Traumatisme cranio-cerebrale și recuperare.
81 de articoleThis study developed the first conscious mouse model of repetitive mild traumatic brain injury using momentum exchange, avoiding confounds of anesthesia and skull fracture. Repetitive impacts induced lasting cerebrovascular dysfunction, reduced brain connectivity, white matter changes, and glial activation detectable 10 days post-injury, validating the model for studying rmTBI mechanisms.
This observational study compared characteristics of adults with persisting post-concussion symptoms (3-18 months post-injury) across two samples: 92 participants followed prospectively from an emergency department and 106 patients referred to outpatient rehabilitation. The clinical rehabilitation sample showed greater symptom severity, worse functional outcomes, and lower return-to-work rates, suggesting treatment-seeking patients represent a more severely affected subgroup.
Analysis of 160 beach soccer matches across five FIFA World Cups (2015-2024) identified 463 potential head injury situations, with incidence rates increasing 1.95-fold over the decade. The increase was primarily driven by contested plays involving upper-extremity-to-head contact, suggesting need for targeted prevention strategies.
A matched-pair experimental study examined whether subconcussive head injuries impact academic performance in adolescent boys (grades 7-12), comparing GPA changes in 45 injured students versus 45 controls. Results indicated that subconcussive head injuries sustained approximately 27 days before examinations produced measurable reductions in academic achievement.
A 71-year-old woman with an initially undiagnosed mild traumatic brain injury (mTBI) from a fall was retrospectively diagnosed 17 months later and subsequently found to have probable Lewy body dementia, with rapid neurological decline leading to death 33 months post-injury. The case highlights concerns about delayed mTBI diagnosis, inadequate provider training, medication overuse without proper diagnosis, and the need for multidisciplinary evaluation and equitable access to specialized concussion care, particularly in elderly populations.
This article presents the first comprehensive ANZ clinical practice guideline for assessing and managing mild traumatic brain injury (mTBI) and concussion across all ages, developed through multidisciplinary and consumer collaboration. The guideline provides evidence-based recommendations to promote consistent, high-quality care and reduce clinical practice variation in mTBI management.
A nationwide survey of 271 PICU physicians across 30 Chinese hospitals examined prophylactic anti-seizure medication use after pediatric traumatic brain injury, finding significant variability in drug selection (levetiracetam most common), treatment duration (ranging from ≤7 days to 3 months), and continuation despite adverse events. The study identifies critical knowledge gaps, particularly regarding criteria for discontinuing prophylactic treatment and adverse event management in post-traumatic epilepsy prevention.
Postoperative delirium (POD) significantly increases mortality, hospitalization duration, and cognitive decline in older surgical patients, with prevention focused on multicomponent non-pharmacological bundles including mobilization, reorientation, sleep promotion, and sensory optimization. Implementation gaps remain substantial, including low screening uptake (<10%), heterogeneous prognostic models, and limited precision medicine approaches for vulnerability stratification.
This study examines diagnostic overshadowing—a cognitive bias where pre-existing conditions obscure recognition of other diagnoses—by analyzing how substance and alcohol use disorders affect time to surgery in traumatic brain injury patients. Using data from 15,207 TBI patients requiring neurosurgery, researchers found patients with substance use disorders experienced delayed surgical intervention (mean 46.7 hours vs 32.4 hours) and worse outcomes, suggesting clinician bias may compromise care quality in this population.