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Traumatic Brain Injury
Published in Charles Theisler, Adjuvant Medical Care, 2023
Traumatic brain injury (TBI) is a disruption in the normal function of the brain and is a major cause of death and disability in the U.S. TBI results from a violent bump, blow, jolt, or other head injury that damages the brain. TBI has a broad spectrum of different symptoms and types of disabilities. Symptoms may not appear until days or weeks following the injury. Initial treatment is to stabilize the patient following brain injury. Acute treatment is aimed at minimizing secondary brain injury. Rehabilitative care helps prepare the patient for participation in daily life.1 The following modes of care are in the sphere of acute treatment.
Early Management of Adult Head Injury
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
M. Karthigeyan, Pravin Salunke, Sunil K Gupta
Although a wide range of definitions exist, traumatic brain injury (TBI) is considered “an alteration in brain function, or other evidence of brain pathology, caused by an external force”. Consistent with global data, the TBI/head injury (HI) disease burden in India has been a major public health issue and contributes to significant morbidity and mortality. In India, road-traffic accident-related injuries are quite common, particularly in younger ages, and remain a major cause of death.
Ear Trauma
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Minor head injuries are extremely common. Concussion (synonymous with mild traumatic brain injury) is a brief loss of consciousness, or any change in mental state, at the time of the accident. A subjective transient hearing loss occurs in 52% of cases lasting for up to 2 days, but there is little evidence for permanent loss. Tinnitus and hyperacusis are common. True vertigo is the only definite otological symptom occurring in 25% of cases, almost always disappearing within 10 days. Non-specific dizziness, often postural perceptive, occurs in many more cases.
Does training therapists to manage benign paroxysmal positional vertigo in patients with acute traumatic brain injury reduce vestibular neurology referrals?
Published in Brain Injury, 2022
Natalie Marroney, Jenna Beattie, Natalie Hildebrand, Thomas Flint, Rebecca M Smith
Complaints of dizziness or imbalance are reported by the majority of patients with acute traumatic brain injury (aTBI) (1). Despite this, there is large variability in how vestibular dysfunction is assessed and treated within the aTBI population. Indeed, previous research has noted many patients who experience a vestibular impairment following TBI either wait years for a diagnosis and correct treatment, or do not receive a definitive diagnosis (2). The variability noted in acute management is perhaps not surprising given the absence of recommendations for vestibular assessment in national early head injury guidelines (3). Failure or even delays to providing accurate treatment can have a large impact on patients’ quality of life and a long-term impact on their function and physical and psychosocial wellbeing (4). Indeed, persistent dizziness has been shown to be an independent factor in regards to return to employment within the TBI population (5).
Design, methods, and baseline characteristics of the Brain Injury Education, Training, and Therapy to Enhance Recovery (BETTER) feasibility study: a transitional care intervention for younger adult patients with traumatic brain injury and caregivers
Published in Current Medical Research and Opinion, 2022
Tolu O. Oyesanya, Callan Loflin, HyunBin You, Melissa Kandel, Karen Johnson, Timothy Strauman, Qing Yang, Jodi Hawes, Lindsey Byom, Rosa Gonzalez-Guarda, Courtney Van Houtven, Suresh Agarwal, Janet Prvu Bettger
Traumatic brain injury (TBI) is defined as “a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain”1. Each year, more than 2.7 million U.S. people sustain a TBI1. Despite high risks of readmission and complex medical needs, there are no U.S. standards of care for patients with mild-to-severe TBI discharged home from acute hospital care without inpatient rehabilitation2. Research suggests up to 60% of patients with mild-to-severe TBI nationwide are discharged home from acute hospital care into a fragmented environment that does not integrate healthcare, community, and social services3. These patients have cognitive, physical, behavioral, and emotional impairments that affect their abilities to independently self-manage their health, wellness, and activities of daily living and are often dependent on family who have difficulty managing the patient’s care and needs4–9. The consequences of TBI have tremendous implications for nuclear and extended family members of younger adult patients with TBI (age 18–64) 10,11, especially for patients who were in school or working, may not yet be financially secure, and/or have small children12.
Association of helmet use with traumatic brain and cervical spine injuries following bicycle crashes
Published in British Journal of Neurosurgery, 2020
Paul S. Page, Daniel J. Burkett, Nathaniel P. Brooks
In 2015, 45,000 bicycle traffic accidents occurred in the US according to the National Highway and Traffic Safety Administration. A survey of the US found that approximately 50% of those surveyed wore a helmet for at least one bicycle trip and only 35% wore a helmet for all or most of their trips.1 The role of helmet use in the prevention of traumatic brain injury and craniofacial trauma is generally accepted by the population at large, but there is little medical literature on the issue.2 Previous studies have given conflicting results. There are large studies that suggest helmets decrease the rates of severe traumatic brain injury (TBI) and death, but others suggest they reduce extra-axial injuries but not intra-cranial hemorrhage.3,4 A systematic review and meta-analysis conducted in 2017 demonstrated a significantly reduced likelihood of suffering a serious head injury (odd ratio (OR) = 0.31, 95% confidence interval (CI): 0.25–0.37) and fatal head injury (OR = 0.35, 95% CI: 0.14–0.88) with helmets.5 Despite the general public perception that helmet use is associated with the prevention of TBI, a majority of bicyclists do not wear a helmet consistently.