Family perspectives on ‘proper medical treatment' for people in prolonged vegetative and minimally conscious states
Sara Fovargue, Alexandra Mullock in The Legitimacy of Medical Treatment, 2015
Prolonged disorders of consciousness are caused by severe brain damage in combination with subsequent medical interventions that prevent the person from dying as a result of that damage. Brain damage is the result of traumatic injury (typically a road traffic accident, sporting injury, or assault), anoxic injury (loss of oxygen to the brain such as is caused by a stroke, cardiac arrest, or near-drowning), or brain disease (for example, viral encephalitis). In the emergency phase, the hours and days after the precipitating event when death is a likely outcome of non-treatment, patients are likely to receive at least some of the following treatments: cardio-pulmonary resuscitation (CPR), tracheotomy, mechanical ventilation, clinically-delivered nutrition and hydration, a brain shunt, and surgery to remove blood clots in the brain and/or a decompressive craniectomy (removal of part of the skull to relieve pressure on a swelling brain).
ENZOGENOL Pine Bark Extract
Dilip Ghosh, Pulok K. Mukherjee in Natural Medicines, 2019
Drs Feigin and Theadom of the National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, investigated the effects of ENZOGENOL in 60 people with persistent cognitive deficits after sustaining a mild traumatic brain injury (mTBI; Theadom 2013). This RCT found that ENZOGENOL helped patients steadily improve recovery of brain function over a 3-month period without regression of cognitive functioning after discontinuation of treatment. Participants, aged between 21 and 64 years (average 44.5), had suffered mTBIs 3–12 months prior to enrolling in the study. The causes of brain injuries were included motor vehicle accidents (33.3%), falls (33.3%), assaults (15.0%), sports-related injuries (10.0%), and being hit by objects (8.3%). Patients were recruited through concussion clinics that specialise in brain injury rehabilitation. An important inclusion criteria was a minimum level of cognitive dysfunction assessed by using the cognitive failures questionnaire (CFQ), a common measure of everyday cognitive functioning. This questionnaire measures how often minor cognitive mistakes, which everyone makes from time to time, happened to participants during the past week. Eligibility criteria included a CFQ score > 38 = 0.5-times the standard deviation above the mean for healthy individuals. The CFQ average for all participants at baseline was a score of 60, indicating a considerable level of everyday cognitive difficulties in these patients.
Traumatic Brain Injury and Neurocognitive Disorders
Gail S. Anderson in Biological Influences on Criminal Behavior, 2019
This chapter examines brain damage and its many causes and implications for our study of biology and criminality. Because the brain is the seat of all behavior, it is logical that any damage to the brain is likely to affect our actions. Although brain damage can be severe at any age, damage to the developing brain is most severe. Brain damage is surprisingly common in society, and modern medical techniques have made it possible for us to understand much more about the brain and brain damage than in the past. In many cases, even minor injuries to brain function can have a major influence on future behavior. Of course, this behavior is not usually criminogenic on its own, but it can lead to criminal behavior, such as increased impulsivity, irritability, and reduced behavioral inhibition. Brain damage can be caused by a direct injury such as a head injury in a vehicular accident, or from child abuse, but it can also be caused by illness and disease. This chapter looks at a number of important studies focusing on the effect of this type of damage on antisocial and criminal activity. A correct understanding of the types of brain injury and their results can also help in finding ways to ameliorate their effects and treat offenders to reduce recidivism.
A tree of life? Multivariate logistic outcome-prediction in disorders of consciousness
Published in Brain Injury, 2020
Inga Steppacher, Peter Fuchs, Michael Kaps, Fridtjof W. Nussbeck, Johanna Kissler
Brain injuries are the number one causes of death and severe disability among the younger population in industrialized countries (1). Among the most severe disabilities resulting from brain injuries are disorders of consciousness (DOC), encompassing the clinical syndromes of the unresponsive wakefulness syndrome (UWS (2)); (former vegetative state (3,4)) and the minimal conscious state (MCS (5)). In the former, patients show no signs of self-awareness or awareness of their surroundings (3). In the latter, patients show some limited, often inconsistent signs of awareness which can reach from sole eye-fixation to the following of simple commands. A patient is considered to have improved above MCS if functional communication and/or functional object use has been reestablished (5). Both syndromes can be steps toward recovery but can also become permanent conditions in which patients can survive for many years without any apparent steps toward consciousness. Thus, a reliable identification of prognostic factors is of importance to all, the patients themselves, family members, as well as for the medical staff involved.
The effects of glial cells inhibition on spatial reference, reversal and working memory deficits in a rat model of traumatic brain injury (TBI)
Published in International Journal of Neuroscience, 2022
Amir Rezagholizadeh, Seyed Asaad Karimi, Narges Hosseinmardi, Mahyar Janahmadi, Mohammad Sayyah
Traumatic brain injury (TBI) is a non-degenerative and non-congenital injury of the brain caused by an external mechanical force that can lead to temporary or permanent neurological disorders (1). Head trauma is currently the third-leading cause of death and disability in developed countries (2). Various symptoms including sensory, motor and cognitive impairments such as memory disturbance and epilepsy can appear after brain injuries (1). Insults resulting from TBI are commonly divided into primary and secondary etiologies. The primary damage (mechanical damage), occurring at the moment of impact, results from the physical displacement of brain structures. The secondary damage (non-mechanical damage) represents various cellular processes, such as necrosis, apoptosis, inflammation and cell toxicity, which initiated minutes and hours after injury. Each of these cellular mechanisms can create a cascade of events that eventually result in brain tissue damage. Therefore, secondary damage is an important determinant of the outcome and appropriate therapeutic interventions targeting chronic phase can prevent or improve probable post-injury deficits (3,4). Besides neurons, glial cells are considered important players in initiating secondary damage after trauma. Glia are known to have key roles in how the brain responds to injury. The numerous activities of glia following an injury can either promote recovery or underlie the pathobiology of disorders (5).
Need of nutritional assessment and monitoring in a population with acquired brain injury: an analytical cross-sectional study
Published in Nutritional Neuroscience, 2023
H. Vázquez-Lorente, L. Herrera-Quintana, J. Molina-López, M. Zapata-Soria, E. Planells
A group of 23 institutionalized volunteer participants from the brain damage center AGREDACE, from the province of Granada (Spain), were recruited for the cross-sectional study. All the participants, together with their family members or their caregivers, were given a full explanation of the study and completed a written consent form. The inclusion criteria were (i) being over 18 years of age, (ii) brain damage diagnosis, (iii) acceptance to participate in the study after being informed about it, (iv) having a sufficient capacity (on a cognitive or language level) to answer questionnaires coherently, and (v) having had at least 1 year of evolution since the ABI diagnosis. The exclusion criteria were (i) to take vitamin or mineral supplements, (ii) inability to stand on the bioimpedance device, and (iii) presence of implants that could alter the bioimpedance results. The confidentiality of all the data used and collected has been guaranteed at all times, complying with the principles of the Declaration of Helsinki and the approval by the Ethics Committee of the University of Granada.
Related Knowledge Centers
- Acquired Brain Injury
- Birth
- Birth Defect
- Brain Cell
- Primary & Secondary Brain Injury
- Traumatic Brain Injury
- Injury
- Head Injury
- Genetic Disorder
- Primary & Secondary Brain Injury
- Focal & Diffuse Brain Injury