Three hundred twenty-three moderate to severe TBI survivors received 2 to 16 years post-trauma an aftercare survey with seven questions asking for changes in behavior and affect, presented both to patients and their proxies. [ncbi.nlm.nih.gov]

15 points, nor “independent” even when they presented an ADS score of 25 points. [hsj.gr]

Statistical analysis and data synthesis Data will be presented in a descriptive manner. [systematicreviewsjournal.biomedcentral.com]

The Effect of Moderate-Severe Traumatic Brain Injury and Subarachnoid Haemorrhage on Cortisol Response to ACTH-Stimulation Presentation Number: MON-0666 Date of Presentation: June 23rd, 2014 Anna Tolli * Karolinska Institutet, Stockholm, Sweden Abstract [endocrine.org]

• Disability

  Those who had been employed at injury decreased in disability over time, while those who had been unemployed increased in disability. [ncbi.nlm.nih.gov]

  There was also significant difference(p＜.001) in the division depending on the discrepancy between subjective symptoms and suggested disability on subscale and global index in each group. [dbpia.co.kr]

  GLOSSARY CI = confidence interval ; DFR = disability-free recovery ; DRS = Disability Rating Scale ; ED = emergency department ; GCS = Glasgow Coma Scale ; OR = odds ratio ; TBI = traumatic brain injury Footnotes Go to Neurology.org for full disclosures [neurology.org]

  Motor Deficits and Disabilities For many patients, the damage to the brain resulting from a moderate to severe TBI may lead to life-long disabilities or motor deficits. [brainline.org]

• Pain

  The Glasgow Coma Scale Best Visual Response Best Verbal Response Best Motor Response None To pain To speech Spontaneous None Incomprehensible Inappropriate words Confused Oriented None Extends to pain Flexes to pain Withdrawl to pain Localizes to pain [shepherd.org]

  If the patient’s eyes open only to someone speaking or only to pain, the score is lower. If the eyes cannot open at all, this indicates a very severe loss of consciousness and, likely, a severe brain injury. [maginnislaw.com]

  Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). [ncbi.nlm.nih.gov]

  NSAIDs and etidronate can help with pain management. The risks and benefits of these drugs in managing established heterotopic ossification should be assessed. [emedicine.medscape.com]

  Abstract Background: Headache symptoms are a major contributor to chronic pain after moderate-to-severe traumatic brain injury (TBI). [digital.lib.washington.edu]

• Epilepsy

  Depression is reported frequently in patients with temporal lobe epilepsy. [scarlettlawgroup.com]

  In the longer term, neurologists are uniquely positioned to treat complications of moderate and severe traumatic brain injury, including epilepsy and cognitive and behavioral issues. © The Author(s) 2014. [ncbi.nlm.nih.gov]

  […] of light (photophobia) Hearing Decrease or loss of hearing Ringing in the ears (tinnitus) Increased sensitivity to sounds Smell Loss or diminished sense of smell (anosmia) Taste Loss or diminished sense of taste Seizures Convulsions associated with epilepsy [traumaticbraininjury.com]

  […] haemorrhage CVA (intracerebral haemorrhage) Face Physical injury due to munitions discharge Fracture Confirmed event of kinetic energy transfer to body No Munitions discharge Brain Concussion (MTBI) OR Moderate to severe traumatic brain injury Seizures Epilepsy [clik.dva.gov.au]

  Epidemiology of posttraumatic epilepsy: a critical review. Epilepsia 2003; 44(10):11-17. Ferguson P, Smith G, Wannamaker B, Thurman D, Pickelsimer E, Selassie A. [hsj.gr]

• Fever

  Children in whom vasospasm developed were more likely to have been involved in motor vehicle accidents, had higher Injury Severity Scores, had fever at admission, and had lower Glasgow Coma Score scores. [ncbi.nlm.nih.gov]

  It is often associated low-grade fever, peri-articular swelling, peri-articular warmth, and peri-articular erythema. In decreasing order of frequency, heterotopic ossification occurs in the hips, knees, elbows, shoulders, hands, and spine. [emedicine.medscape.com]

• Anemia

  Therefore, in the absence of vessel stenosis, vasospasm, arterial hypotension, or profound anemia, PI reflects the distal cerebrovascular resistance. [anesthesiology.pubs.asahq.org]

  […] poterior pituitary gland. [2], [19], [20] The cause of pituitary dysfunction after TBI is still not well understood, but evidence suggests few possible mechanisms: [21] Primary injury Secondary injury by events like hypoxia, brain swelling, hypotension, anemia [ijem.in]

• Pneumonia

  The study also suggested that TBI patients with in-hospital seizures have higher rates of complications such as pneumonia, acute respiratory distress syndrome, acute kidney injury, and increased intracranial pressure. [emedicine.medscape.com]

• Vomiting

  Moderate or Severe Traumatic Brain Injury Symptoms Symptoms of moderate or severe TBIs may include: Coma or loss of consciousness lasting minutes to hours Persistent headaches or headaches that worsen Ongoing vomiting or nausea Convulsions or seizures [braininjurylaw.ca]

  Call emergency services for anyone who’s unconscious for more than a minute or two, or who experiences seizures, repeated vomiting or symptoms that seem to worsen as time passes. [alz.org]

  Symptoms of severe traumatic brain injury can include loss of consciousness, headache, nausea, vomiting, lack of coordination, dizziness, trouble with balance, dilation of one or more pupils, slurred speech, behavioral or mood changes, loss of coordination [paterehab.com]

  Communicating hydrocephalus is the most common form after TBI and occurs when the obstruction is in the subarachnoid space. [31] Patients with hydrocephalus can clinically present with nausea, vomiting, headache, papilledema, obtundation, dementia, ataxia [emedicine.medscape.com]

• Dysphagia

  Some of the most frequent GI complications are stress ulcers, dysphagia, bowel incontinence, and elevated levels on liver function tests. Underlying constipation and/or impaired communication and mobility are often the causes of bowel incontinence. [emedicine.medscape.com]

• Hypertension

  […] cerebral blood flow; CO2R = carbon dioxide reactivity; CPP = cerebral perfusion pressure; CVR = cerebrovascular reactivity; ETCO2 = end-tidal CO2; GCS = Glasgow Coma Scale; GOS-E Peds = Glasgow Outcome Scale Extended Pediatric Version; ICH = intracranial hypertension [ncbi.nlm.nih.gov]

  Risk factors for ischemic stroke in young adults include hypertension, smoking, diabetes mellitus, and obesity. 30 Stroke in young adults also has other etiologies that are not fully understood but may differ from those of ischemic stroke in individuals [stroke.ahajournals.org]

  KEYWORDS: Traumatic brain injury, intracranial hypotension, intracranial hypertension, elevated intracranial pressure (ICP), cerebral vasospasm, hypoxemia, respiratory ventilation, device TPOC-1: Dr. Tammy Crowder TPOC-2: Dr. Therese West [sbir.gov]

  Health complications from TBI may include: Seizure Hydrocephalus Cerebrospinal fluid leaks Infections Cranial nerve injuries Pain Hypertension Hormonal changes Decreased immune system response Sleep disorders Increased risk of later disease such as dementia [paterehab.com]

  The oval pupil: Clinical significance and relationship to intracranial hypertension. J Neurosurg 1983 Apr;58(4):566-8. 17. Stone MB, Tubridy CM, Curran R. The effect of rigid cervical collars on internal jugular vein dimensions. [oapublishinglondon.com]

• Photophobia

  […] sensory impressions into psychologically meaningful data Vision Partial or total loss of vision Weakness of eye muscles and double vision (diplopia) Blurred vision Problems judging distance Involuntary eye movements (nystagmus) Intolerance of light (photophobia [traumaticbraininjury.com]

  […] senses (sight, smell, touch, hearing, and taste) Effects on vision Partial or total loss of vision Diplopia, which is weakness of eye muscles that causes double vision Blurred vision Problems judging distance Involuntary eye movements, called nystagmus Photophobia [brainline.org]

• Contusion

  There was no significant difference between two study group regarding the baseline, 3rd day and 7th day of the contusion volume and the rate of contusion expansion. [ncbi.nlm.nih.gov]

  Multiple criteria are used in each diagnosis including loss of consciousness, post-traumatic amnesia, skull fracture, and evidence of neuroradiological abnormalities including subdural haematoma, cerebral contusion, and hemorrhagic contusion. [acnr.co.uk]

  Figure 1: CT scan image of 43-year old male after a motor vehicle accident showing subdural hematoma, brain contusion and frontal bone fracture. [scitechnol.com]

  The risk factors of PSH included higher systolic blood pressure >140 mmHg at admission， lower GCS score， with brain contusion and with hydrocephalus. [lchc.hebmu.edu.cn]

• Ulcer

  Enteral feeding can help prevent gastric stress ulcers [ 9 ]. Patients should also receive medications to prevent stress ulcers [ 9 ]. [oapublishinglondon.com]

  Some of the most frequent GI complications are stress ulcers, dysphagia, bowel incontinence, and elevated levels on liver function tests. Underlying constipation and/or impaired communication and mobility are often the causes of bowel incontinence. [emedicine.medscape.com]

• Amnesia

  OBJECTIVE: Posttraumatic amnesia is superior to the initial Glasgow Coma Scale score for predicting traumatic brain injury recovery, but it takes days/weeks to assess. [ncbi.nlm.nih.gov]

  Post traumatic amnesia (PDF) and Coma and reduced awareness states (PDF) describe these in more detail. [headway.org.uk]

  Analgesia and other causes of amnesia that mimic post-traumatic amnesia (PTA): A cohort study. Journal of Neuropsychology. 2010;(4):231-6. Bryant R. Post-traumatic stress disorder vs traumatic brain injury. [acnr.co.uk]

• Seizure

  In 6 of 34 patients (17%), clinical seizures developed despite levetiracetam prophylaxis. An additional two patients had nonconvulsive seizures. [ncbi.nlm.nih.gov]

  Posttraumatic seizures Posttraumatic seizures (PTS) frequently occur after moderate or severe TBI. Seizures are usually general or partial, and absence seizures are uncommon. [emedicine.medscape.com]

  Where severe traumatic brain injury occurs, the risk of seizure will remain for decades. Where a seizure occurs within days of insult, the risk of development of seizure disorder is greater. [scarlettlawgroup.com]

  Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia 1999; 40(5):584-589. [hsj.gr]

• Confusion

  The Glasgow Coma Scale Best Visual Response Best Verbal Response Best Motor Response None To pain To speech Spontaneous None Incomprehensible Inappropriate words Confused Oriented None Extends to pain Flexes to pain Withdrawl to pain Localizes to pain [shepherd.org]

  These brain injuries result in temporary mental changes, such as confusion and memory loss or unconsciousness for less than 30 minutes. [greylaw.com]

  Mild traumatic brain injuries result in concussions or feelings of confusion that last 30 minutes or less. Moderate or severe TBIs can be caused by significant falls, car accidents, sports injuries or child abuse. [braininjurylaw.ca]

  Assessment of the person's level of consciousness and confusion. Neurological examination to assess memory and thinking, vision, hearing, touch, balance, reflexes, and other indicators of brain function. [alz.org]

  Resources available to aid recovery Areas of function not affected by TBI The impact of a moderate to severe brain injury can include cognitive deficits including difficulties with: Attention Concentration Distractibility Memory Speed of Processing Confusion [traumaticbraininjury.com]

• Dizziness

  TOOLS PDF Links PubReader ePub Link Full text via DOI Download Citation CrossRef TDM E-Mail Print Share: METRICS 0 Crossref 1,045 View 49 Download Related articles Dizziness after Traumatic Brain Injury: Neurological Aspects 2019 September;18(3) Dizziness [e-rvs.org]

  Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). [ncbi.nlm.nih.gov]

  Mild TBI Symptoms Fatigue Headaches Light sensitivity Dizziness and balance problems Irritability Depression and mood swings Nausea General confusion and mental fog Moderate Traumatic Brain Injury Moderate brain injuries score between 8 and 13 on the [shepherd.org]

  Symptoms of mild traumatic brain injury include: Headache Dizziness Insomnia, Decreased concentration and attention span Depression Anxiety Mood swings Impaired balance Decreased speed of information processing Decreased ability to learn new things and [paterehab.com]

  The most commonly reported symptoms include tiredness, headaches and dizziness ( physical effects ) difficulties with thinking, attention, memory planning, organising, concentration and word-finding problems ( cognitive effects ) and irritability (a behavioural [headway.org.uk]

• Encephalopathy

  The neuropathologic diagnoses were atypical Alzheimer disease (AD) with features of chronic traumatic encephalopathy and white matter loss (Case 1), and atypical AD, dementia with Lewy bodies and coexistent TDP-43 pathology (Case 2). [ncbi.nlm.nih.gov]

  They suggest that patients with even remote concussion histories may have prolonged risk for fall injuries. [38] Chronic traumatic encephalopathy Persons with a history of repetitive brain trauma, including boxers and football players, are at risk for [emedicine.medscape.com]

  However, emerging evidence does suggest that repeated mild traumatic brain injuries, such as those that can occur in sports like American football, boxing, hockey and soccer, may be linked to a greater risk of chronic traumatic encephalopathy (CTE), a [alz.org]

An appropriate workup to evaluate GU symptoms and rule out infection is indicated. When the causes of urinary incontinence are impaired communication and mobility, a trial of a timed voiding is indicated to manage overflow incontinence. [emedicine.medscape.com]

We examined variation in treatment for traumatic brain injury by assessing factors influencing treatment and the association between treatment and patient outcome. DESIGN: Secondary analysis of prospectively collected data. [ncbi.nlm.nih.gov]

Consider using behavioural techniques early in treatment to build confidence and engagement Behavioural techniques (e.g., relaxation, behavioural activation, insomnia treatments, exposure therapies) are a good first-line treatment for anxiety and depression [psychology.org.au]

We found a low level of evidence that a comprehensive holistic day treatment program resulted in greater productivity, but not improved community integration, than the standard treatment. [effectivehealthcare.ahrq.gov]

EEG-neurobiofeedback treatment of patients with brain injury Part 4: Duration of treatments as a function of both the initial load of clinical symptoms and the rate of rehabilitation. Journal of Neurotherapy, 6(1), 23-38. Byers, A. P. (1995). [hjernetraening.dk]

[…] compared with the group with a favourable prognosis. 36 Analyses were performed with random effects models. [bmj.com]

This paper will focus on classification of traumatic brain injury by severity, outcome, and prognosis. [acnr.co.uk]

Predicting the Prognosis of TBI is Difficult 2.9.1. Glasgow Outcome Scale 2.9.2. Disability Rating Scale 2.9.3. The NIH's International Mission for Prognosis and Clinical Trial (IMPACT) Prognosis Model 2.9.4. [gii.co.jp]

KEYWORDS: AIS = Abbreviated Injury Scale; BAC = blood alcohol concentration; GCS = Glasgow Coma Scale; NMDAR = N-methyl-d-aspartate receptor; TBI = traumatic brain injury; alcohol; ethanol; intoxication; mortality; outcome; prognosis; trauma; traumatic [ncbi.nlm.nih.gov]

Chesnut RM, Ghajar J, Maas AR (2000) Guidelines for the Management and prognosis of severe traumatic brain injury part II: Early indicators of prognosis in severe traumatic brain injury. J Neurotrauma 17: 556-627. [scitechnol.com]

CONCLUSION: Given the unique etiological features and treatment challenges associated with managing spasticity after TBI, more TBI-specific spasticity CPGs are required. [ncbi.nlm.nih.gov]

Given the unique etiological features and treatment challenges associated with managing spasticity after TBI, more TBI -specific spasticity CPGs are required. [journals.lww.com]

In severe brain injury, more often than not there is an organic based etiology. Increased rates of personality disorder involving sensitive-compulsive individuals are often times seen. Social isolation is common. [scarlettlawgroup.com]

Risk factors for ischemic stroke in young adults include hypertension, smoking, diabetes mellitus, and obesity. 30 Stroke in young adults also has other etiologies that are not fully understood but may differ from those of ischemic stroke in individuals [stroke.ahajournals.org]

Yet, this large-scale epidemiological study does not prove that there is a causal relationship between moderate-to-severe TBI and NDD. [ncbi.nlm.nih.gov]

There were consistent epidemiological characteristics of severe TBI from both rural and urban regions. [karger.com]

Its pathophysiology is divided into two major phases: the initial neuronal injury (or primary injury) followed by secondary insults (secondary injury). [ncbi.nlm.nih.gov]

Rumination worsens depressive symptoms over time and is a risk factor for developing future major depressive disorders. 44,48–50 Pathophysiology Lesion location may be related to the development of depression following TBI. [touchneurology.com]

The risk of heterotopic ossification is greatest during the first 3-4 months after injury. [32] The pathophysiology of heterotopic ossification remains unclear. [emedicine.medscape.com]

Major Unmet Needs in TBI Figure 3: Finanical Forecast of the Potential TBI Market, in 2014 and 2020 in the US and EU ($ billions) Figure 4: The Anatomy of the Human Brain Figure 5: Cause of all TBIs within the US General Population, 2010 Figure 6: The Pathophysiological [gii.co.jp]

This finding demonstrates that therapy directed by PbtO2 monitoring is valuable for the treatment of patients with moderate and severe TBI and that increasing PaO2 to 150 mmHg may be efficacious for preventing cerebral hypoxic events after brain trauma [ncbi.nlm.nih.gov]

Enteral feeding can help prevent gastric stress ulcers [ 9 ]. Patients should also receive medications to prevent stress ulcers [ 9 ]. [oapublishinglondon.com]

PHASE I: Design/develop an innovative device to prevent or reduce secondary brain injury for use point of injury/Role1. [sbir.gov]