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Mild head trauma

Ronald W Gimbel, Ronald G Pirrallo, Steven C Lowe, David W Wright, Lu Zhang, Min-Jae Woo, Paul Fontelo, Fang Liu, Zachary Connor
BACKGROUND: The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering...
March 12, 2018: BMC Medical Informatics and Decision Making
Chong Sherry Cheever, Celestina Barbosa-Leiker
OBJECTIVE: The aims of this study were to determine the prevalence and describe the importance of alcohol screening for all patients with traumatic brain injury (TBI) and examine the relationship between gender, age, Abbreviated Injury Scale (AIS), emergent decompressive craniectomy, Glasgow Coma Scale (GCS) from the emergency department (ED), and the length of stay with alcohol screening. METHOD: This is a retrospective analysis of de-identified data from the 2012 TBI registry of a level 1 trauma center in the Pacific Northwest...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
K K Devulapalli, J F Talbott, J Narvid, A Gean, B Rehani, G Manley, A Uzelac, E Yuh, M C Huang
BACKGROUND AND PURPOSE: In blunt traumatic brain injury with isolated falcotentorial subdural hematoma not amenable to neurosurgical intervention, the routinely performed, nonvalidated practice of serial head CT scans frequently necessitates increased hospital resources and exposure to ionizing radiation. The study goal was to evaluate clinical and imaging features of isolated falcotentorial subdural hematoma at presentation and short-term follow-up. MATERIALS AND METHODS: We performed a retrospective analysis of patients presenting to a level 1 trauma center from January 2013 to March 2015 undergoing initial and short-term follow-up CT with initial findings positive for isolated subdural hematoma along the falx and/or tentorium...
March 1, 2018: AJNR. American Journal of Neuroradiology
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Tuncer Goker, Oguzhan Eylen, Omer Faruk Turkoglu
The Fahr syndrome (FS) is a rare degenerative neurological disorder (its prevalence is <0.5%). FS is distinguished by the presence of abnormal bilateral intracranial calcifications with a predilection for the basal ganglia, also presented by movement disorders such as parkinsonism, paresis, and speech disorders. Chronic subdural hematoma (CSH), which is typically the result of mild head trauma, is a regularly encountered condition in elderly. A 63-year-old man has referred to our clinic from another hospital with a history of mild head trauma approximately a month ago...
January 2018: Asian Journal of Neurosurgery
Rena Pombo, Etta Johnson, Alejandra Gamboa, Bennet Omalu
Manic episodes induced by antidepressant withdrawal are rarely reported. Mirtazapine is a tetracyclic, piperazinoazepine compound and is a noradrenergic, adrenergic, serotonergic, histaminergic, and muscarinic-antagonist antidepressant that is used for the treatment of major depression and other psychiatric illnesses. There are several reported cases of manic/hypomanic episodes induced by mirtazapine withdrawal based on suspected clinical symptoms that were not confirmed by autopsy and toxicology. We present the first reported case of mirtazapine withdrawal-induced mania/hypomania associated with sudden death and confirmed by autopsy and toxicology...
October 2017: Journal of Pharmacology & Pharmacotherapeutics
Andrea Ciofalo, Marco De Vincentiis, Giannicola Iannella, Giampietro Zambetti, Paola Giacomello, Giancarlo Altissimi, Antonio Greco, Massimo Fusconi, Benedetta Pasquariello, Giuseppe Magliulo
OBJECTIVE: To evaluate olfactory function and clinical-neurological characteristics in a group of patients with mild head trauma. METHODS: A total of 352 patients with MTBI underwent olfactory function evaluation. The site of head trauma, loss of consciousness <20 min, memory loss, subjective presence or absence of olfaction and other clinical, neurological and radiological aspects were evaluated and compared with the olfactory dysfunction. RESULTS: A total of 33...
February 15, 2018: Brain Injury: [BI]
Xianghong Arakaki, Michael Shoga, Lianyang Li, George Zouridakis, Thao Tran, Alfred N Fonteh, Jessica Dawlaty, Robert Goldweber, Janice M Pogoda, Michael G Harrington
Diagnosing and monitoring recovery of patients with mild traumatic brain injury (mTBI) is challenging because of the lack of objective, quantitative measures. Diagnosis is based on description of injuries often not witnessed, subtle neurocognitive symptoms, and neuropsychological testing. Since working memory (WM) is at the center of cognitive functions impaired in mTBI, this study was designed to define objective quantitative electroencephalographic (qEEG) measures of WM processing that may correlate with cognitive changes associated with acute mTBI...
2018: PloS One
Ashwath Kumar, Anthony Alvarado, Kushal Shah, Paul M Arnold
BACKGROUND: The standard of care for isolated mild traumatic subarachnoid hemorrhage (itSAH) involves serial head CT examinations at dedicated time-intervals to monitor neurologic status and hemorrhagic progression. Considering recent evidence questioning such an aggressive monitoring protocol, this study aimed to assess the necessity of repeat head CT imaging in managing itSAH. METHODS: All patients who presented to our academic institution with mild traumatic brain injury were evaluated...
February 10, 2018: World Neurosurgery
Angeline Thomas, Els F M Dobbels, Priscilla E Springer, Christelle Ackermann, Mark F Cotton, Barbara Laughton
The first case of Glutaric aciduria Type 1(GA1) in an African child was reported in 2001. GA1 has a prevalence of 1:5000 in black South Africans. Although early diagnosis is essential for a favourable outcome, newborn screening is not routine in South Africa where an estimated 320,000 children have HIV infection. Neurodevelopmental delay and encephalopathy are complications of both HIV and GA1. In such a setting it is important to recognise that HIV and GA1 can occur simultaneously. We present an HIV-infected South African male child of Xhosa descent with macrocephaly who commenced combination antiretroviral therapy (ART) at 8 weeks of age in a clinical trial which included a neurodevelopmental sub-study...
February 9, 2018: Metabolic Brain Disease
Sung Ho Jang, Jeong Pyo Seo
RATIONALE: No study on the association of absent-mindedness and injury of the ascending reticular activating system (ARAS) has been reported. We report on a patient who showed absent-mindedness and injury of the ARAS following mild traumatic brain injury. PATIENT CONCERNS: The patient complained of absent-mindedness since the head trauma, which was mainly observed while dining for several (5-10) minutes approximately 3 to 4 times a day: according to the patient's family, he usually stopped eating while holding the spoon in the air for approximately 5∼10 minutes...
December 2017: Medicine (Baltimore)
Sung Ho Jang, Jeong Pyo Seo
RATIONALE: We report on a patient who showed delayed degeneration of the left fornical crus with verbal memory impairment following mild traumatic brain injury (TBI), which was demonstrated by diffusion tensor tractography (DTT). PATIENT CONCERNS:: fter flexion and hyperextension of her head to the opposite side, the patient experienced a dazed feeling for a while at the time of head trauma. The patient's Glasgow Coma Scale score was 15, and mini-mental state examination score was 30...
December 2017: Medicine (Baltimore)
Sung Ho Jang, Jeong Pyo Seo
RATIONALE: We report on a patient who developed limb-kinetic apraxia (LKA) due to an injured corticofugal tract (CFT) from the secondary motor area following mild traumatic brain injury (TBI), demonstrated on diffusion tensor tractography (DTT). PATIENT CONCERNS: She was struck in the right leg by a sedan at a crosswalk and fell to the ground. She lost consciousness and experienced post-traumatic amnesia for approximately ten minutes. She was obliged to wear a cast for a left humerus fracture for two months, and she found she could not move her left hand quickly with intention after removal of the cast; consequently her left hand was almost non-functional...
December 2017: Medicine (Baltimore)
Jonathan M Oliver, Anthony J Anzalone, Stephanie M Turner
Even in the presence of underreporting, sports-related concussions/mild traumatic brain injuries (mTBI) are on the rise. In the absence of proper diagnosis, an athlete may return to play prior to full recovery, increasing the risk of second-impact syndrome or protracted symptoms. Recent evidence has demonstrated that sub-concussive impacts, those sustained routinely in practice and competition, result in a quantifiable pathophysiological response and the accumulation of both concussive and sub-concussive impacts sustained over a lifetime of sports participation may lead to long-term neurological impairments and an increased risk of developing neurodegenerative diseases...
January 24, 2018: Sports Medicine
Nadine Pelzer, Joost Haan, Anine H Stam, Lisanne S Vijfhuizen, Stephany C Koelewijn, Amber Smagge, Boukje de Vries, Michel D Ferrari, Arn M J M van den Maagdenberg, Gisela M Terwindt
OBJECTIVE: To investigate whether the clinical characteristics of patients with hemiplegic migraine with and without autosomal dominant mutations in CACNA1A , ATP1A2 , or SCN1A differ, and whether the disease may be caused by mutations in other genes. METHODS: We compared the clinical characteristics of 208 patients with familial (n = 199) or sporadic (n = 9) hemiplegic migraine due to a mutation in CACNA1A , ATP1A2 , or SCN1A with those of 73 patients with familial (n = 49) or sporadic (n = 24) hemiplegic migraine without a mutation in these genes...
February 13, 2018: Neurology
Grace E Martin, Christopher P Carroll, Zach J Plummer, D A Millar, Timothy A Pritts, Amy T Makley, Bellal A Joseph, Laura B Ngwenya, Michael D Goodman
BACKGROUND: Patients with mild-to-moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an ACS-accredited level 1 trauma center to triage mild-to-moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a level III trauma center. We hypothesized that BIG criteria can be safely adapted to an ACS-accredited level III trauma center to guide transfers to a higher echelon of care...
December 14, 2017: Journal of Trauma and Acute Care Surgery
Kun Hou, Xiaobo Zhu, Jinchuan Zhao, Yang Zhang, Xianfeng Gao, Kai Jiang, Guichen Li
BACKGROUND: Chronic subdural hematoma (CSDH) is a common entity in neurosurgical practice. However, as a result of the high rate in recurrence, morbidity, and mortality for surgical management, conservative management of CSDH is emerging as a new treatment strategy. Head trauma is a known risk factor of CSDH and plays as an initiator in the genesis of CSDH. We hypothesized that physical activity might also play an important role in the progression of an asymptomatic CSDH. METHODS: A prospective pilot study aiming to evaluate the efficacy of reinforced restriction of physical activity for the management of asymptomatic or mild symptomatic CSDH was conducted...
February 2018: World Neurosurgery
Mukesh Jain, Nirupama Kasturi, Renuka Srinivasan
Traumatic isolated divisional oculomotor nerve palsy has not been reported following mild head injury. We present an interesting case of a 10-year-old male boy who presented with right-sided ptosis, upgaze palsy, and horizontal nystagmus following a mild head trauma. Magnetic resonance imaging showed right superior rectus muscle atrophy. After observing for 6 months, right inferior rectus recession was done. The abnormal head posture and diplopia got corrected, but nystagmus persisted, although with appreciably decreased amplitude...
July 2017: Journal of Pediatric Neurosciences
Melissa A Powell, Raiford T Black, Terry L Smith, Thomas M Reeves, Linda L Phillips
Despite the regenerative capacity of the olfactory bulb (OB), head trauma causes olfactory disturbances in up to 30% of patients. While models of olfactory nerve transection, olfactory receptor neuron (ORN) ablation, or direct OB impact have been used to examine OB recovery, these models are severe and not ideal for study of OB synaptic repair. We posited that a mild fluid percussion brain injury (mFPI), delivered over mid-dorsal cortex, would produce diffuse OB deafferentation without confounding pathology...
February 10, 2018: Neuroscience
Arko Sen, Katherine Gurdziel, Jenney Liu, Wen Qu, Oluwademi O Nuga, Rayanne B Burl, Maik Hüttemann, Roger Pique-Regi, Douglas M Ruden
Traumatic brain injury (TBI) can cause persistent pathological alteration of neurons. This may lead to cognitive dysfunction, depression and increased susceptibility to life threatening diseases, such as epilepsy and Alzheimer's disease. To investigate the underlying genetic and molecular basis of TBI, we subjected w 1118 Drosophila melanogaster to mild closed head trauma and found that mitochondrial activity is reduced in the brains of these flies 24 h after inflicting trauma. To determine the transcriptomic changes after mild TBI, we collected fly heads 24 h after inflicting trauma, and performed RNA-seq analyses...
2017: Frontiers in Genetics
Laura Campiglio, Francesca Bianchi, Claudio Cattalini, Daniela Belvedere, Chiara Emilia Rosci, Chiara Livia Casellato, Manuela Secchi, Maria Cristina Saetti, Elena Baratelli, Alessandro Innocenti, Ilaria Cova, Chiara Gambini, Luca Romano, Gaia Oggioni, Rossella Pagani, Marco Gardinali, Alberto Priori
Background: Despite the higher theoretical risk of traumatic intracranial hemorrhage (ICH) in anticoagulated patients with mild head injury, the value of sequential head CT scans to identify bleeding remains controversial. This study evaluated the utility of 2 sequential CT scans at a 48-hour interval (CT1 and CT2) in patients with mild head trauma (Glasgow Coma Scale 13-15) taking oral anticoagulants. Methods: We retrospectively evaluated the clinical records of all patients on chronic anticoagulation treatment admitted to the emergency department for mild head injury...
August 2017: Neurology. Clinical Practice
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