Latest & greatest articles for traumatic brain injury

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Top results for traumatic brain injury

201. A systematic review and meta-analysis of sleep architecture and chronic traumatic brain injury. (Abstract)

A systematic review and meta-analysis of sleep architecture and chronic traumatic brain injury. Sleep quality appears to be altered by traumatic brain injury (TBI). However, whether persistent post-injury changes in sleep architecture are present is unknown and relatively unexplored. We conducted a systematic review and meta-analysis to assess the extent to which chronic TBI (>6 months since injury) is characterized by changes to sleep architecture. We also explored the relationship between (...) was not associated with any significant alteration of sleep architecture. The present findings are consistent with the hypothesis that increased SWS after moderate-severe TBI reflects post-injury cortical reorganization and restructuring. Suggestions for future research are discussed, including adoption of common data elements in future studies to facilitate cross-study comparability, reliability, and replicability, thereby increasing the likelihood that meaningful sleep (and other) biomarkers of TBI

2018 Sleep medicine reviews

202. Therapeutic hypothermia for intacranial hypertension following traumatic brain injury

cerebral perfusion pressure, the fundamental therapeutic goals after TBI. 2 Traumatic brain injury may be caused by a variety of mechanisms. Aetiology of TBI includes traffic accidents, falls, gunshot wounds, sports, combat events and other violence-related Hypothermia for intracranial hypertension: December 2016 2 incidents. 3, 4 TBI ranges in severity from mild to severe, and in addition to short-term impairment, those who sustain TBI often suffer from persistent symptoms. Symptoms may be lifelong (...) Therapeutic hypothermia for intacranial hypertension following traumatic brain injury Health Policy Advisory Committee on Technology Technology Brief Therapeutic hypothermia for intracranial hypertension following traumatic brain injury December 2016 © State of Queensland (Queensland Department of Health) 2016 This work is licensed under a Creative Commons Attribution Non-Commercial No Derivatives 3.0 Australia licence. In essence, you are free to copy and communicate the work in its current

2018 COAG Health Council - Horizon Scanning Technology Briefs

203. Cognitive rehabilitation therapy for traumatic brain injury (TBI)

Cognitive rehabilitation therapy for traumatic brain injury (TBI) Cognitive rehabilitation therapy for traumatic brain injury (TBI) Cognitive rehabilitation therapy for traumatic brain injury (TBI) HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Cognitive rehabilitation therapy for traumatic brain injury (TBI (...) ) Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Rationale: Cognitive rehabilitation therapy (CRT) is a treatment approach used for patients with traumatic brain injury (TBI) that focuses on improving cognitive impairments on attention, memory and learning, affect and expression, problem solving, and executive function. Technology Description: CRT is most often used as part of a comprehensive, multidisciplinary program that also involves traditional speech and language therapy

2018 Health Technology Assessment (HTA) Database.

204. Systematic review of hearing loss after traumatic brain injury without associated temporal bone fracture. (Abstract)

Systematic review of hearing loss after traumatic brain injury without associated temporal bone fracture. While hearing loss following temporal bone fracture is a well-described phenomenon, few data exist on auditory dysfunction in patients with traumatic brain injury (TBI) without temporal bone fracture. Herein, we aim to systematically review hearing loss after TBI without bony fracture and describe its etiologies.Pubmed, Embase, Cochrane databases.A systematic review of the literature from (...) , four retrospective cohort studies, two case-control studies, and six case reports. The studies with the highest level of evidence report a change in hearing of at least 10-15 dB across a range of frequencies in as many as 58% percent of TBI patients without bony fracture, which was transient or chronic. The mechanism/severity of injury may impact the rate of hearing loss.Hearing loss after TBI in the absence of bony injury appears to be a clinically significant but poorly characterized

2018 American Journal of Otolaryngology

205. Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis. (Full text)

Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis. Optimal glycaemic targets in traumatic brain injury (TBI) remain unclear. We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing intensive with conventional glycaemic control in TBI requiring admission to an intensive care unit (ICU).We systematically searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to November 2016. Outcomes

2018 Critical care (London, England) PubMed abstract

206. Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis. (Abstract)

Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: a meta-analysis. Diffusion tensor imaging quantifies the asymmetry (fractional anisotropy; FA) and amount of water diffusion (mean diffusivity/apparent diffusion coefficient; MD/ADC) and has been used to assess white matter damage following traumatic brain injury (TBI). In healthy brains, diffusion is constrained by the organization of axons, resulting in high FA and low MD/ADC. Following a TBI (...) and acquisition parameters were investigated in subgroup analyses, with the findings indicating that mild TBI should be examined separately to that of moderate to severe injuries. Lower FA values were found in 88% of brain regions following mild TBI and 92% following moderate-severe TBI, compared to Controls. MD/ADC was higher in 95% and 100% of brain regions following mild and moderate-severe TBI, respectively. Moderate to severe TBI resulted in larger changes in FA and MD/ADC than mild TBI. Overall, changes

2018 Brain imaging and behavior

207. Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review. (Full text)

Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review. Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT.We included patients (...) with TBI (Glasgow Coma Scale ≤ 12 and trauma-associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti-TC, BI-VILI and ATLANREA. CHT consisted of an intravenous infusion of NaCl 20% for 24 hours or more. The primary outcome was the risk of survival at day 90, adjusted for predefined covariates and baseline differences, allowing us to reduce the bias resulting from confounding factors in observational studies. A systematic review

2018 Critical care (London, England) PubMed abstract

208. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Initial Management of Concussion/mTBI

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Initial Management of Concussion/mTBI Initial Management of Concussion/mTBI // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Initial Management of Concussion/mTBI Whether a patient first presents to the Emergency Department (ED) or to the primary care (...) provider’s (PCP’s) office, ruling out traumatic brain or spine injury that requires emergency intervention is the initial priority. Acutely following injury, it is essential that a management plan be initiated for each patient including: information regarding monitoring for potential acute complications requiring re-assessment, education regarding expected symptoms and course of recovery, and recommendations for healthcare follow-up post-injury. 1 Treatment should be individualized and based

2018 Ontario Neurotrauma Foundation

209. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sport-Related Concussion/mTBI

(post-traumatic amnesia) less than 24 hours Any alteration in mental state at the time of the injury (e.g., confusion, disorientation, slowed thinking, alteration of consciousness/mental state) Physical symptoms (e.g., vestibular, headache, weakness, loss of balance, change in vision, auditory sensitivity, dizziness) Note: No evidence of intracranial lesion on standard imaging (if present, it is suggestive of more severe brain injury) Refer to Table for a comprehensive list of signs for possible (...) Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sport-Related Concussion/mTBI Sport-Related Concussion/mTBI // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Sport-Related Concussion/mTBI In the sports literature, the effects of traumatic biomechanical forces on the brain have traditionally been referred

2018 Ontario Neurotrauma Foundation

210. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Cognitive Difficulties

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Cognitive Difficulties Cognitive Difficulties // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Cognitive Difficulties The presence and persistence of cognitive symptoms following concussion/mTBI can affect an individual’s ability to function in everyday life (...) O'Neil ME, Carlson K, Storzbach D, et al. Complications of Mild Traumatic Brain Injury in Veterans and Military Personnel: A Systematic Review. VA Evidence-based Synthesis Program Reports. 2013. Country: USA Design: Systematic Review Quality Rating: PRISMA: 18/27 *Additional analyses were not undertaken (i.e., meta-analyses), so 5 of the items were not applicable Waldron-Perrine B, McGuire AP, Spencer RJ, Drag LL, Pangilinan PH, Bieliauskas LA. The influence of sleep and mood on cognitive functioning

2018 Ontario Neurotrauma Foundation

211. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction Vestibular (Balance/ Dizziness) & Vision Dysfunction // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Vestibular (Balance/ Dizziness) & Vision Dysfunction Vestibular (Balance/Dizziness) Dysfunction (...) of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2016). 10.2 A If symptoms of benign positional vertigo are present, the Dix-Hallpike Manoeuvre (Appendix ) should be used for assessment once the cervical spine has been cleared. 10.3 A A canalith repositioning maneuver should be used to treat benign positional vertigo (BPPV) if the Dix-Hallpike manoeuvre is positive. The Epley manoeuvre (Appendix ) should be used on patients with positive Dix-Hallpike manoeuvre for both

2018 Ontario Neurotrauma Foundation

212. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Fatigue

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Fatigue Fatigue // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Fatigue Fatigue has been conceptualized as an experience of weariness or tiredness following mental or physical exertion, often resulting in a reduced capacity for work and limited efficiency (...) , Moss NE, Wade DT. The Rivermead Post Concussion Symptoms Questionnaire: A measure of symptoms commonly experienced after head injury and its reliability". J. Neurol . 1995; 242(9):587–92. Description: A questionnaire that can be administered to someone who sustains a concussion or other form of traumatic brain injury to measure the severity of symptoms. The RPQ is used to determine the presence and severity of post-concussion syndrome symptoms (i.e., a set of somatic, cognitive, and emotional

2018 Ontario Neurotrauma Foundation

213. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Post-Traumatic Headache

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Post-Traumatic Headache Post-Traumatic Headache // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Post-Traumatic Headache Headache is the most common and among the most prevalent persistent symptoms following mTBI. 1-4 Studies to date have documented (...) of the environment. Pharmacologic interventions as appropriate both for acute pain and prevention of headache attacks. Taken from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2016). Pharmacological Treatment of Post-Traumatic Headache New Key Section Level of evidence A B C Updated Evidence 6.7 C All patients with frequent headaches should be strongly encouraged to maintain an accurate headache diary (see Appendix ), medication calendar and activity log

2018 Ontario Neurotrauma Foundation

214. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sleep-Wake Disturbances

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sleep-Wake Disturbances Sleep-Wake Disturbances // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Sleep-Wake Disturbances More than 50% of patients report sleep disturbances following mTBI, specifically insomnia, hypersomnia, obstructive sleep apnea, poor (...) Injury. J Head Trauma Rehabil. 2015;30(6):E67-75. Country: Canada Design: Retrospective Cohort Quality Rating: DOWNS & BLACK: 13/32 *7 of the sections were not applicable Theadom A, Cropley M, Parmar P, et al. Sleep difficulties one year following mild traumatic brain injury in a population-based study. Sleep Med. 2015;16(8):926-932. Country: New Zealand Design: Prospective Cohort Quality Rating: DOWNS & BLACK: 16/32 *5 of the sections were not applicable Tkachenko N, Singh K, Hasanaj L, Serrano L

2018 Ontario Neurotrauma Foundation

215. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Mental Health Disorders

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Mental Health Disorders Mental Health Disorders // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Mental Health Disorders General considerations Mental health disorders are common following mTBI, and appear to be major determinants of post-mTBI wellness (...) ). Adapted from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2009). 8.3 C Immediate referral to a regulated mental health practitioner should be obtained if: The presentation is complex and/or severe (e.g., suicide risk) Initial treatment is not effective There is a failure of or contraindication to usual medication strategies It is not necessary for the mental health practitioner to be someone who has a specialty in the treatment of concussion

2018 Ontario Neurotrauma Foundation

216. Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms

Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Management of Persistent Symptoms General Recommendations Regarding Management of Persistent Symptoms // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age General Recommendations Regarding Management of Persistent Symptoms (...) Authority NSW, Guidelines for Mild Traumatic Brain Injury following a Closed Head Injury (MAA, NSW, 2008). *NOT AN ORIGINAL RECOMMENDATION - REPEAT OF 2.3 5.2 A Persistent symptoms after concussion/mTBI should lead primary care providers to consider that many factors may contribute to the persistence of post-concussive symptoms (see Table ). All relevant factors (medical, cognitive, psychological and psychosocial) should be examined with regards to how they contribute to the patient’s symptom

2018 Ontario Neurotrauma Foundation

217. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Return-to-Activity / Work / School Considerations

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Return-to-Activity / Work / School Considerations Return-to-Activity / Work / School Considerations // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Return-to-Activity / Work / School Considerations Returning to usual activities after a concussion/mTBI can (...) Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2009). 12.2* A There is currently insufficient evidence that prescribing complete rest may ease discomfort during the acute recovery period by mitigating post-concussion symptoms and/or that rest may promote recovery by minimizing brain energy demands following concussion. An initial period of rest in the acute symptomatic period following injury (24-48 hours) may be of benefit. After a brief period of rest

2018 Ontario Neurotrauma Foundation

218. Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms

Guideline for concussion/mild traumatic brain injury & persistent symptoms - General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms General Recommendations Regarding Diagnosis/Assessment of Persistent Symptoms // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age General Recommendations Regarding Diagnosis/Assessment (...) as some symptoms may exacerbate others. Adapted from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2009). 4.3 C The assessment should include a review of currently prescribed medications, over-the-counter medications/supplements and substance use, including alcohol, marijuana and other recreational drugs. 4.4 C The persisting physical, cognitive, and/or psychological symptoms following mTBI can be nonspecific and may overlap. Therefore, careful

2018 Ontario Neurotrauma Foundation

219. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Diagnosis/Assessment of Concussion/mTBI

Guideline for concussion/mild traumatic brain injury & persistent symptoms - Diagnosis/Assessment of Concussion/mTBI Diagnosis/Assessment of Concussion/mTBI // Brain Injury Guidelines Toggle navigation NAVIGATION > > > > > > > > > > > > > > > > > > Guideline For Concussion/Mild Traumatic Brain Injury & Persistent Symptoms 3rd Edition, for Adults over 18 years of age Diagnosis/Assessment of Concussion/mTBI Diagnosis of mTBI/concussion (Table B) is the first critical step in successful management (...) outcomes for patients. Concussion can be recognized in the community by a non-medical professional, whereas diagnosis should be made by a physician/ nurse practitioner. Adapted from the Motor Accidents Authority NSW, Guidelines for Mild Traumatic Brain Injury following a Closed Head Injury (MAA, NSW, 2008). 1.2 A On presentation, the primary care provider should conduct a comprehensive review of every patient who has sustained concussion/mTBI (see Appendix ). The assessment should include taking

2018 Ontario Neurotrauma Foundation

220. Assessment of traumatic brain injury, acute

include the following: Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008 Aug;7(8):728-41. http://www.ncbi.nlm.nih.gov/pubmed/18635021?tool=bestpractice.com Cerebral oedema Increased intracranial pressure (ICP) Haemorrhage Seizures Ischaemia Infection. Epidemiology of TBI TBI is a substantial cause of morbidity and mortality, leading to more than 2 million accident and emergency department visits annually in the US, Coronado VG, McGuire LC (...) /pubmed/11356436?tool=bestpractice.com After traumatic brain injury, there is an inverse relationship between the GCS score and the incidence of positive findings on CT; in fact, the rate of intracranial injury (ICI) and need for neurosurgical intervention doubles when the GCS drops from 15 to 14. Smits M, Dippel DW, Steyerberg EW, et al. Predicting intracranial traumatic findings on computed tomography in patients with minor head injury: the CHIP prediction rule. Ann Intern Med. 2007;146(6):397-405

2018 BMJ Best Practice