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Concussion mild traumatic brain

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https://www.readbyqxmd.com/read/29766124/routine-repeat-head-ct-may-not-be-necessary-for-patients-with-mild-tbi
#1
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29757076/economic-evaluation-of-concussion-programs-in-the-state-of-idaho-the-collective-potential-of-prevention-and-clinical-care
#2
Susie Bergeron, Hilary Flint, Zeynep Hansen
Concussion, or mild traumatic brain injury, especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment, and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care...
May 14, 2018: Population Health Management
https://www.readbyqxmd.com/read/29755402/default-mode-network-oscillatory-coupling-is-increased-following-concussion
#3
Benjamin T Dunkley, Karolina Urban, Leodante Da Costa, Simeon M Wong, Elizabeth W Pang, Margot J Taylor
Concussion is a common form of mild traumatic brain injury. Despite the descriptor "mild," a single injury can leave long-lasting and sustained alterations to brain function, including changes to localized activity and large-scale interregional communication. Cognitive complaints are thought to arise from such functional deficits. We investigated the impact of injury on neurophysiological and functionally specialized resting networks, known as intrinsic connectivity networks (ICNs), using magnetoencephalography...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29738554/repeated-mild-traumatic-brain-injury-can-cause-acute-neurologic-impairment-without-overt-structural-damage-in-juvenile-rats
#4
Alicia Meconi, Ryan C Wortman, David K Wright, Katie J Neale, Melissa Clarkson, Sandy R Shultz, Brian R Christie
Repeated concussion is becoming increasingly recognized as a serious public health concern around the world. Moreover, there is a greater awareness amongst health professionals of the potential for repeated pediatric concussions to detrimentally alter the structure and function of the developing brain. To better study this issue, we developed an awake closed head injury (ACHI) model that enabled repeated concussions to be performed reliably and reproducibly in juvenile rats. A neurological assessment protocol (NAP) score was generated immediately after each ACHI to help quantify the cumulative effects of repeated injury on level of consciousness, and basic motor and reflexive capacity...
2018: PloS One
https://www.readbyqxmd.com/read/29734566/hyperbaric-oxygen-for-post-concussive-symptoms-in-united-states-military-service-members-a-randomized-clinical-trial
#5
Lindell K Weaver, Steffanie H Wilson, Anne S Lindblad, Susan Churchill, Kayla Deru, Robert C Price, Chris S Williams, William W Orrison, James M Walker, Anna Meehan, Susan Mirow
Background: In prior military randomized trials, participants with persistent symptoms after mild traumatic brain injury (TBI) reported improvement regardless of receiving hyperbaric oxygen (HBO₂) or sham intervention. This study's objectives were to identify outcomes for future efficacy trials and describe changes by intervention. Methods: This Phase II, randomized, double-blind, sham-controlled trial enrolled military personnel with mild TBI and persistent post-concussive symptoms...
March 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29726314/effect-of-depression-on-cognition-after-mild-traumatic-brain-injury-in-adults
#6
Douglas P Terry, Michelle Brassil, Grant L Iverson, William J Panenka, Noah D Silverberg
OBJECTIVE: The current study examined the effect of depression on cognitive test performance in a sample of adults seeking treatment for a mild traumatic brain injury (MTBI). We hypothesized that patients with greater depressive symptoms would perform worse on tasks of fluid cognition compared to those without depression, after controlling for potential confounds. METHOD: Patients (N = 76) completed a brief cognitive test battery (NIH Toolbox Cognition Battery; NIHTB-CB) and a depression screening questionnaire (PHQ-9) at 11...
May 4, 2018: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/29712487/prospective-study-of-myelin-water-fraction-changes-after-mild-traumatic-brain-injury-in-collegiate-contact-sports
#7
Heather S Spader, Douglas C Dean, W Curt LaFrance, Neha P Raukar, G Rees Cosgrove, Stephanie A Eyerly-Webb, Anna Ellermeier, Stephen Correia, Sean C L Deoni, Jeffrey Rogg
OBJECTIVE Mild traumatic brain injury (mTBI) in athletes, including concussion, is increasingly being found to have long-term sequelae. Current imaging techniques have not been able to identify early damage caused by mTBI that is predictive of long-term symptoms or chronic traumatic encephalopathy. In this preliminary feasibility study, the authors investigated the use of an emerging magnetic resonance imaging (MRI) technique, multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT), in visualizing acute and chronic white matter changes after mTBI in collegiate football and rugby players...
May 1, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29690799/prediction-of-persistent-post-concussion-symptoms-following-mild-traumatic-brain-injury
#8
Maryse C Cnossen, Joukje van der Naalt, Jacoba M Spikman, Daan Nieboer, John K Yue, Ethan A Winkler, Geoffrey Manley, Nicole von Steinbuechel, Suzanne Polinder, Ewout W Steyerberg, Hester Lingsma
Persistent post-concussion symptoms (PPCS) occur frequently after mild traumatic brain injury (mTBI). The identification of patients at risk for poor outcome remains challenging since valid prediction models are missing. The objectives of the current study were to assess the quality and clinical value of prediction models for PPCS , and to develop a new model based on the synthesis of existing models and addition of complaints at emergency department (ED). MTBI patients (Glasgow Coma Scale score 13-15) were prospectively recruited from three Dutch level I trauma centers between 2013-2015 in the UPFRONT study...
April 25, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29685463/a-prospective-evaluation-of-the-influence-of-an-electronic-clinical-practice-guidelines-on-concussion-patients-future-activities-and-outcomes
#9
Brian H Rowe, Leeor Eliyahu, Justin Lowes, Lindsay A Gaudet, Jeremy Beach, Martin Mrazik, Garnet Cummings, Donald Voaklander
BACKGROUND: Patients with mild traumatic brain injury or concussion commonly present to the emergency department for assessment; providing patients with information on usual symptoms and their progression may encourage faster recovery. OBJECTIVES: This study aimed to document the role of an electronic clinical practice guideline (eCPG) patient handout on concussion recovery in adult patients discharged from the hospital. METHODS: A prospective cohort study was carried out in 3 Canadian urban emergency departments...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29678928/imaging-in-pediatric-concussion-a-systematic-review
#10
REVIEW
Julia Schmidt, Kathryn S Hayward, Katlyn E Brown, Jill G Zwicker, Jennie Ponsford, Paul van Donkelaar, Shelina Babul, Lara A Boyd
CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging may index brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016...
April 20, 2018: Pediatrics
https://www.readbyqxmd.com/read/29674994/a-cross-sectional-study-on-cerebral-hemodynamics-after-mild-traumatic-brain-injury-in-a-pediatric-population
#11
Corey M Thibeault, Samuel Thorpe, Michael J O'Brien, Nicolas Canac, Mina Ranjbaran, Ilyas Patanam, Artin Sarraf, James LeVangie, Fabien Scalzo, Seth J Wilk, Ramon Diaz-Arrastia, Robert B Hamilton
The microvasculature is prominently affected by traumatic brain injury (TBI), including mild TBI (concussion). Assessment of cerebral hemodynamics shows promise as biomarkers of TBI, and may help inform development of therapies aimed at promoting neurologic recovery. The objective of this study was to assess the evolution in cerebral hemodynamics observable with transcranial Doppler (TCD) ultrasound in subjects suffering from a concussion at different intervals during recovery. Pediatric subjects between the ages of 14 and 19 years clinically diagnosed with a concussion were observed at different points post-injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29674712/when-light-hurts-comparative-morphometry-of-human-brainstem-in-traumatic-photalgia
#12
Lora T Likova, Christopher W Tyler
Traumatic brain injury is an increasingly common affliction, although many of its serious repercussions are still underappreciated. A frequent consequence is the development of light-induced pain, or 'photalgia', which can often lead to prolonged debilitation. The mechanism underlying the sensitivity to light, however, remains unresolved. Since tissue oedema (swelling) is a common feature of traumatic brain injury, we propose that the brainstem oedema, in particular, might sensitize the brainstem trigeminal complex to signals from ocular mechanisms activated in bright light...
April 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29670568/the-dynamics-of-concussion-mapping-pathophysiology-persistence-and-recovery-with-causal-loop-diagramming
#13
Erin S Kenzie, Elle L Parks, Erin D Bigler, David W Wright, Miranda M Lim, James C Chesnutt, Gregory W J Hawryluk, Wayne Gordon, Wayne Wakeland
Despite increasing public awareness and a growing body of literature on the subject of concussion, or mild traumatic brain injury, an urgent need still exists for reliable diagnostic measures, clinical care guidelines, and effective treatments for the condition. Complexity and heterogeneity complicate research efforts and indicate the need for innovative approaches to synthesize current knowledge in order to improve clinical outcomes. Methods from the interdisciplinary field of systems science, including models of complex systems, have been increasingly applied to biomedical applications and show promise for generating insight for traumatic brain injury...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29665736/fear-avoidance-and-clinical-outcomes-from-mild-traumatic-brain-injury
#14
Noah D Silverberg, William Panenka, Grant L Iverson
Characterizing psychological factors that contribute to persistent symptoms after mild traumatic brain injury (MTBI) can inform early intervention. To determine whether fear avoidance, a known risk factor for chronic disability after musculoskeletal injury, is associated with worse clinical outcomes from MTBI, adults were recruited from four outpatient MTBI clinics and assessed at their first clinic visit (M=2.7, SD=1.5 weeks post-injury) and again 4-5 months later. Of 273 patients screened, 102 completed the initial assessment and 87 returned for the outcome assessment...
April 18, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29648487/bdnf-expression-increases-without-changes-in-play-behavior-following-concussion-in-juvenile-rats-rattus-norvegicus-brief-report
#15
Allison C F Dyck, Tammy L Ivanco
PURPOSE: Young children have a high risk of concussion or mild traumatic brain injury (mTBI). Children often appear healthy soon after mTBI, but some have pervasive cognitive and/or motor impairments. Understanding underlying mechanisms recruited after concussion may help for return to play protocols and mitigating what might be lifelong impairments. METHODS: We investigated molecular and behavioral changes in a rat model of childhood concussion. Rats received an injury or sham procedure at an age approximately equivalent to the human period of early childhood...
April 12, 2018: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/29619800/not-just-contact-sports-significant-numbers-of-sports-related-concussions-in-cycling
#16
Ingo Helmich, Daniel von Götz, Carina Emsermann, Fu Xuanjin, Anne Griese, Ilka Lauterbach, Hedda Lausberg
BACKGROUND: Although sports-related concussions (SRCs) / mild traumatic brain injuries (mTBIs) in contact sports have recently received much attention, investigation of SRCs in cycling - a sport yielding some of the highest percentages of SRC - remains strikingly limited. In particular, rates of incidence, cycling-specific causes, and potential long-term effects of SRC have not been examined in this sport. Here, a retrospective online survey was used to investigate the incidence and potential long-term effects of SRCs among cyclists...
April 4, 2018: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29611892/mlc901-neuroaid-ii-%C3%A2-for-cognition-after-traumatic-brain-injury-a-pilot-randomised-clinical-trial
#17
Alice Theadom, Suzanne Barker-Collo, Kelly M Jones, Priya Parmar, Rohit Bhattacharjee, Valery L Feigin
BACKGROUND: Treatments to facilitate recovery after traumatic brain injury (TBI) are urgently needed. To examine the safety and potential effects of herbal supplement MLC901 (NeuroAiD IITM ) on cognitive functioning following TBI, we conducted a nine-month pilot, randomised placebo-controlled clinical trial. METHODS: Adults aged 18-65 years, 1-12-months post-mild or moderate TBI, were randomised to receive MLC901 (0.8g capsules/day) or placebo for 6-months. The primary outcome was cognitive functioning assessed by the CNS-Vital Signs online neuropsychological test...
April 3, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29609574/utility-of-serum-igf-1-for-diagnosis-of-growth-hormone-deficiency-following-traumatic-brain-injury-and-sport-related-concussion
#18
Kirstie Lithgow, Alex Chin, Chantel T Debert, Gregory A Kline
BACKGROUND: Growth hormone deficiency (GHD) is a potential consequence of traumatic brain injury (TBI), including sport-related concussion (SRC). GH stimulation testing is required for definitive diagnosis; however, this is resource intensive and can be associated with adverse symptoms or risks. Measurement of serum IGF-1 is more practical and accessible, and pituitary tumour patients with hypopituitarism and low serum IGF-1 have been shown to have a high probability of GHD. We aimed to evaluate IGF-1 measurement for diagnosing GHD in our local TBI population...
April 2, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29564659/subcortical-shape-and-neuropsychological-function-among-u-s-service-members-with-mild-traumatic-brain-injury
#19
David F Tate, Benjamin S C Wade, Carmen S Velez, Ann Marie Drennon, Jacob D Bolzenius, Douglas B Cooper, Jan E Kennedy, Matthew W Reid, Amy O Bowles, Paul M Thompson, Boris A Gutman, Jeffrey D Lewis, John L Ritter, Gerald E York, Erin D Bigler
In a recent manuscript, our group demonstrated shape differences in the thalamus, nucleus accumbens, and amygdala in a cohort of U.S. Service Members with mild traumatic brain injury (mTBI). Given the significant role these structures play in cognitive function, this study directly examined the relationship between shape metrics and neuropsychological performance. The imaging and neuropsychological data from 135 post-deployed United States Service Members from two groups (mTBI and orthopedic injured) were examined...
March 21, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29557322/is-concussion-a-risk-factor-for-epilepsy
#20
Richard Wennberg, Carmen Hiploylee, Peter Tai, Charles H Tator
BACKGROUND: Epidemiologic studies have suggested that concussion, or mild traumatic brain injury (mTBI), is associated with a twofold or greater increase in relative risk for the development of post-traumatic epilepsy. To assess the clinical validity of these findings, we analyzed the incidence of epilepsy in a large cohort of post-concussion patients in whom concussion was strictly defined according to international guidelines. METHODS: A retrospective cohort study of 330 consecutive post-concussion patients followed by a single concussion specialist...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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