Brain injury : [BI]
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Brain injury : [BI] · Jan 2013
Multicenter StudyParent perceptions of early prognostic encounters following children's severe traumatic brain injury: 'locked up in this cage of absolute horror'.
Little guidance exists for discussing prognosis in early acute care with parents following children's severe traumatic brain injury (TBI). Providers' beliefs about truth-telling can shape what is said, how it is said and how providers respond to parents. ⋯ Parents blatantly and tacitly revealed their beliefs that providers play an important role in shaping parent reception of and synthesis of prognostic information, which constructs the family's ability to cope and participate in shared decision-making. Negative medical certainty created a fearful or threatening environment that kept parents from being fully informed.
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Brain injury : [BI] · Jan 2013
Comparative StudyDifferentiated patterns of cognitive impairment 12 months after severe and moderate traumatic brain injury.
To assess cognitive function at 12 months after moderate and severe traumatic brain injury (TBI) separately, as well as improvement from 3 to 12 months and relationship to global outcome. ⋯ Differentiating between patients with moderate and severe TBI yields a more accurate description of cognitive deficits and their improvement over time. Further, executive dysfunction and attention problems affected the ability to resume independent living and employment regardless of injury severity and age.
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To understand what influences surrogate decision-makers' expectation that a patient with a disorder of consciousness (DOC; those in a coma, the vegetative state or the minimally conscious state) will recover. ⋯ Relational factors between the patient and the surrogate may explain the surrogate's expectation that the patient will recover more than factors that matter to clinicians such as the source of injury or the patient's diagnosis.
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Brain injury : [BI] · Jan 2013
Comparative StudyA prospective study of symptoms and neurocognitive outcomes in youth with concussion vs orthopaedic injuries.
This study examined symptom reports and neurocognitive outcomes in children (8-17 years) with mild traumatic brain injury (mTBI) or orthopaedic injury (OI). ⋯ As expected, more post-concussion symptoms were initially reported by children and adolescents with mTBI vs orthopaedic injury, but there was no difference at 3 months. The BRIEF and ImPACT cognitive measures did not differentiate concussed subjects from controls, with the exception of concussed subjects' lower performance on a visual memory test at both initial assessment and at 3 months.
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Brain injury : [BI] · Jan 2013
Individual profiles of predictors and their relations to 10 years outcome after childhood traumatic brain injury.
Outcome after childhood traumatic brain injury (CTBI) is heterogeneous, with several predictors influencing long-term outcome. ⋯ The findings suggest that pre-injury adaptive function is an influential predictor of outcome following moderate CTBI. Age at injury in the severe group appears to have increased influence over time, with younger age at injury associated with reduced outcome at 10 years after severe CTBI.