Traumatisme cranio-cerebrale și recuperare.
81 de articoleThis consensus study used modified Delphi methodology with UK Head Injury Network specialists to establish evidence-based standards for concussion care structure and processes in England. Final consensus produced 18 statements covering care pathways, prognosis assessment, recovery measures, and outpatient clinic provision to improve healthcare quality and patient outcomes.
This meta-analysis of 16 studies compared two widely-used prognostic models (CRASH and IMPACT) for predicting mortality and functional outcomes in traumatic brain injury patients. Both core models showed comparable predictive accuracy, with no significant differences in area under the curve for mortality or six-month unfavorable outcomes.
This systematic review examined evidence for nutritional and dietary interventions in humans with chronic mild traumatic brain injury or concussion, identifying nine studies across six intervention types (omega-3 fatty acids, melatonin, Enzogenol, MLC901, ketogenic diet, phytocannabinoids). The review found these interventions to be safe and potentially beneficial for cognitive and sleep issues, but emphasized the paucity of human evidence and need for further research due to study heterogeneity.
This clinical review examines mild traumatic brain injury (concussion), which affects millions annually and is increasingly recognized as causing long-lasting functional deficits affecting work and social function. The article discusses epidemiology, common persistent symptoms, and evidence-based treatment strategies, emphasizing early recognition and risk identification for optimal recovery outcomes.
This qualitative study examines how medical coders assign diagnostic codes to head and brain injuries in emergency department settings, identifying barriers to precise coding documentation. The research reveals that inadequate clinical documentation and time constraints in triage environments lead to frequent use of nonspecific injury codes, which affects the reliability of TBI surveillance data.
This commentary examines methodological considerations for animal models used in traumatic brain injury research. It presents critical questions to improve the validity and translational relevance of preclinical TBI studies.
This review traces the evolution of concussion knowledge from the 10th century to modern times, highlighting Harrison Martland's 1928 postmortem studies of boxers that first documented structural brain changes underlying 'punch drunk' syndrome. The article examines how understanding of concussion's long-term consequences has progressed to include recognition of chronic traumatic encephalopathy (CTE) in athletes and military personnel, and discusses current preventative and therapeutic research directions.
This prospective study evaluated the feasibility of screening for convergence insufficiency (CI) symptoms in emergency department patients with mild traumatic brain injury using the Convergence Insufficiency Symptom Survey (CISS). Higher CISS scores were associated with adverse outcomes including post-concussive symptoms and hospital admission, suggesting oculomotor assessment may help identify patients at risk for poor recovery after mTBI.
This preclinical study demonstrates that JNJ-7777120, a histamine H4 receptor antagonist, improves motor and sensory function in rats with mild traumatic brain injury by reducing neuroinflammation, apoptosis, and oxidative stress. The neuroprotective effects occur through blockade of ERK1/2/NF-κB signaling pathways.
This cross-sectional study examined 709 Spanish-speaking adults (aged 18–65) to determine whether repeated head/neck injuries without loss of consciousness (subconcussive exposures) correlate with neurobehavioral symptoms. Results showed significant effects of both lifetime injury history and frequency of subconcussive exposure on symptom severity measured by the Neurobehavioral Symptom Inventory.
This study demonstrates that repetitive traumatic brain injury can trigger reactivation of herpes simplex virus-1 (HSV-1) in human brain tissue, leading to pathological features characteristic of Alzheimer's disease. The research was conducted using advanced 3D brain tissue models, providing insights into potential mechanisms linking TBI to neurodegenerative disease risk.
This observational study of 110 traumatically injured individuals found that while fatigue and sleep disturbance were elevated compared to controls, these symptoms were not specifically attributable to mild traumatic brain injury itself. Rather, psychological distress and pain—common to all trauma survivors—were the primary predictors of fatigue and sleep disruption, regardless of head injury status.
This systematic review evaluated the effectiveness of psychological interventions for prolonged post-concussion symptoms lasting more than 12 months after mild traumatic brain injury. Cognitive Behavioural Therapy showed the strongest evidence for improving anxiety, anger, and mental well-being, though the overall evidence base remains preliminary and requires more rigorous research.
This study evaluated the feasibility and utility of ImPACT-QT, a brief iPad-based cognitive screening tool, in acutely hospitalized trauma patients with mild TBI. The test was completed in ~9 minutes with high usability, and memory scores significantly differentiated mTBI patients from non-TBI controls, suggesting potential clinical utility for rapid bedside cognitive assessment.
This systematic review and meta-analysis synthesized data from observational studies (2000-2024) to assess post-traumatic headache (PTH) prevalence in TBI patients, finding a pooled prevalence of 49.3%. Subgroup analyses revealed variations across measurement tools and study characteristics, with interviews reporting higher prevalence rates than other assessment methods.
This clinical case describes a 31-year-old man who developed cerebral venous sinus thrombosis (CVST) after a moderate traumatic brain injury from a motorbike accident, despite the absence of severe skull fracture. Early detection via CT venography and conservative management without anticoagulation led to partial thrombus resolution and neurological recovery by discharge.
This study examined 208 adults to determine whether fatigue, sleep disruption, and sex differences uniquely predict post-concussion symptom severity in mild TBI patients compared to trauma controls and healthy controls. Female sex and elevated fatigue independently predicted post-concussion symptoms only in the mTBI group, while psychological status was the primary predictor across all groups.
This study successfully adapted the Rivermead Post-Concussion Symptoms Questionnaire into Hindi and validated it for use in Hindi-speaking TBI patients. The Hindi version demonstrated good reliability, temporal stability, and a six-factor structure with adequate psychometric properties for assessing post-head injury symptoms.