ENTRIES A–Z
Philip Winn in Dictionary of Biological Psychology, 2003
Closed head injury refers to brain damage arising from the forces generated when the head is rapidly accelerated or decelerated as a result of trauma—for example, hitting a car windscreen in a traffic accident or striking the ground with the head in a fall. The ensuing BRAIN INJURY has both focal and diffuse components. Focal injuries often include a LESION (in the form of contusion) of the extremities of the brain, notably the frontal and temporal polar regions, and haematomas (blood clots) arising from the rupture of blood vessels. Diffuse injury arises from the stretching and shearing of axons, known as DIFFUSE AXONAL INJURY. Diffuse axonal injury is widespread through the brain, its severity proportional to the strength of the accelerative force generated during the trauma. Long axons, such as those comprising the CORPUS CALLOSUM are particularly at risk.
Cognition, Language and Intelligence
Rolland S. Parker in Concussive Brain Trauma, 2016
Cognitive findings are stated to be similar to those reported following mild closed head injury, or with mixed results. Positive findings are reported for attentional deficits at 6 months, and also concentration, memory, and cognitive flexibility. The postinjury duration of cognitive defects varies with the function. There is some evidence for residual deficits in attention and concentration for up to 2 years. There are opposing views whether psychological variables are critical in symptom maintenance. In a retrospective study: the neurological examination was abnormal in only 1 of 32 patients. Six of 13 EEGs displayed abnormalities (excessive slow-wave activity in frontocentral and frontoanteriotemporal areas). Quantified EEG was more sensitive than routine clinical EEG in detecting abnormalities in all 11 examinations. The only participant offered functional neuroimaging (PET) produced frontocentral hypometabolism. Sleep studies were abnormal. Ninety-seven percent of patients complained of problems in attention and concentration. Executive functioning was impaired (reduced information-processing capacity; impaired divided attention). There was an advantage of trying to recall meaningful information: delayed story recall improved, but not delayed list learning.
Mechanisms of Recovery After Acquired Brain Injury
Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth in Neuropsychological Rehabilitation, 2017
Despite these caveats, several older studies, which were conducted when rehabilitation was not as common, point to considerable spontaneous recovery of cognitive processes, mainly during the first six months after brain injury. In a cross-sectional study, Bond (1976) found that, even without rehabilitation interventions, the IQ of TBI patients with a post-traumatic amnesia (PTA) of less than 11 weeks recovered substantially within the first six months post onset and stabilised to within one standard deviation of the mean. After this period a slower rate of recovery was observed that reached a maximum after 24 months. In another study of that epoch (Bond and Brooks, 1976), performed longitudinally with a subset of the patients of the Bond (1976) study, it was also found that most of the improvement in IQ scores occurred during the first six months, with only a slight change from six months to two years after injury. Although both studies can be criticised for several reasons, amongst others for the absence of a control group, the learning effects due to the repeated use of the same IQ test, the absence of premorbid IQ scores and other confounding factors, they support the idea that the brain is capable of a large degree of self-repair. Another clear example of spontaneous recovery is the study of reaction times. Van Zomeren and Deelman (1978) charted the recovery curves of reaction times in untreated patients with closed head injury of varying degrees of severity. In this case, the reaction times of all the severity groups improved swiftly during the first six to eight months, while progress slowed during the subsequent 18 months.
Moral reasoning and decision-making in adolescents who sustain traumatic brain injury
Published in Brain Injury, 2019
M.H. Beauchamp, E Vera-Estay, F Morasse, V. Anderson, J. Dooley
Participants were 43 adolescents aged 11 to 18 years (M = 14.7, SD = 2.1 years, 27 males) with varying levels of TBI severity. They were recruited retrospectively based on admission to two urban pediatric emergency departments and pediatric rehabilitation centers using the following criteria: (i) age at injury 11.0–18.0 years, (ii) documented evidence of a closed head injury and (iii) at least 6 months post-injury at the time of recruitment. Exclusion criteria were (i) documented history of previous TBI; (ii) non-accidental injury; and (iii) evidence of a documented pre-existing neurological, psychiatric or developmental disorder. Participants with TBI were divided into injury severity groups according to the Mayo Classification System (51): 20 (46.5%) participants were classified as mild (probable) and 23 (53.5%) as moderate/severe TBI (msTBI).
Go baby go café: a case study on an immersive rehabilitation environment to improve functional outcomes and quality of life
Published in Disability and Rehabilitation, 2018
Devina S. Kumar, Darcy S. Reisman, James C. Galloway
The participant was a 34-year-old woman who sustained a severe closed head injury 17 years ago due to a motor vehicle accident. Her Glasgow Coma Scale [15] was 6 on admission and she was ventilated in the Intensive Care Unit for one month. Brain imaging studies at initial injury showed comprehensive lesions including marked swelling, right thalamic bleed and diffuse axonal injury. During inpatient rehabilitation admission, her major impairments were comprehensive and included upper and lower extremity mobility, language and communication and cognition (short and long term memory) with retrograde amnesia of a year before her accident. Since discharge to the community in 1998, she has been to various outpatient facilities for speech and language, physical therapy, occupational therapy and cognitive rehabilitation.
Cognitive and physical impairment in spinal cord injury: A scoping review and call for new understanding
Published in The Journal of Spinal Cord Medicine, 2023
Lana Sargent, Jonice Smitherman, Matthew Sorenson, Roy Brown, Angela Starkweather
Moreover, the incidence of head injury was a significant factor in 4 other studies that assessed cognitive impairment in patients with SCI.30,33–35 Traumatic SCI is accompanied by a moderate to severe head injury in significant numbers of patients with SCI. One study found that 41% of SCI individuals who acquired their SCI from a traumatic event had cognitive impairment.30 In another study, 57% of participants had abnormal Halstead Category Test (HCT) scores suggestive of cognitive impairment.35 However, this study found that premorbid factors, such as socioeconomic group or drug dependency, may have influenced the performance of patients on the HCT. Another study also found that the prevalence of cognitive impairment was reflected in the high incidence of closed-head injury and recent history of alcohol and/or substance abuse.31
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