Brain injury : [BI]
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Brain injury : [BI] · Jan 2011
Comparative StudyTo exclude or not to exclude: white matter hyperintensities in diffusion tensor imaging research.
A practical methodological issue for diffusion tensor imaging (DTI) researchers is determining what to do about incidental findings, such as white matter hyperintensities (WMHI). The purpose of this study was to compare healthy control subjects with or without WMHIs on whole brain DTI. ⋯ The decision to include or exclude subjects who have incidental findings can influence the results of a study.
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Brain injury : [BI] · Jan 2011
A prospective study of early versus late craniectomy after traumatic brain injury.
Decompressive craniectomy is an important method for managing traumatic brain injury (TBI). At present, controversies about this procedure exist, especially about the optimum operative time for patients with TBI. ⋯ Early decompressive craniectomy as a first-tier therapy for intracranial hypertension did not improve patient outcome when compared with "late" decompressive craniectomy for managing TBI.
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Brain injury : [BI] · Jan 2011
Head injury in polytrauma-Is there an effect on outcome more than 10 years after the injury?
Head injuries are of great relevance for the prognosis of polytrauma patients during acute care. However, knowledge about the impact on the long-term outcome is sparse. Therefore, this study analysed the role of head injuries on the outcome of polytrauma patients more than 10 years after injury in a matched-pair analysis. ⋯ Matching pairs of equally injured polytrauma patients of same gender with and without head injury 10 years following trauma indicated significantly worse results in the GOS due to head injury.
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A small minority of individuals experience long-term or permanent post-concussion symptoms (PCS) after a mild head injury (MHI). There has been no systematic, quantitative research examining a wide range of variables in a representative sample of such patients (i.e. with PCS for more than 18 months). This study explores a broad spectrum of demographic, cognitive, emotional and psychosocial factors (known to be important in the development of early PCS) in a representative sample of patients with permanent PCS. ⋯ Very high levels of PCS, high post-injury unemployment and measurable cognitive deficits can be permanent features of MHI. Quality-of-life is directly related to symptom severity. Age, pre-/post-morbid concomitant factors, neuropsychological deficits and emotional status are key variables in understanding the phenomenon of permanent PCS. Important vulnerability factors in the development of such may therefore be older age and any additional compromise to an individual's emotional or cognitive capacities.
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Brain injury : [BI] · Jan 2011
ReviewDefining meaningful outcomes after decompressive craniectomy for traumatic brain injury: existing challenges and future targets.
Optimal management of increased intra-cranial pressure following severe traumatic brain injury comprises a combination of sequential medical and surgical interventions. Decompressive craniectomy (DC) is a cautiously recommended surgical option that has been shown to reduce intracranial pressure. Considerable variability in the timing and frequency of using DC across neurosurgical centres reflects, in part, the lack of clarity regarding long-term outcomes. The majority of previous work reporting outcomes among individuals who have received DC following traumatic brain injury (TBI) has focused predominantly on gross physical outcomes, to the relative exclusion of more subtle functional, social and psychological factors. ⋯ This paper reviews the methodological aspects of previous studies that have reported outcomes following DC and provides recommendations to guide the future assessment of recovery to enable meaningful conclusions to be drawn from the literature describing outcomes after DC following severe TBI.