis of expected function is important for optimizing care. The power of several common brain injury severity measures for predicting functional outcome in children with TBI was investigated; the severity variables studied were Glasgow Coma Scale (GCS) score, time to follow commands (TFC), duration of post-traumatic amnesia (PTA), and total duration of impaired consciousness (TFC+PTA). Outcome was assessed using the Functional Independence Measure for Children (WeeFIM) at discharge from inpatient rehabilitation (n = 120) and, in a subset of children, at 3 months following discharge. ⋯ Models in which TFC and PTA duration were entered as separate variables and as a combined variable (TFC+PTA) were all significantly predictive of WeeFIM scores at discharge; however, TFC accounted for the greatest portion of variance in WeeFIM scores. Among children with moderate to severe TBI who received inpatient rehabilitation, TFC was the best predictor of general functional outcome at discharge and follow-up. Our findings highlight the need for careful and consistent assessment of TFC to assist in predicting functional outcomes as early and accurately as possible.
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Oxid Med Cell Longev · Oct 2008
Variation in chronic nicotinamide treatment after traumatic brain injury can alter components of functional recovery independent of histological damage.
Previously, we have shown that the window of opportunity for nicotinamide (NAM) therapy (50 mg/kg) following cortical contusion injuries (CCI) extended to 4-8 hrs post-CCI when administered over a six day post-CCI interval. The purpose of the present study was to determine if a more chronic NAM treatment protocol administered following CCI would extend the current window of opportunity for effective treatment onset. Groups of rats received either unilateral CCI's or sham procedures. ⋯ The lesion analysis showed that treatment with NAM out to 8 hrs post-CCI significantly reduced the size of the injury cavity. The window of opportunity for NAM treatment is task-dependent and in some situations can extend to 24 hrs post-CCI. These results suggest that a long term treatment regimen of 50 mg/kg of NAM starting at the clinically relevant time points may prove efficacious in human TBI.