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Tramatic brain injury

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Parmenion P Tsitsopoulos, Sami Abu Hamdeh, Niklas Marklund
Traumatic brain injury (TBI) is a multidimensional and highly complex disease commonly resulting in widespread injury to axons, due to rapid inertial acceleration/deceleration forces transmitted to the brain during impact. Axonal injury leads to brain network dysfunction, significantly contributing to cognitive and functional impairments frequently observed in TBI survivors. Diffuse axonal injury (DAI) is a clinical entity suggested by impaired level of consciousness and coma on clinical examination and characterized by widespread injury to the hemispheric white matter tracts, the corpus callosum and the brain stem...
2017: Frontiers in Neurology
John B Hiebert, Qiuhua Shen, Amanda R Thimmesch, Janet D Pierce
Traumatic brain injury (TBI) is a major cause of death and disability in the United States and causes mitochondrial damage leading to impaired brain function. The purpose of this review is to (1) describe TBI processes and manifestations, (2) examine the mitochondrial alterations after TBI, specifically increased reactive oxygen species production, decreased bioenergetics and apoptosis and (3) current TBI treatments. There are various degrees of severity of TBI, yet all affect mitochondrial function. Currently, health care professionals use various methods to assess TBI severity-from brain imaging to serum biomarkers...
August 2015: American Journal of the Medical Sciences
Jasmeet P Hayes, Danielle R Miller, Ginette Lafleche, David H Salat, Mieke Verfaellie
Blast-related traumatic brain injury (TBI) has been a common injury among returning troops due to the widespread use of improvised explosive devices in the Iraq and Afghanistan Wars. As most of the TBIs sustained are in the mild range, brain changes may not be detected by standard clinical imaging techniques such as CT. Furthermore, the functional significance of these types of injuries is currently being debated. However, accumulating evidence suggests that diffusion tensor imaging (DTI) is sensitive to subtle white matter abnormalities and may be especially useful in detecting mild TBI (mTBI)...
2015: NeuroImage: Clinical
Patricia M Washington, Sonia Villapol, Mark P Burns
Neuropathological studies of human traumatic brain injury (TBI) cases have described amyloid plaques acutely after a single severe TBI, and tau pathology after repeat mild TBI (mTBI). This has helped drive the hypothesis that a single moderate to severe TBI increases the risk of developing late-onset Alzheimer's disease (AD), while repeat mTBI increases the risk of developing chronic traumatic encephalopathy (CTE). In this review we critically assess this position-examining epidemiological and case control human studies, neuropathological evidence, and preclinical data...
January 2016: Experimental Neurology
Dina Lo Giudice, Kate Smith, Stephen Fenner, Zoë Hyde, David Atkinson, Linda Skeaf, Roslyn Malay, Leon Flicker
INTRODUCTION: Aboriginal Australians are reported to develop dementia earlier than the general population. The causes remain unknown. METHODS: This was a longitudinal study of 363 participants aged ≥45 years. Consensus diagnoses were established for cognitive impairment or dementia. RESULTS: At follow-up, 189 people (mean ± standard deviation age, 65.4 ± 10.3 years) participated, as 109 (30%) had died and 65 (18%) were unavailable...
March 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Sharon Shively, Ann I Scher, Daniel P Perl, Ramon Diaz-Arrastia
Traumatic brain injury (TBI) is among the earliest illnesses described in human history and remains a major source of morbidity and mortality in the modern era. It is estimated that 2% of the US population lives with long-term disabilities due to a prior TBI, and incidence and prevalence rates are even higher in developing countries. One of the most feared long-term consequences of TBIs is dementia, as multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life...
October 2012: Archives of Neurology
Ann C McKee, Thor D Stein, Patrick T Kiernan, Victor E Alvarez
Repetitive brain trauma is associated with a progressive neurological deterioration, now termed as chronic traumatic encephalopathy (CTE). Most instances of CTE occur in association with the play of sports, but CTE has also been reported in association with blast injuries and other neurotrauma. Symptoms of CTE include behavioral and mood changes, memory loss, cognitive impairment and dementia. Like many other neurodegenerative diseases, CTE is diagnosed with certainty only by neuropathological examination of brain tissue...
May 2015: Brain Pathology
John E Buonora, Angela M Yarnell, Rachel C Lazarus, Michael Mousseau, Lawrence L Latour, Sandro B Rizoli, Andrew J Baker, Shawn G Rhind, Ramon Diaz-Arrastia, Gregory P Mueller
Important challenges for the diagnosis and monitoring of mild traumatic brain injury (mTBI) include the development of plasma biomarkers for assessing neurologic injury, monitoring pathogenesis, and predicting vulnerability for the development of untoward neurologic outcomes. While several biomarker proteins have shown promise in this regard, used individually, these candidates lack adequate sensitivity and/or specificity for making a definitive diagnosis or identifying those at risk of subsequent pathology...
2015: Frontiers in Neurology
Jennifer L Hartwell, M Chance Spalding, Brian Fletcher, M Shay O'mara, Chris Karas
Traditional care of mild traumatic brain injury (MTBI) is to discharge patients from the emergency department (ED) if they have a Glasgow Coma Score (GCS) of 15 and a normal head computed tomography (CT) scan. However, this does not address short-term neurocognitive deficits. Our hypothesis is that a notable percentage of patients will need outpatient neurocognitive therapy despite a reassuring initial presentation. This is a retrospective review of patients with MTBI at an urban Level I trauma center. Inclusion criteria were a diagnosis of MTBI in patients 14 years old or older, GCS 15, negative head CT scan, a completed neurocognitive evaluation, blunt mechanism, and no confounding psychiatric comorbidities...
April 2015: American Surgeon
Yuri Rassovsky, Yifat Levi, Eugenia Agranov, Michal Sela-Kaufman, Anna Sverdlik, Eli Vakil
OBJECTIVE: Traumatic brain injury (TBI) is the most common cause of brain damage, resulting in long-term disability. The ever increasing life expectancies among TBI patients necessitate a critical examination of the factors that influence long-term outcome. Our objective was to evaluate the contribution of premorbid factors (which were identified in our previous work) and acute injury indices to long-term functioning following TBI. METHOD: Eighty-nine participants with moderate-to-severe TBI were evaluated at an average of 14...
2015: Journal of Clinical and Experimental Neuropsychology
Hélène Pineau, André Marchand, Stéphane Guay
Characterization of cognitive and behavioral complaints is explored in Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (MTBI) samples according to the severity of PTSD, depression and general anxiety conditions. Self-reported questionnaires on cognitive and behavioral changes are administered to PTSD, MTBI, MTBI/PTSD and control groups. Confounding variables are controlled. All groups report more complaints since the traumatic event. PTSD and MTBI/PTSD groups report more anxiety symptoms, depression and complaints compared to the MTBI group...
2015: Behavioral Sciences
Johnathan L Saxe, Christopher L Perdue
Traumatic brain injuries and other blast-related injuries have been identified as the signature injury of the wars in Iraq and Afghanistan. Some operational units in Iraq, especially those responsible for clearing roadways, were exposed to hundreds of blast incidents and thousands of individual doses of concussive energy during their lengthy deployments. Using operational records maintained by a single command element, the researchers conducted a retrospective cohort study evaluating the association between estimated individual exposures to blasts and the risk for postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD)...
January 2015: U.S. Army Medical Department Journal
Diego Lozano, Gabriel S Gonzales-Portillo, Sandra Acosta, Ike de la Pena, Naoki Tajiri, Yuji Kaneko, Cesar V Borlongan
Traumatic brain injury (TBI) is a serious public health problem accounting for 1.4 million emergency room visits by US citizens each year. Although TBI has been traditionally considered an acute injury, chronic symptoms reminiscent of neurodegenerative disorders have now been recognized. These progressive neurodegenerative-like symptoms manifest as impaired motor and cognitive skills, as well as stress, anxiety, and mood affective behavioral alterations. TBI, characterized by external bumps or blows to the head exceeding the brain's protective capacity, causes physical damage to the central nervous system with accompanying neurological dysfunctions...
2015: Neuropsychiatric Disease and Treatment
Irene Cristofori, Harvey S Levin
Traumatic brain injury (TBI) is a major cause of death and disability, and therefore an important health and socioeconomic problem for our society. Individuals surviving from a moderate to severe TBI frequently suffer from long-lasting cognitive deficits. Such deficits include different aspects of cognition such as memory, attention, executive functions, and awareness of their deficits. This chapter presents a review of the main neuropsychological and neuroimaging studies of patients with TBI. These studies found that patients evolve differently according to the severity of the injury, the mechanism causing the injury, and the lesion location...
2015: Handbook of Clinical Neurology
Thomas W McAllister
Outcome after a traumatic brain injury (TBI) can be quite variable and unpredictable. This suggests factors other than injury severity play important roles in outcome. Host genotype might be one such factor. This chapter reviews key concepts important to understanding genetic influences on the response to and recovery from TBI. As an organizing framework, four broad contexts in which individual differences could play an important role in outcome after trauma are presented: (1) genes that may modulate injury extent and serve to augment or dampen the impact of a given "dose" of neurotrauma, (2) genes that may play a role in repair and recovery from injury and thus impact the trajectory of recovery and ultimate functional outcome, (3) genes modulating preinjury traits (e...
2015: Handbook of Clinical Neurology
Ann C Mckee, Daniel H Daneshvar
Traumatic brain injury, a leading cause of mortality and morbidity, is divided into three grades of severity: mild, moderate, and severe, based on the Glasgow Coma Scale, the loss of consciousness, and the development of post-traumatic amnesia. Although mild traumatic brain injury, including concussion and subconcussion, is by far the most common, it is also the most difficult to diagnose and the least well understood. Proper recognition, management, and treatment of acute concussion and mild traumatic brain injury are the fundamentals of an emerging clinical discipline...
2015: Handbook of Clinical Neurology
Douglas I Katz, Sara I Cohen, Michael P Alexander
Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia...
2015: Handbook of Clinical Neurology
Patrick T Kiernan, Philip H Montenigro, Todd M Solomon, Ann C McKee
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that develops as a result of repetitive mild traumatic brain injury. Chronic traumatic encephalopathy is characterized by a unique pattern of accumulation of hyperphosphorylated tau in neurons and astrocytes. The tau abnormalities begin focally and perivascularly at the depths of the cerebral sulci, spread to the superficial layers of the adjacent cortex, and eventually become widespread throughout the medial temporal lobes, diencephalon, and brainstem...
February 2015: Seminars in Neurology
Philip H Montenigro, Christine M Baugh, Daniel H Daneshvar, Jesse Mez, Andrew E Budson, Rhoda Au, Douglas I Katz, Robert C Cantu, Robert A Stern
The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma...
2014: Alzheimer's Research & Therapy
Gilles Lavigne, Samar Khoury, Jean-Marc Chauny, Alex Desautels
Concussion after a force to the head is called mild traumatic brain injury (mTBI). Approximately 1 in 5 patients with mTBI will develop chronic pain (headache and widespread pain, possibly of central origin) and/or sleep problems (insomnia, disordered breathing, periodic limb movements). However, the predisposing mechanisms for chronic pain in patients with mTBI are unknown. Mild traumatic brain injury is a rare model to prospectively assess the risk factors and mechanisms for pain chronification from the injury onset in the absence of pretrauma comorbidity or medication...
April 2015: Pain
2015-03-28 05:34:51
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