Posttraumatic Personality Disorders
Rolland S. Parker in Concussive Brain Trauma, 2016
Weltanschauung (world outlook): After brain damage, the view of the world in which one lives becomes changed. One’s security is precarious because of the life changes occurring as a consequence of the accident. The familiar support system may have disappeared, and others have become unfriendly. The environment is seen as having deteriorated because one’s handicaps prevent obtaining the customary material and spiritual supplies. The patient wonders about the meaning of the event: Why did so great a catastrophic injury and impairment happen to me? The themes expressed in the person’s Weltanschauung include: Search for the meaning of life.One’s world or adaptation to it has been destroyed.The world is dangerous.Life has deteriorated.The world is unsupportive or unfriendly.To retreat is the best choice.
A Global Perspective on Neuropsychological Rehabilitation
Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth in Neuropsychological Rehabilitation, 2017
The Centers for Disease Control (CDC) in the US have estimated that 1.6 to 3.8 million sport-related concussions occur each year (Langlois et al., 2006). Youth athletes are particularly at risk for serious or even catastrophic injury. The CDC (2011) recommend that both primary and secondary prevention strategies (i.e. using protective equipment and increasing awareness of the signs and symptoms of concussion, respectively) are needed to reduce the incidence and severity of concussions in sports. To this end, the CDC has developed a public health tool, the Heads Up Initiative, a programme that provides education to relevant audiences. This and other resources can be found at www.cdc.gov/concussion.
Psychological and Behavioral Complications of Trauma
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
The duration of coma and the period of posttraumatic amnesia (PTA) are important predictors of outcome. The patient’s condition during the first few hours after injury is an important early index of severity and is most commonly measured by the Glasgow Coma Scale (GCS) [2], which serves as an objective measure of level of consciousness. This scale allows for the best assessment of verbal, motor, and visual response with a corresponding classification of brain injury as mild (GCS score, 13–15), moderate (GCS score, 9–12), or severe (GCS score, 3–8). The period of PTA was first described by Russell [8] and refers to the duration of time from the point of injury to until the patient has continuous memory of ongoing events and is able to retain new information. Cognitive function during PTA is highly variable and difficult to evaluate. Those patients who remain in coma longer and experience longer periods of PTA suffer significant neurological and behavioral deficits that are often irreversible. The effect of age at the time of injury to the brain is also an important variable that should not be ignored. Many clinicians assume that because of brain plasticity, children will have a better prognosis for neurobehavioral recovery after TBI than will adults [9]. Studies have reported that an early injury to the brain in younger children may limit the brain’s ability to develop normally or may interfere with the timing of neural development [10]. In addition, new deficits may emerge at later stages after injury. Therefore, from the mildest of injuries to the most catastrophic injury, patients may demonstrate different severities of brain injury, which results in different types of cognitive and behavioral impairments.
Rationalising neurosurgical head injury referrals: development and validation of the Liverpool Head Injury Tomography Score (Liverpool HITS) for mild TBI
Published in British Journal of Neurosurgery, 2020
Conor S. Gillespie, Christopher M. Mcleavy, Abdurrahman I. Islim, Sarah Prescott, Catherine J. McMahon
The sensitivity is very high, which indicates that the scoring system is able to delineate what a ‘surgically significant’ mild TBI is, in addition to reducing the number of inappropriate referrals. This means that the score is highly unlikely to miss any surgically significant injuries and thus will recommend referral for almost all injuries that go on to be transferred to a neurosurgical centre. The specificity is not high which indicates that the score becomes less accurate for predicting need for admission due to TBI as the mean score increases. Analysing our admissions data, this was mainly due to the presence of patients that were deemed ‘not appropriate for neurosurgical intervention’ whether this be due to catastrophic injury, increasing age or multiple co-morbidities. In this situation, patients would score highly on initial assessment but not be accepted by a centre, creating a false positive result. These patients will therefore often be rejected by the centre for reasons not linked to the severity and score of the mild TBI.
Accessing healthcare as a person with a rugby-related spinal cord injury in South Africa: the injured player’s perspective
Published in Physiotherapy Theory and Practice, 2022
Marelise Badenhorst, Evert Verhagen, Mike Lambert, Willem van Mechelen, James Brown
Health-related factors have previously been identified as an important contributor to quality of life (World Health Organization, 2013). Health is also the basis for every person’s participation in society, including the right to education, employment, and social participation (Sherry, 2015). Therefore, as health status influences SES and vice versa, and also the inter-generational transmission of SES, access to quality healthcare may play a role in perpetuating inequality in a country with vast socio-economic disparity (Ataguba, Akazili, and McIntyre, 2011; McLaren, Ardington, and Leibbrandt, 2014). Every effort should be made to facilitate healthcare to optimize quality of life in SCI patients. Similarly, from a sports medicine perspective, a recent editorial promoted the duty of care that clinicians, clubs and governing bodies have in the long-term health outcomes of professional football players (Carmody et al., 2018). The findings of this study, in our view, extend this responsibility and duty of care to amateur athletes and especially, athletes who suffer a permanent, life changing disability by playing their sport. Sporting bodies have an opportunity to improve the quality of life of these athletes by considering the myriad of healthcare factors requiring intervention, as was presented in this study. The issue of health insurance for all players sustaining a catastrophic injury (including SCIs) also requires consideration. However, assisting in strategies to create alternative forms of financial self-sufficiency may be the most crucial to create relief from at least some of the healthcare barriers experienced and importantly, to provide choice and financial independence.
Evaluating client experience of rehabilitation following acquired brain injury: a cross-sectional study
Published in Brain Injury, 2021
Lauren Christie, Cara Egan, Josephine Wyborn, Grahame K Simpson
To date, there has been limited research exploring family perspectives of the experiences of brain injury rehabilitation programs. An integrative review by Aggar and colleagues (2017) investigated the experiences of partners in providing care and their perceptions of inpatient rehabilitation following their relative experiencing a catastrophic injury. This review found limited evidence focussed on the experience of partners following stroke (n = 4 studies) and no research focussed on the experience of partners after a person has experienced a TBI (22).
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