Traumatisme cranio-cerebrale și recuperare.
81 de articoleThis editorial discusses the clinical presentations and manifestations observed in patients with mild-to-moderate traumatic brain injury. The piece addresses recognized neurological and functional outcomes in this patient population.
This study compared lifetime concussion history in 199 patients with isolated REM sleep behavior disorder (IRBD) versus 168 matched controls, finding concussions more common in IRBD patients (21.1% vs 10.1%). However, concussion history did not significantly predict progression to overt synucleinopathy, suggesting concussion exposure alone is not a strong determinant of IRBD development or disease course.
This systematic review analyzed TBI research publications from North Africa over 22 years (2000-2021), identifying 22 eligible studies from over 168,000 records across major databases. The findings reveal that North Africa accounts for less than 1% of global TBI research output, with low annual productivity and minimal research prior to 2004, indicating substantial research gaps compared to other regions.
This observational study examined 287 TBI patients (251 moderate, 36 severe) across two hospitals to evaluate how BMI changes during hospitalization affect functional recovery measured by Glasgow Outcome Scale-Extended (GOSE). Results showed differing BMI patterns between moderate and severe TBI groups, with significant associations identified between BMI changes and patient outcomes at discharge.
This study used magnetic resonance spectroscopy within 72 hours of mild TBI to measure brain metabolites (NAA, creatinine, choline) in specific brain regions and assessed their ability to predict post-concussion syndrome at 6-month follow-up. Early metabolite patterns in the anterior cingulate cortex, particularly NAA/choline ratios, were identified as significant predictors of both PCS occurrence and severity, suggesting neurochemical markers may help identify which patients develop prolonged symptoms.
This systematic review examined how climate and environmental conditions affect concussion rates in outdoor contact sports by analyzing 20 studies from major medical databases. The evidence indicates no significant difference in concussion risk based on playing surface type (grass vs. artificial) or game location (home vs. away), though findings on altitude and temperature effects remain inconclusive.
A cross-sectional study of 315 medical students in Saudi Arabia found that 68.3% demonstrated good knowledge about concussions as mild traumatic brain injuries, with 80.3% correctly recognizing the need to report symptoms to healthcare providers. However, misconceptions persisted, including the belief that all concussion patients require seven days of complete rest, highlighting gaps in clinical training despite overall adequate foundational understanding.
A study of over 3,000 athletes examined whether pre-season visual attention testing could identify those at risk for clinically significant concussions. Both traditional and penalized regression models found that prior head injury history and visual attention deficits were associated with worse concussion outcomes.
This 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 epidemiological study examined head injury prevalence and outcomes in 818 older American Indians (mean age 73) from the Strong Heart Study, finding 40% reported prior head injury with 4-6% experiencing loss of consciousness exceeding 20 minutes. Those with previous head injury demonstrated significantly worse depressive symptoms, quality of life, fatigue, and social functioning compared to those without injury history, with male sex and prior stroke identified as independent risk factors.
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.